OMRSE: Current status and our strategy for future development 256 Baynes St Buffall 14213 W.R. Hogan and M. Brochhausen Division of Biomedical Informatics

OMRSE The Ontology of Medically Related Social Entities based on BFO 1.1 (for the time being) spin-off of the OGMS effort open source, community-driven development OBO Foundry candidate ontology reuses IAO ontology metadata 119 classes, 7 object properties

Initial Motivation Capture common electronic health record data Demographics Gender Marital status Address Healthcare provider (role) Patient (role) Encounter (in OGMS)

Existing branches role in human social process aggregate of organizations aggregate of organisms geopolitical organization

role in human social process

object aggregate Note that a nation is not self-identical to the territory it owns. Nations—not territories—declare war. You are sitting in a territory—not a nation. We need one URI for the nation, and one for its (current) territory.

Marriage according to OMRSE For healthcare use cases, it is the legal aspects of marriage that matter Visitation rights Decision making proxy Each person in the marriage is a party to a marriage contract (Even in common law, which even then exists in only 9 states and still requires some evidence of agreement) The legal system recognizes these contracts and confers the rights and decision-making proxy

For the Skeptical… Arkansas code, Title 9, Subtitle 2, Chapter 11, Subchapter 1 Marriage is considered in law a civil contract… Pennsylvania Code, Part II, Chapter 11, Section 1102, Definitions “Marriage” A civil contract…

And in Arkansas… …Any one of the following persons may consent, either orally or otherwise, to any surgical or medical treatment or procedure… … (10) Any married person, for a spouse of unsound mind;

And in Pennsylvania… 20 Pa. Cons. Stat. 5461 (d)(1) …any member of the following classes, in descending order of priority…may act as health care representative: (i) The spouse, … http://law.onecle.com/pennsylvania/decedents-estates-and-fiduciaries/00.054.061.000.html

But aren’t there health implications of marriage? Doctors do not recommend marriage to their single patients for its health benefits The gap between singles and marrieds is decreasing The only place “marital status” is captured as a discrete data element is in the patient registration system, for administrative purposes (i.e., decision making contingencies) Mentions of marriage in the social history of patients, that go beyond mentioning “status”, usually describe the health of the interpersonal relationship, which indeed requires an ontological treatment at some point, but and because it is a different entity from the contract

Using OMRSE to capture demographics data

Use of Notation instance relation Type lower-case italics lower-case bold Type First-letter uppercase, italics

An Instance-based Representation of “Married” Entities: jd John Doe jd_mc_role J. Doe’s party to a marriage contract role t1 Instant at which marriage contract begins to exist Instantiations: jd instance_of Human being jd_mc_role instance_of Party to a marriage contract t1 instance_of Temporal boundary Relation: jd bearer_of jd_mc_role since t1

Not/Never Married: No New Codes or Ontology Terms Necessary! Entities: jd John Doe t2 Temporal boundary at end of J. Doe’s birth interval (or last marriage contract interval) Instantiations: t2 instance_of Temporal boundary Relation: jd lacks Party to a marriage contract with respect to bearer_of since t2

Not/Never Married: No New Codes or Ontology Terms Necessary! Entities: jd John Doe t2 Temporal boundary at end of J. Doe’s birth interval (or last marriage contract interval) Instantiations: t2 instance_of Temporal boundary Relation: jd lacks Party to a marriage contract with respect to bearer_of since t2 John Doe does not stand in the bearer_of relation to any instance of Party to a marriage contract since t2

Implications for Ontology Development Do not put ‘marital status’, ‘married’, ‘not married’, etc. in the ontology Especially do not put ‘widowed’, ‘divorced’, or ‘married living apart’ in ontology! Do not even fathom putting ‘newly married’, ‘spinster’, or ‘eloped’ into ontology!!!! Instead, we need to represent marriage contracts and the roles they bring into existence

Benefits of This Approach Fewer things to standardize in the ontology Fewer terms, URIs, etc. Fewer relations (no special relations, attributes, properties, etc. for demographics) Greater flexibility Can handle jurisdictional issues (where a given jurisdiction may not recognize marriage contracts created within another) Can track history over time (e.g., divorced twice and widowed once)

Similar Approach to Other Demographics Sex jd_sex_quality inheres_in jd since t1 jd_sex_quality instance_of Male sex since t1 Gender jd_gender_role inheres_in jd since t2 jd_gender_role instance_of Male gender since t2 Birth date jd_birth instance_of Birth event jd participates_in jd_birth at jdb_t jdb_t during Jan 1, 1970

Example of Added Flexibility Birthplace: lr IUI of geographical region within the boundaries of Little Rock, AR at jdb_t lr instance_of Geographical region at t9 jd located_in lr at jdb_t Can add birth place with no additional tables, fields, relations, etc. Just need an IUI for territory of Little Rock .

