CCE Theses and Dissertations

Chiro-information © : Towards a Semantic Web Health Record and Ontology for Coordination of Patient Information Between Chiropractic and Allopathic Physicians

Date of Award


Document Type


Degree Name

Doctor of Philosophy in Computer Information Systems (DCIS)


Graduate School of Computer and Information Sciences


Maxine S. Cohen

Committee Member

Sumitra Mukherjee

Committee Member

Junping Sun


The lack of coordination of clinical information communicated between chiropractic and allopathic physicians is detrimental to patients' overall health care. This lack of coordination and communication contributes significantly to the fragmentation of shared patient care among these medical providers. The goal of this research was to identify effective ways to improve coordination of patient information between chiropractic and allopathic physicians through secure methods of electronic communication. This research investigated applying digital pen-and-paper technology, Semantic Web technology standards, and biomedical ontologies to improve coordination of patient information. Specifically, the dissertation investigated whether I) digital pen and- paper technology was a viable approach to capture health data electronically; 2) the proposed agile software development methodology was appropriate for prototyping a secure Web-based Health Record (WHR); and 3) a Semantic Web ontology of an electronic health record for chiropractic medicine was feasible. This investigation also initiated awareness for a new informatics specialty coined Chiro-informatics - the application of computing to solve problems in chiropractic medicine.

Volunteer patients from a chiropractic group who were also being treated by an orthopedist, neurologist, or internist were recruited for this investigation. Authentic health data was collected from these patients using digital pen-and-paper technology, and verified for accuracy using Mi-Forms software. The verified data was then transferred automatically into a relational database where ID Protect was executed to secure anonymity for the patients' identities. This authentic health data along with the anonymous identities provided the information base for prototyping the WHR. Next, the Extreme Programming (XP) agile software development methodology was followed to prototype the secure WHR successfully. XP use case stories recorded on CRC cards specified nine software requirements of this proof-of-concept: populating, logging in securely, logging out securely, authenticating, authorizing, viewing, updating, downloading, and printing.

Ontologies constitute the backbone of the Semantic Web, which provides data with structure and meaning for computational processing. This research germinated chiro-ontology’s©, a Semantic Web ontology of an electronic health record for chiropractic medicine. Constructing chiro-ontology is feasible by me deploying Semantic Web technology standards for interoperability; 2) leveraging reference ontologies for semantic consistency; and 3) integrating chiropractic expertise for spinal manipulation knowledge.

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