Semantic validation of the use of SNOMED CT in HL7 clinical documents

We represent the CDA using the Ontology Web Language OWL and further use the OWL version of SNOMED CT？ to enable the translation of CDA documents to so-called OWL ontologies. We formalize a subset of the constraints in the implementation guide on Using SNOMED CT in HL7 Version 3 as OWL Integrity Constraints and show that we can automatically validate CDA documents using OWL reasoners such as Pellet. Finally, we evaluate our approach via a prototype implementation that plugs in the Open Health Workbench.We present a methodology to automatically check the validity of CDA documents which make reference to SNOMED CT？ terminology. The methodology relies on semantic technologies such as OWL. As such it removes the burden from IT health care professionals of having to manually implement such guidelines in systems that use HL7 Version 3 documents.Health Level Seven International (HL7) [1] is a non-profit organization that develops standards to increase the interoperability of health care information technology. One such standard is the Reference Information Model (RIM) [2] that functions as the common information model for all further specified information models and messages developed under the auspices of HL7. For example, the HL7 standard for writing clinical documents is provided by the Clinical Document Architecture (CDA) [3] and is a constraining of the RIM. It specifies how HL7 clinical documents should be structured while using classes and attributes defined in the RIM.The advantage of using such a layered architecture of models for different purposes is its provision of syntactic (and to a certain extent semantic) interoperability throughout the health care domain. Clinical documents for exchange between health care professionals that satisfy this CDA (CDA documents), are syntactically understandable by both ends of the exchange. The CDA caters for some semantic interoperability. Indeed, it prescribes what meta-vocabulary to use in the form of directions such as to