More Recent Use Cases for OMRSE Organization Health insurance company Physician group practice Trauma system Simulating/simulation Simulating outbreaks Simulating patient encounters (for medical education, for example) Socio-legal entities Claims Obligations

organization So far OMRSE has re-used the OBI class "organization" and its definition: "An organization is a continuant entity which can play roles, has members, and has a set of organization rules. Members of organizations are either organizations themselves or individual people. Members can bear specific organization member roles that are determined in the organization rules. The organization rules also determine how decisions are made on behalf of the organization by the organization members.' Even though a good start, we believe that we need to be more specific regarding organizations.

What else is out there? social group: a set of organisms belonging to the same species that remain together for any period of time while interacting with one another to a much greater degree than with other conspecific organisms (Wilson: Sociobiology, 1975). informal organization: The informal organization expresses the personal objectives and goals of the individual membership. The informal organization represents an extension of the social structures that generally characterize human life – the spontaneous emergence of groups and organizations as ends in themselves (http://en.wikipedia.org/wiki/Organization). formal organization: An organization that is established as a means for achieving defined objectives has been referred to as a formal organization. Its design specifies how goals are subdivided and reflected in subdivisions of the organization (http://en.wikipedia.org/wiki/Organization).

Questions Are organizations subtypes of social groups? Are formal organizations subtypes of informal organizations?

Are organizations subtypes of social groups? No (this answer runs against our initial intuitions) Arguments organizations are geographically spread out members of organizations do not necessarily need to interact as massively as social groups (according to Wilson's definition) I interact more with this group than with the members of my Academic Club in Germany Thought: Maybe there is a mutual subclass of social group and organization. Something like 'social aggregate of organisms'

Are formal organizations subtypes of informal organizations? No Formal organizations: have group intentions Informal organizations: organizational structures established to help each individual to pursue his/her own intention(s). Informal vs. formal organization: possible example: vigilante committee vs. police force Both formal and informal organizations are subtype to a common superclass 'organization'.

One remark regarding animal societies: Not all kinds of social hierarchy should be regarded as an indicator of the presence of an "organization". Basic hierarchies are part of the extended phenotype of a species (insect states, alpha animals, etc.).

What we propose:

OMRSE: 'collection of organisms' social collection of organisms social group organization Legally personal organizations are an attributive collection of formal organiations. formal organization informal organization legally personal organization

social group A collection of organisms belonging to the same species that remain together for any period of time while interacting with one another to a much greater degree than with other conspecific organisms (based on: Wilson: Sociobiology, 1975).

organization An organization is a continuant entity which can play roles, has members, and has a set of organization rules. Members of organizations are either organizations themselves or individual people. Members can bear specific organization member roles that are determined in the organization rules. The organization rules also determine how decisions are made on behalf of the organization by the organization members. (from OBI)

informal organization An organization established to enable or support their members to pursue their personal objectives and goals (based on: http://en.wikipedia.org/wiki/Organization).

legally personal organization Definition: A formal organization that recognized by municipal or international law has legal person (Shaw: International Law. Sixth Edition, 2008). 'legally personal organization' is a subclass to formal organization This is an attributive collection. Which organization gets attributed legal personality differs from legal system to legal system and across time. legal person role exists in OMRSE

formal organization An organization that is established as a means for achieving defined organizational objectives. Its design specifies how goals are subdivided and reflected in subdivisions of the organization (based on: http://en.wikipedia.org/wiki/Organization).

legally-personal organization A formal organization that recognized by municipal or international law has legal person (Shaw: International Law. Sixth Edition, 2008).

Introducing 'purely intentional entity' based on Roman Ingarden's ontology Tentative definition: Social or cultural entity that owes its existence to the human consciousness and is not a representation of something in reality. PIEs ≠ ICEs Examples: literary works, musical works

Examples of PIEs Superman a specific simulation of an anthrax outbreak in New York City last May Obviously, there are multiple subtypes of PIEs. The examples above are examples of : fictions (Superman) simulations (anthrax outbreak)

socio-legal entities are specified output of/revoked by/transferred by social actions based on A. Reinach's legal theory1 http://purl.obolibrary.org/obo/iao/d-acts.owl All socio-legal entities ultimately originate form social act. 1 Reinach, A. (2012), The Apriori Foundations of the Civil Law. Edited by John F. Crosby. Frankfurt: ontos Verlag.

How are socio-legal entities transferred? I own a piece of land. There exists, since the land was claimed (social action), a right of ownership. At this time it is concretized as my owner role, which is realized by me setting up “keep out” signs, selling the right to use the land for a specific period of time, etc. Then I sell my land to Bill. My ownership role goes out of existence and from then on the right of ownership for the land is concretized as Bill's ownership role.

Changed sub-hierarchy for generically dependent continuants: Information content entity Purely intentional entity Socio-legal entity