Democratizing health data semantics: A commons-based technology-enhanced activity space to support productive work with health data semantics

This work has two main objectives: (1) to improve the understanding of semantic interoperability issues in healthcare and (2) to find possible solutions to these issues. Several research projects focusing on semantic interoperability support the work to achieve these goals. Semantic interoperability problems are caused by value conflicts between different stakeholders in the health care system over semantic resources that define the meaning of data. These conflicting values cause containment, which is the dominant business model in healthcare. For this purpose, data is not available where it is needed. In turn, this results in a significant power asymmetry with regard to semantic resources that are locked up in different systems. Furthermore, this power asymmetry causes problems in the management of health data.
This thesis proposes a solution for this chain of effects of semantic interoperability in the form of a work practice for productive work on semantic resources. Ideas from participatory design and co-design support the work practice—specifically, technology-enhanced activity spaces as an approach to solving different value concepts of the participants. In addition, the work practice uses OpenEHR's detailed clinical modelling approach to create semantic resources. The theory from the Commons studies supports a governance model of the work practice that is independent of state and the market. The specification of such a work practice is considered a formalization innovation.
This work leads to an interesting innovation that has the potential to help solve semantic interoperability problems or at least provide enough knowledge to improve their understanding. Thus, both goals of the work have been achieved.