Ontological Context for Data Use and Integration


Increasingly powerful computers and increased emphasis on evidence based decision making are creating a demand for merging and integrating data from different sources into a single data set. The demand for data is outstripping our ability to ensure data integrity, and sometimes analysis is performed on data that are not appropriate for the purposes they are used for. Here we describe problems that arise when data from different sources are merged, and we suggest that one way to add context to data so that users can make informed decisions about their ontological context is through ontology-based metadata. Examples of the problem are taken from health data with emphasis on difficulties in standardizing Emergency Room wait times. We describe eight fields that can be used to capture contextual metadata. These fields are captured using ethnographic methods from users and database stewards who frequently understand precisely how context and institutional usage have shaped interpretation of semantic fields. We argue that attaching a portable archive of ontological context to travel with data—based on information from users and developers—is a means of ensuring that data are integrated and compared in multiple contexts with greater integrity and more robust results.

This is a preview of subscription content, access via your institution.



  1. 1.

    “Informational continuity reflects the notion that details on past events are available and used to inform current care. Management continuity means that care is clinically consistent over time, that someone is managing the case, or that the management responsibility is efficiently and effectively transferred, and that as a result duplication of procedures and communications are kept to a minimum. Relational continuity means that ongoing patient provider relationships are nurtured in order to bridge healthcare events and create an expectation for future care” (Reid et al. 2004, p.2)

  2. 2.

    Bingham, J. W. (2004, Oct. 29). Director, Health Reports and Analysis Canadian Institute for Health Information. Personal Communication (by e-mail).

  3. 3.

    ER wait time data more often than not are reported in the press without reference to CTAS scores, which reflect how ill a patient is, and hence to what extent they urgently require care. For patients who are not ill at all long wait times are not inappropriate. The frequent failure to include CTAS scores in press coverage of ER wait times reflects an overly simplistic understanding of both the politics of health care and the complexities of data.


  1. Armstrong, P., H. Armstrong and D. Coburn (2001): Unhealthy Times: Political Economy Perspectives on Health and Care in Canada. Oxford: Oxford University Press.

    Google Scholar 

  2. Balka, E. (2003a): Getting the Big Picture: The Macro-politics of Information System Development (and Failure) in a Canadian Hospital. Methods of Information in Medicine, vol. 42(4), pp. 324–330.

    Google Scholar 

  3. Balka, Ellen (2003b): The Role of Technology in Making Gender Count on the Health Information Highway. Atlantis, vol. 27(2), pp. 49–56.

    Google Scholar 

  4. Balka, E. (2004): Fragmented Views from the Field: Reflections on Field Observations of Computerized Health Sector Work. In E. Balka and I. Wagner (eds): Proceedings, Work Practice Research and Information Technology Development in Hospitals and Community Health Care Settings. Workshop Held in Conjunction with CSCW 2004, Chicago Il., Nov. 7 pp. 7–12 New York: ACM.

    Google Scholar 

  5. Balka, E. (2005): The Production of Health Indicators as Computer Supported Cooperative Work: Reflections on the Multiple Roles of Electronic Health Records. In E. Balka and I. Wagner (eds): Reconfiguring Healthcare: Issues in Computer Supported Cooperative Work in Healthcare Environments. Workshop Organized by Ellen Balka & Ina Wagner European Computer Supported Cooperative Work Conference, September 19 2005, (pp. 67–75). Paris, France.

  6. Balka, E., P. Bjorn and I. Wagner (2008). Steps Toward a Typology for Health Informatics. Computer Supported Cooperative Work. (CSCW 08) (in press).

  7. Balka, E., M. Doyle-Waters, D. Lecznarowicz and J.M. FitzGerald (2007): Technology, Governance and Patient Safety: Systems Issues in Technology and Patient Safety. International Journal of Medical Informatics, vol. 76(Supplement 1), pp. S48–S57. doi:10.1016/j.ijmedinf.2006.05.038.

