Keep everything as simple as possible; but no simpler. - Albert Einstein
MLHIM is an agile and open framework for computable semantic interoperability in healthcare. This capability is required in order to advance the usage of clinical (and other) decision support services (DSS) and Big Data analysis across data coming from multiple points. These points of data creation are increasing every day as a result of more institutions bringing new digital capabilities to more functions, in addition to the plethora of new devices arriving in the personal healthcare marketplace.
MLHIM is not a standard in the historical sense of the term. The standards development process is far from agile; healthcare is too dynamic to wait for the 20th century standards processes. In addition, healthcare is too broad for a top-down, one-size-fits-all solution for information interoperability. MLHIM is based on widely used standards for Linked Data exchange and expression on the semantic web.
MLHIM uses these tools in conjunction with the Unix/Linux model of iterate and release often. A new release does not invalidate the previous models or data.
In designing MLHIM we took the view that data is produced by people that have a need to record that data. Often that data is useful to others. In healthcare this is certainly true. To transfer raw data is not enough for the receiver to determine if it is useful for their needs. They need to know much more about the contexts (ontological, spatial, temporal) in which the data was captured.
If I have a leaky faucet in my home and need a washer to repair it. I go to the local hardware store to purchase a new one. The attendant there doesn’t know what I need because they do not know what type of faucet I have. However, I can look at the package information and determine based on thickness, inside and outside diameters and shape (flat, conical, round, etc.) if a particular washer fits my needs. In this sense, MLHIM is the packaging for data. It allows the data consumer to determine if the data is useful to them as is or maybe it can even be adjusted because the consumer knows the context in which the data was captured. Of course there are certain base standards in the plumbing industry. Just like we have datatypes (string, integer, dateTime, etc. ) and XML constructs (element, complexType, etc.). But the overall concept is similar.
MLHIM can be implemented as the information model for applications ranging from mobile apps to enterprise suites. MLHIM is also useful to enhance semantic interoperability of existing systems and healthcare IT interfaces such as those based on HL7 messaging.
MLHIM specifically addresses the need to communicate syntactically sound data with the intended semantics. The larger, point to point issues of information exchange are already handled by other formal and de-facto standards such as SOAP, REST, etc. and MLHIM is fully capable of utilizing systems built on those standards.
MLHIM is the foundation for retro-fitting your current applications to interoperate with your future applications using the semantic web tools and Linked Data, without requiring wholesale replacement.
For every complex problem there is an answer that is clear, simple, and wrong. - H. L. Mencken