Abstract
For improving quality and safety of healthcare as well as efficiency and efficacy of care processes, health systems turn toward personalized, preventive, predictive, participative precision medicine. The related pHealth ecosystem combines different domains represented by a huge variety of different human and non-human actors belonging to different policy domains, coming from different disciplines. Those actors deploy different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. Core challenge is the formal representation and management of multiple domains' knowledge. For correctly modeling such systems and their behavior, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. The ISO Interoperability Reference Architecture model and framework offers such approach. The paper describes and classifies the ongoing paradigm changes. It presents requirements and solutions for designing and implementing advanced pHealth ecosystems, thereby correctly adopting and integrating existing pHealth interoperability standards, specifications and projects.
Highlights
Starting in the nineties of the last century and speeding up during the last 10 years, healthcare systems undergo organizational and methodological paradigm challenges
Trust calculation services be provided [24, 31]. Those different interoperability levels are directly related to different viewpoints of the ISO 10764 Open Distributed Systems Reference Modell (RM-ODP) [30] from Technology through Engineering View, Computational View, and Information View up to Enterprise View, necessarily extended by the Business View of the pHealth ecosystem
PHealth ecosystems have to meet the following requirements and characteristics supported by appropriate methodologies and technologies to realize P5M (Table 1)
Summary
Starting in the nineties of the last century and speeding up during the last 10 years, healthcare systems undergo organizational and methodological paradigm challenges. They provide an optimum between restriction to special structure and generative power enabling the rich and sufficiently unambiguous representation of real-world concepts, supported by common sense knowledge This is one of the reasons for representing facts and knowledge about a system and its domain-specific subsystems, their architecture and behavior by deploying natural language based domain-specific terminologies and concepts, i.e., domainspecific ontologies, extensively exploited in good modeling best practices. The ISO Interoperability Reference Architecture Framework describes the rules applied to formally represent the concepts and behavioral aspects of, and the relations between, the system’s components both inside and between the domains That way, it enables analysis, design and implementation of multidisciplinary pHealth systems by formally representing and mapping the different involved domains’ perspectives. Interoperability beyond ICT-related business cases represented through domain-specific ontologies such as knowledge-based domain-domain interoperability and even skills based interoperability addressing the end-user has to FIGURE 3 | Design and implementation framework for pHealth ecosystems
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