    Article  Google Scholar 

  8. Balka, E. and S. Whitehouse (2007): Whose Work Practice? Situating an Electronic Triage System within a Complex System. In E. Coiera, J.I. Westbrook, J.L. Callen and J. Aarts (eds): Information Technology in Health Care 2007: Proceedings of the Third International Conference on Information Technology in Health Care. Socio-technical Approaches Vol. 130 Studies in Health Technology and Informatics. Amsterdam: IOS, pp. 59–74.

    Google Scholar 

  9. Bisby, F.A. (2000): The Quiet Revolution: Biodiversity Informatics and the Internet. Science, vol. 289, pp. 2309–2312. doi:10.1126/science.289.5488.2309.

    Article  Google Scholar 

  10. Bishr, Y.A. (1997): Semantic Aspects of Interoperable GIS. Spatial Information. Enschede, The Netherlands, International Institute for Aerospace Survey and Earth Sciences (ITC).

  11. Bishr, Y.A. (1998): Overcoming the Semantic and Other Barriers to GIS Interoperability. International Journal of Geographical Information Science, vol. 12, pp. 299–314. doi:10.1080/136588198241806.

    Article  Google Scholar 

  12. Bishr, Y.A., H. Pundt, W. Kuhn and M. Radwan (1999): Probing the Concept of Information Communities—A First Step Toward Semantic Interoperability. In M.F. Goodchild, M. Egenhofer, R. Fegeas and C. Kottman (eds): Interoperating Geographic Information Systems. Boston: Kluwer Academic.

    Google Scholar 

  13. Bittner, T. and G. Edwards (2001): Towards an Ontology for Geomatics. Geomatica, vol. 55, pp. 475–490.

    Google Scholar 

  14. Bjorn, P. and E. Balka (2007): Health Care Categories have Politics Too: Unpacking the Managerial Agendas of Electronic Triage Systems. In L.J. Bannon, I. Wagner, C. Gutwin, R.H.R. Harper and K. Schmidt (eds): ECSCW 2007: Proceedings of the 10th European Conference on Computer Supported Cooperative Work pp. 371–390 London: Springer.

    Google Scholar 

  15. Bowker, G.C. and S.L. Star (2000): Sorting Things Out: Classification and its Consequences. Cambridge, MA: MIT.

    Google Scholar 

  16. Brodaric, B. and J. Hastings (2002): An Object Model for Geologic Map Information. Joint International Symposium on Geospatial Theory, Processing and Applications. Ottawa, Canada: ISPRS Commission IV.

    Google Scholar 

  17. Brodeur, J., Y. Bedard, G. Edwards and B. Moulin (2003): Revisiting the Concept of Geospatial Data Interoperability Within the Scope of the Human Communication Processes. Transactions in GIS, vol. 7, pp. 243–265. doi:10.1111/1467-9671.00143.

    Article  Google Scholar 

  18. Burrough P.A. (1996): Natural Objects with Indeterminate Boundaries. In P.A. Burrough and A.U. Frank (eds): Geographic Objects with Indeterminate Boundaries. Bristol, PA: Taylor & Francis.

    Google Scholar 

  19. Calgary Health Region Newslink, Emergency Department Operational Overview. (2005): (3/8/2005).

  20. Canadian Institute of Health Information (CIHI). (2003, February). Data Quality Documentation: Discharge Abstract Databases 2001–2003. Ottawa: CIHI. (Also available at; viewed online Dec. 16, 2004.

  21. Canada NewsWire (2004): MEDIA ADVISORY – Canada’s Emergency Physicians Want First Minister to Address ED. Wait Times, Canada NewsWire: Ottawa: September 9, 2004, pg. 1.

  22. Capital Health (2004): 10-point Plan for System Improvement: Emergency Overcrowding & Long Waits for Hospital Services. (3/8/2004).

  23. Chan, B., M. Schull and S. Schultz (2001): Emergency Department Services in Ontario 1993–2000. Toronto: Institute for Clinical Evaluative Sciences.

    Google Scholar 

  24. Chrisman, N. (1999): Trading Zones of Boundary Objects: Understanding Incomplete Translations of Technical Expertise. Intersections: Society, Technology, and Geographic Thought, an Invited Workshop on GIS. Rough River Resort, Kentucky.

