The Active Semantic Electronic Medical Record (ASEMR) represents an application of Active Semantic Documents (ASDs) in health care.

ASDs, typically XML based, are semantically annotated documents using one or more relevant ontologies that provide the nomenclature and conceptual model for interpreting and reasoning. They can be further annotated using lexically significant concepts and phrases. ASDs are active in the sense that they support automatic and dynamic validation and decision making. This is typically carried out by executing rules (such as SWRL or in the form of RDQL) on semantic annotations and relationships that span across ontologies.

Applied in this context, ASDs are designed to help reduce medical errors, improve physician efficiency and improve patient safety and satisfaction. Semantic Web technology helps achieve these goals in an ontology driven process that involves multiple ontologies, automatic semantic annotation of documents, and rule processing.

Examples of a semantic rule include prevention of drug interaction (i.e., not allowing a patient to be prescribed two interacting drugs) or ensuring the procedure performed has a supporting diagnosis.

To date, the development of the Active Semantic Electronic Medical Record has involved:

• the development of ontologies relevant to cardiology (including practice ontology, a drug ontology and a diagnosis/procedure ontology
• the development of a patient record annotation tool (using the above specialised ontologies)
• the development of decision support algorithms that support rule- and ontology-based checking/validation and evaluation.

ASEMR decision support features (achieved by executing rules over semantic annotations) implemented to date include:

• drug-drug interaction check,
• drug formulary check (e.g., whether the drug is covered by the insurance company of the patient, and if not what the alternative drugs in the same class of drug are),
• drug dosage range check,
• drug-allergy interaction check,
• ICD-9 annotations choice for the physician to validate and choose the code for the treatment type and preferred drug recommendation based on drug and patient insurance information.