HONselect: a multilingual and intelligent search tool integrating heterogeneous web resources.
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Biomedical subjects
Publications and source records attributed to J R Scherrer.
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Migrations and expansions of information systems are constantly at the front line of all the computer science problems to be overcome in medical / health informatics systems. It is shown here that one effective way to open the communication between heterogeneous systems is depending upon the ease of putting all the systems at work together using the middleware level to facilitate the interconnection between heterogeneous applications. However the most difficult application to migrate is certainly the ADT. It is shown here how the Pilot could facilitate the migration of applications namely with the migration of the ADT itself from a centralized platform to a full scale distributed system. Indeed the Pilot has been developed up to the stage of a pre-product and is on sale already. It has been experienced satisfactorily and is presented here.
Any new user to the Internet will think that to retrieve the relevant document is an easy task especially with the wealth of sources available on this medium, but this is not the case. Even experienced users have difficulty formulating the right query for making the most of a search tool in order to efficiently obtain an accurate result. The goal of this work is to reduce the time and the energy necessary in searching and locating medical and health information. To reach this goal we have developed HONselect [1]. The aim of HONselect is not only to improve efficiency in retrieving documents but to respond to an increased need for obtaining a selection of relevant and accurate documents from a breadth of various knowledge databases including scientific bibliographical references, clinical trials, daily news, multimedia illustrations, conferences, forum, Web sites, clinical cases, and others. The authors based their approach on the knowledge representation using the National Library of Medicine's Medical Subject Headings (NLM, MeSH) vocabulary and classification [2,3]. The innovation is to propose a multilingual "one-stop searching" (one Web interface to databases currently in English, French and German) with full navigational and connectivity capabilities. The user may choose from a given selection of related terms the one that best suit his search, navigate in the term's hierarchical tree, and access directly to a selection of documents from high quality knowledge suppliers such as the MEDLINE database, the NLM's ClinicalTrials.gov server, the NewsPage's daily news, the HON's media gallery, conference listings and MedHunt's Web sites [4, 5, 6, 7, 8, 9]. HONselect, developed by HON, a non-profit organisation [10], is a free online available multilingual tool based on the MeSH thesaurus to index, select, retrieve and display accurate, up to date, high-level and quality documents.
ARCHIMED is a Network of Integrated Information Systems (NIIS). This novel concept of hospital information system has a major advantage over the currently used distributed systems. The normalized representation structure of its databases enable its Navigators to reach simultaneously not only the data coming from different hospital departments, laboratories, and other hospital facilities, but also the data from different hospitals associated in the network.
The patient in a hospital bed is also a private individual that might access his or her own Electronic Patient Record (EPR) in association with additional tools that are able to show critical up-to-date knowledge about diagnoses, clinical investigations or treatments. The distributed EPRs are shown here in full production with the DOMED application of DIOGENE 2. Besides, in order to facilitate an easier understanding of the EPRs by the patient, the HON Web Site services are at his or her disposal in this respect at the same terminal.
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Since its birth in 1978, DIOGENE, the hospital information system of Geneva University Hospital has been constantly evolving, with a major change in 1995, when migrating from a centralized to an open distributed architecture. For a few years, the hospital had to face health policy revolution with both economical constraints and opening of the healthcare network. The hospital information system DIOGENE plays a significant role by integrating four axes of knowledge: medico-economical context for better understanding and influencing resources consumption; the whole set of patient reports and documents (reports, encoded summaries, clinical findings, images, lab data, etc.), patient-dependent knowledge, in a vision integrating time and space; external knowledge bases such as Medline (patient-independent knowledge); integration of these patient-dependent and independent knowledge in a case-based reasoning format, providing on the physician desktop all relevant information for helping him to take the most appropriate adequate decision.
The Internet is becoming more and more part of our habits regarding documentation and communication, thus limiting the frontiers to only that of the language. As in many other fields, the Internet is also present in the medical domain. The Internet is accessible to all, providing a technology which is simple and ergonomic and furthermore less costly. A growing number of individuals are indeed offering information, and the multiplication and diversification of documentary thus resulting renders the quality often questionable and the search for information difficult. This article firstly presents the Internet services with examples in the medical domain and more particularly in paediatrics. It then identifies the problems related to the Internet and further details three tools useful to find medical information and to surf on the Internet: Medline, a bibliographical reference search tool (from the National Library of Medicine-NLM); Medhunt, a search tool of the Health on the Net Foundation specialised in the health domain; and the HONcode, a code of ethics developed to homogenize medical information on the Internet.
The venue of Electronic Patient Record (EPR) implies an increasing amount of medical texts readily available for processing, as soon as convenient tools are made available. The chief application is text analysis, from which one can drive other disciplines like indexing for retrieval, knowledge representation, translation and inferencing for medical intelligent systems. Prerequisites for a convenient analyzer of medical texts are: building the lexicon, developing semantic representation of the domain, having a large corpus of texts available for statistical analysis, and finally mastering robust and powerful parsing techniques in order to satisfy the constraints of the medical domain. This article aims at presenting an easy-to-use parser ready to be adapted in different settings. It describes its power together with its practical limitations as experienced by the authors.