  25. Cuthbert, A. (1999): OpenGIS: Tales from a Small Market Town. In A. Vckovski, K.E. Brassel and H.J. Schek (eds): Interoperating Geographic Information Systems, 1580 ed. Zurich, Switzerland: Springer.

    Google Scholar 

  26. Fabrikant, S.I. (2000): Spatialized Browsing in Large Data Archives. Transactions in GIS, vol. 4, pp. 65–78.

    Article  Google Scholar 

  27. Fonseca, F. (2004): An Algebraic Specification of Geo-ontologies for Interoperability. International Journal of Geographical Information Science.

  28. Fonseca, F.T., M.J. Egenhofer, P. Agouris and G. Camara (2002): Using Ontologies for Integrated Information Systems. Transactions in GIS, vol. 6, pp. 231–257.

    Article  Google Scholar 

  29. Frank, A.U. and M. Raubal (1998): Specifications for Interoperability: Formalizing Image Schemata for Geographic Space. In T.K. Poiker and N. Chrisman (eds): Proceedings from the 8th International Symposium on Spatial Data Handling.

  30. Fujimura, J. (1992): Crafting Science: Standardized Packages, Boundary Objects, and “Translation”. In A. Pickering (ed): Science as Practice and Culture. Chicago: The University of Chicago Press.

    Google Scholar 

  31. Gerson, E. (1989): Personal Communication Cited in Schmidt, K. and Bannon, L.J., (1992). Taking CSCW Seriously: Supporting Articulation Work. Computer Supported Cooperative Work, vol. 1(1–2), pp. 7–40.

    Google Scholar 

  32. Giuffre, M. (2005): Progress is Being Made...But There is a Long Way to Go, Vital Signs January, 2005, pp. 4–5. (3/8/2005).

  33. Government of Alberta (2002): Alberta’s Health System: Some Performance Indicators. December 2002 Technical Notes. Viewed August 5, 2005.

  34. Guardian (2005): Saskatoon Senior Waits 52 Hours in Emergency. Guardian. Charlottetown, P.E.I.: June 4, 2005. pg. A. 11.

  35. Harvey, F. (2003): The Linguistic Trading Zones of Semantic Interoperability. In D. Unwin (ed): Re-presenting GISLondon: Wiley.

    Google Scholar 

  36. Harvey, F. and N.R. Chrisman (1998): Boundary Objects and the Social Construction of GIS Technology. Environment & Planning A, vol. 30, pp. 1683–1694 doi:10.1068/a301683.

    Article  Google Scholar 

  37. Harvey, F., W. Kuhn, H. Pundt and Y. Bishr (1999): Semantic Interoperability: A Central Issue for Sharing Geographic Information. The Annals of Regional Science, vol. 33, pp. 213–232. doi:10.1007/s001680050102.

    Article  Google Scholar 

  38. Kirkey, S. (2005): Heart Patients Dying in Hospital Emergency Departments [Final Edition], The Vancouver Province, Nov. 26, 2004, p. A.13.

  39. Kottman, C. (1999): The Open GIS Consortium and Progress Toward Interoperability in GIS. In M. Goodchild, M. Egenhofer, R. Fegeas and C. Kottman (eds): Interoperating Geographic Information Systems. Boston: Kluwer Academic.

    Google Scholar 

  40. Kuhn, W. (2002): Modeling the Semantics of Geographic Categories through Conceptual Integration. In M.J. Egenhofer and D.M. Mark (eds): Geographic Information Science. Berlin: Springer-Verlag.

    Google Scholar 

  41. Laurini, R. (1998): Spatial Multi-database Topological Continuity and Indexing: A Step Towards Seamless GIS Data Interoperability. Geographical Information Science, vol. 12, pp. 373–402. doi:10.1080/136588198241842.

    Article  Google Scholar 

  42. Longley, P.A., M.F. Goodchild, D.J. Maguire and D.W. Rhind (eds) (2001): Geographical Information Systems and Science. New York: Wiley.

