Semantic Web-Based Information Systems: State-of-the-Art ...
Semantic Web-Based Information Systems: State-of-the-Art ...
Semantic Web-Based Information Systems: State-of-the-Art ...
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Distributed Patient Identification Protocol 251<br />
clear-text blocking variables comprise <strong>the</strong> month and year <strong>of</strong> birth, <strong>the</strong> patient’s<br />
sex, and place <strong>of</strong> residence. They evaluated 27,262 record linkage processes performed<br />
in <strong>the</strong> year 1998 for a database <strong>of</strong> 101,880 patients. In this case, <strong>the</strong> record<br />
linkage provided a false positive rate (i.e., patients that were incorrectly selected<br />
as a match) <strong>of</strong> 0.36% and a false negative rate (i.e., matches in <strong>the</strong> database that<br />
were not found) <strong>of</strong> 1.81%. Krieg et al. (2001) emphasise that <strong>the</strong>se figures depend<br />
significantly on <strong>the</strong> size <strong>of</strong> <strong>the</strong> database. Never<strong>the</strong>less, <strong>the</strong> figures indicate that <strong>the</strong><br />
patient identification protocol provides good results even with a ra<strong>the</strong>r limited set<br />
<strong>of</strong> demographics available. It should be noted that in countries that have a national<br />
patient identifier available, <strong>the</strong> record linkage process would be able to provide<br />
0% false positive and false negative rate in repositories that support <strong>the</strong> national<br />
patient ID while still providing results in <strong>the</strong> order <strong>of</strong> magnitude shown above for<br />
o<strong>the</strong>r repositories (i.e., o<strong>the</strong>r countries). Additional work will be needed to improve<br />
<strong>the</strong> internationalisation <strong>of</strong> <strong>the</strong> splitting and standardisation algorithms for control<br />
number generation, which currently are based mainly on German experiences with<br />
epidemiological cancer registries. Fine-tuning may be needed for <strong>the</strong> parameters<br />
<strong>of</strong> <strong>the</strong> record linkage process in order to maximise specificity and sensitivity <strong>of</strong> <strong>the</strong><br />
record linkage process.<br />
Conclusion<br />
The patient identification protocol described in this article provides a solution for a<br />
common problem in <strong>the</strong> health care sector that is likely to become very important<br />
with <strong>the</strong> increasing mobility <strong>of</strong> <strong>the</strong> workforce in Europe — locating and accessing<br />
prior clinical records for <strong>the</strong> continuity <strong>of</strong> care. The solution combines techniques<br />
from different domains — control numbers, blocking variables, and record linkage<br />
procedures as used in epidemiological registries, knowledge distribution, and TTP<br />
services from cryptographic communication protocols, semantic annotation, and<br />
ontology-based mediation, core technologies <strong>of</strong> <strong>the</strong> <strong>Semantic</strong> <strong>Web</strong>. The protocol<br />
reflects <strong>the</strong> way clinical records typically are stored, indexed, and accessed in today’s<br />
health care information systems. While <strong>the</strong> advent <strong>of</strong> a universally accepted standard<br />
for electronic health care records possibly could render <strong>the</strong> patient identification<br />
protocol obsolete in <strong>the</strong> future, <strong>the</strong>re is no indication at <strong>the</strong> moment that such a standard<br />
is going to be established in <strong>the</strong> foreseeable future, and even <strong>the</strong>n, <strong>the</strong> issue <strong>of</strong><br />
historical records would remain for a number <strong>of</strong> years. Therefore, <strong>the</strong> authors believe<br />
that <strong>the</strong> patient identification protocol can be a significant help in improving access<br />
to clinical information while safeguarding data protection rules and protecting <strong>the</strong><br />
patient’s right <strong>of</strong> self-determination regarding his or her clinical records.<br />
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