Medical documentation is central in health care, as it constitutes the main means of communication between care providers. However, there is a gap to bridge between storing information and extracting the relevant underlying knowledge. We believe natural language processing (NLP) is the best solution to handle such a large amount of textual information. In this paper we describe the construction of a semantic tagset for medical document indexing purposes. Rather than attempting to produce a home-made tagset, we decided to use, as far as possible, standard medicine resources. This step has led us to choose UMLS hierarchical classes as a basis for our tagset. We also show that semantic tagging is not only providing bases for disambiguisation between senses, but is also useful in the query expansion process of the retrieval system. We finally focus on assessing the results of the semantic tagger.
The use of middleware to develop widely distributed healthcare information systems (HIS) has become inevitable. However, the fact that many different platforms, even sometimes heterogeneous to each other, are hooked into the same network makes the integration of various middleware components more difficult than some might believe. This paper discusses the HISA standard and proposes extensions to the model that, in turn, could be compliant with other various existing distributed platforms and their middleware components.
The integration and evolution of existing systems represents one of the most urgent priorities of health care information systems in order to allow the whole organisation to meet the increasing clinical organisational and managerial needs. The CEN ENV 12967-1 'Healthcare Information Systems Architecture'(HISA) standard defines an architectural approach based on a middleware of business-specific common services, enabling all parts of the local and geographical system to operate on the common information heritage of the organisation and on exploiting a set of common business-oriented functionality. After an overview on the key aspects of HISA, this paper discusses the positioning of the authorization and security aspects in the overall architecture. A global security framework is finally proposed.
Healthcare enters the information age and professionals are finding an ever-growing role for computers in the daily practice of medicine. However, a number of problematic issues are associated with electronic publications, especially through Internet. Whilst access to any information has been improved, access to specific information has become more and more difficult [1], due to the lack of a general meta-knowledge allowing to structure Internet resources. Physicians have to learn and adapt themselves to computers and Internet, but Internet has to meet the specific requirements of Healthcare. Important issues must therefore be addressed to allow a real and daily use of Internet in the medical practice. The paper discusses most of these issues and proposes a solution developed at the University Hospital of Geneva that integrates an Electronic Patient Record with Internet, without compromises on security or on performances and that runs on standard PCs'.
Internet has become one of the most used communication media. This and the fact that no constraining information publishing policy exists have created an urgent need to control the quality of information circulating through this media. To this purpose, the Health On the Net Foundation has initiated the Code of Conduct (HONcode) for the health/medical domain. This initiative proposes guidelines to information providers, with the aim, on the one hand, of raising the quality of data available on the Net and, on the other hand, of helping to identify Internet sites that are maintained by qualified people and contain reliable data. The HONcode mainly includes the following ethical aspects: the author's credentials, the date of the last modification with respect to clinical documents, confidentiality of data, source data reference, funding and the advertising policy. This article presents the HONcode and its evolution since it was launched in 1996.
DIOGENE 2 is a full-scale distributed/open hospital information system that by June 1995 had already achieved its migration from a former mainframe system. Thanks to that architecture there is an obvious need for a common "glue" devoted to tightening up scattered applications into a middleware-based network of interoperability. After this the design of open/distributed Electronic Patient Records (EPRs) became feasible. A brief historical sketch of DIOGENE is presented from its initial to its present phase. A working prototype of these distributed EPRs is discussed showing current achievements during its first stage of production in the clinics of the University Hospitals of Geneva. On-going expansion to other public hospitals, as well as to general practioners (GPs) in the Geneva area, are partly described.
The authors present an automatic tool able to provide real-time morphosemantic decomposition of natural language sentences in French, German and English. This tool demonstrates the feasibility of Natural Language Processing on standard PC computers and the technology involved has been successfully implemented in daily used applications in several European hospitals. It considerably alleviates the burden of coding with various international classification and enhances the quality of the final results. This tool, delivered on PC platforms, is highly convivial and provides a versatile interface to any existing applications based on the Microsoft Windows standards. Moreover, all high levels functions have been encapsulated in Object Oriented Components and can therefore be reused using the Common Object Model standards to develop stand-alone or Internet applications.
Middleware is now a commonly used expression and anyone building distributed applications is referring to "middleware services". Nevertheless this notion lacks of sound theoretical foundation. This paper tries to clarify the relationship between the components of distributed environments, especially in healthcare, and to establish some classification aiming at gaining a common understanding of the functionalities and interdependency of the existing modules of distributed environments.
Automatic extraction of knowledge from large corpus of texts is an essential step toward linguistic knowledge acquisition in the medical domain. The current situation shows a lack of computer-readable large medical lexicons, with a partial exception for the English language. Moreover, multilingual lexicons with versatility for multiple languages applications are far from reach as long as only manual extraction is considered. Computer-assisted linguistic knowledge acquisition is a must. A multilingual lexicon differs from a monolingual one by the necessity to bridge the words in different languages. A kind of interlingua has to be built under the form of concepts to which the specific entries are attached. In the present approach, the authors have developed an intelligent rule-based tool in order to focus on a multilingual source of medical knowledge, like the International Classification of Disease (ICD) which contains a vocabulary of some 20,000 words, translated in numerous languages.