international journal of medical informatics 79 ( 2 0 1 0 ) 370–387 journal homepage: www.intl.elsevierhealth.com/journals/ijmi Using ontologies for structuring organizational knowledge in Home Care assistance Aida Valls a,* , Karina Gibert b , David Sánchez a , Montserrat Batet a a Department of Computer Science and Mathematics, Universitat Rovira i Virgili, Av Països Catalans 26, 43007 Tarragona, Catalonia, Spain b Department of Statistics and Operational Research, Universitat Politècnica de Catalunya, C/ Jordi Girona 1-3, 08034 Barcelona, Catalonia, Spain article info Article history: Received 1 July 2009 Received in revised form 26 January 2010 Accepted 26 January 2010 Keywords: Medical informatics Telemedicine Organizational models Home Care services Knowledge representation Ontologies Distributed systems abstract Purpose: Information Technologies and Knowledge-based Systems can significantly improve the management of complex distributed health systems, where supporting multidisciplinar- ity is crucial and communication and synchronization between the different professionals and tasks becomes essential. This work proposes the use of the ontological paradigm to describe the organizational knowledge of such complex healthcare institutions as a basis to support their management. The ontology engineering process is detailed, as well as the way to maintain the ontology updated in front of changes. The paper also analyzes how such an ontology can be exploited in a real healthcare application and the role of the ontology in the customization of the system. The particular case of senior Home Care assistance is addressed, as this is a highly distributed field as well as a strategic goal in an ageing Europe. Materials and methods: The proposed ontology design is based on a Home Care medical model defined by an European consortium of Home Care professionals, framed in the scope of the K4Care European project (FP6). Due to the complexity of the model and the knowledge gap existing between the – textual – medical model and the strict formalization of an ontology, an ontology engineering methodology (On-To-Knowledge) has been followed. Results: After applying the On-To-Knowledge steps, the following results were obtained: the feasibility study concluded that the ontological paradigm and the expressiveness of mod- ern ontology languages were enough to describe the required medical knowledge; after the kick-off and refinement stages, a complete and non-ambiguous definition of the Home Care model, including its main components and interrelations, was obtained; the formalization stage expressed HC medical entities in the form of ontological classes, which are interrelated by means of hierarchies, properties and semantically rich class restrictions; the evaluation, carried out by exploiting the ontology into a knowledge-driven e-health application running on a real scenario, showed that the ontology design and its exploitation brought several ben- efits with regards to flexibility, adaptability and work efficiency from the end-user point of view; for the maintenance stage, two software tools are presented, aimed to address the incor- poration and modification of healthcare units and the personalization of ontological profiles. ∗ Corresponding author. Tel.: +34 977 55 96 88; fax: +34 977 55 97 10. E-mail address: aida.valls@urv.cat (A. Valls). 1386-5056/$ – see front matter © 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijmedinf.2010.01.012