Elements for discussion ARGOS Framework 15-3-2010 Gerard Freriks This project is funded by the European Union 1

Standar-disation Organisations General Framework Agency / Regulator Member States Policies Legislation Infostructure (Information = Semantic Stack) Infrastructure (Communication Technology) Standar-disation Organisations CEN/ISO GOAL: one INFRASTRUCTURE for CROSS-BORDER SEMANTIC INTEROPERABILITY Each INFRASTRUCTURE including the INFOSTRUCTURE needs a supporting FRAMEWORK. Without such a framework there will not be any infrastructure. 1- Government: Policies, Rules and Regulations, proper long term funding. 2- Standardisation organisations: with PUBLIC, OPEN, SPECIFICATIONS. It is impossible to create an infra-/info-structure with proprietary specifications 3- Governance: Validation of claims to conformance with standards, certification using standardised transparent procedures 4- Agency/Regulator: A neutral organisation with experts that help co-ordinate harmonise the complex process. Governance Patient Safety = Validation/certification 2

Semantic Stack Model of Knowledge - Encylopedia Reference Coding System - Dictionary INFOSTRUCTURE = Semantic Stack 0- Technology: Secure transport of packets of data - like the postal system 1- Model of Documentation/Archiving: like language syntaxis. CESIL (Cross-Enterprise Semantic Interoperable Layer) when implemented in an EHR-system it is a piece of middleware that normalises data and information. Seamless federation of systems become possible. 2- Models of Use: With a dictionary and syntax correct but nonsensical sentences/phrases can be formed. Archetypes/Templates specify what can be documented about a clinical topic but are defined as a Detailed Clinical Model by healthcare providers. 3- Reference Coding System: Like any dictionary. SNOMED is the candidate reference coding system onto which other coding systems (ICPC, ICD, etc) but local code list, also, can be mapped. 4- Model of Knowledge: One Reference Ontology like an encyclopedia that can be used to provide consistency between, and inside, each of the layers. Helps EHR-systems to reason about the data and information stored in the EHR. Models of Use (clinical content) - Phrases Models of Use (technical representation) Model of Documentation and Archiving - Syntaxis Technology Database - Health Record 3

Conclusion ARGOS needs a common FRAMEWORK for discussions and analysis where and how to co- operate between developments in Europe and the USA a FRAMEWORK was presented the presented Semantic Stack defines the layers in the INFOSTRUCTURE where co-ordination, co- operation and harmonisation can take place 4

Conclusion ARGOS what will it be? a buzling Greek city? Odysseus' faithful dog. He waited for his master's return to Ithaca for over twenty years while most presumed Odysseus dead Name of one of the 'hellhounds', the dogs of the underworld, brother of Cerberus ... ? 5

Standar-disation Organisations General Framework ARGOS /Agency / Regulator / Member States Policies Legislation Standar-disation Organisations CEN/ISO Infostructure (Information = Semantic Stack) Infrastructure (Communication Technology) GOAL: one INFRASTRUCTURE for CROSS-BORDER SEMANTIC INTEROPERABILITY Each INFRASTRUCTURE including the INFOSTRUCTURE needs a supporting FRAMEWORK. Without such a framework there will not be any infrastructure. 1- Government: Policies, Rules and Regulations, proper long term funding. 2- Standardisation organisations: with PUBLIC, OPEN, SPECIFICATIONS. It is impossible to create an infra-/info-structure with proprietary specifications 3- Governance: Validation of claims to conformance with standards, certification using standardised transparent procedures 4- Agency/Regulator: A neutral organisation with experts that help co-ordinate harmonise the complex process. Governance Patient Safety = Validation/certification 6