title: Automatic generation of computable implementation guides from clinical information models.
abstract: Clinical information models are increasingly used to describe the contents of Electronic Health Records. Implementation guides are a common specification mechanism used to define such models. They contain, among other reference materials, all the constraints and rules that clinical information must obey. However, these implementation guides typically are oriented to human-readability, and thus cannot be processed by computers. As a consequence, they must be reinterpreted and transformed manually into an executable language such as Schematron or Object Constraint Language (OCL). This task can be difficult and error prone due to the big gap between both representations. The challenge is to develop a methodology for the specification of implementation guides in such a way that humans can read and understand easily and at the same time can be processed by computers. In this paper, we propose and describe a novel methodology that uses archetypes as basis for generation of implementation guides. We use archetypes to generate formal rules expressed in Natural Rule Language (NRL) and other reference materials usually included in implementation guides such as sample XML instances. We also generate Schematron rules from NRL rules to be used for the validation of data instances. We have implemented these methods in LinkEHR, an archetype editing platform, and exemplify our approach by generating NRL rules and implementation guides from EN ISO 13606, openEHR, and HL7 CDA archetypes.
authors.affiliation: Instituto Universitario de Aplicaciones de las Tecnologías de la Información y Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain. Electronic address: diebosto@upv.es.
authors.forename: Diego
authors.initials: D
authors.lastname: Boscá
authors.affiliation: Instituto Universitario de Aplicaciones de las Tecnologías de la Información y Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain; VeraTech for Health SL, Valencia, Spain.
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Maldonado
authors.affiliation: Instituto Universitario de Aplicaciones de las Tecnologías de la Información y Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Moner
authors.affiliation: Instituto Universitario de Aplicaciones de las Tecnologías de la Información y Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Robles
mesh_terms: D057225:Data Mining / Q000592:standards*; D057286:Electronic Health Records / Q000592:standards*; D008498:Medical Record Linkage / Q000592:standards*; D009323:Natural Language Processing; D017410:Practice Guidelines as Topic; D012660:Semantics; D014584:User-Computer Interface; D018875:Vocabulary, Controlled
keywords: Archetype; Clinical information model; Data validation; Implementation guide; Natural Rule Language