  43. McIntosh, T. (2005): The taming of the Queue II, Colloquim Report, March 31 and April 1, 2005, Ottawa: Westin Hotel.

  44. National Ambulatory Care Reporting System (NACRS) (2005): General data limitations. March 2005. Ottawa.–2004_EN.pdf.

  45. Ottawa Hospital (2004): The Ottawa Hospital Performance Indicator Report. For period ending December 31, 2004. Viewed August 5, 2005.

  46. Peuquet, D. (1983): A Hybrid Structure for the Storage and Manipulation of very Large Spatial Data Sets. Computer Vision Graphics and Image Processing, vol. 24, pp. 14–27. doi:10.1016/0734-189X(83)90018-X.

    Article  Google Scholar 

  47. Reid R. J., M. Barer, R. McKendry, K. McGrail, B. Prosser, Green B., et al. (2004): Patient-focused care over time: issues related to measurement, prevalence, and strategies for improvement among patient populations. Paper presented for and published by the Canadian Health Services Research Foundation. July 2003. (32 pages) CHSPR 2004:22R. Viewed August 2, 2005.

  48. Schmidt, K. and L.J. Bannon (1992): Taking CSCW Seriously: Supporting Articulation Work. Computer Supported Cooperative Work, vol. 1(1–2), pp. 7–40. doi:10.1007/BF00752449.

    Article  Google Scholar 

  49. Schuurman N. (1999): Critical GIS: Theorizing an Emerging Discipline. Cartographica, vol. 36(1), Monograph 53.

  50. Schuurman, N. (2002): Flexible Standardization: Making Interoperability Accessible to Agencies with Limited Resources. Cartography and Geographic Information Science, vol. 29, pp. 343–353. doi:10.1559/152304002782008350.

    Article  Google Scholar 

  51. Schuurman, N. (2004a): GIS: A Short Introduction. Oxford: Blackwell.

    Google Scholar 

  52. Schuurman, N. (2004b): Social Perspectives on Semantic Interoperability: Constraints to Geographical Knowledge from a Database Perspective. In F. Harvey and M.-P. Kwan (eds): Reconstructing GIS: Critical Perspectives. Philadelphia: Temple University Press.

    Google Scholar 

  53. Schuurman, N. (2005): Social Perspectives on Semantic Interoperability: Constraints on Geographical Knowledge from a Data Perspective. Cartographica, vol. 40, p. 47.

    Google Scholar 

  54. Schuurman N. (2008): Database Ethnographies. Using Social Science Methodologies to Enhance Data Analysis and Interpretation. Geography Compass. (in press).

  55. Schuurman, N. and A. Leszczynski (2008): A Method to Map Heterogeneity Between Near But Non-equivalent Semantic Attributes in Multiple Health Data Registries. Health Informatic Journal, vol. 14, pp. 39–57.

  56. Schuurman, N. and A. Leszczynski (2006): Ontology-based Metadata. Transactions in Geographic Information Science, vol. 10(5), pp. 709–726.

    Google Scholar 

  57. Sharman, Z. (2007): Remembering the Basics: Administrative Technology and Nursing Care in a Hospital Emergency Department. International Journal of Medical Informatics, vol. 76(Supplement 1), pp. S222–S228.

    Article  MathSciNet  Google Scholar 

  58. Sheth, A.P. (1999): Changing Focus on Interoperability in Information Systems: From System, Syntax, Structure to Semantics. In M.F. Goodchild, M. Egenhofer, R. Fegeas and C. Kottman (eds): Interoperating Geographic Information Systems. Boston: Kluwer Academic.

    Google Scholar 

  59. Sin, L. (2005): Kelowna Hospital Trial Helps Clear ED Backlog: DIAGNOSTIC WORK: Nurses Help Cut Wait Times, [Final Edition], The Vancouver Province, May 22, 2005, pg. A.25.

  60. Star S.L. and J.R. Griesemer (1989): Institutional Ecology, ‘Translations’, and Boundary Objects: Amateurs and Professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–39. Social Studies of Science, vol. 19(3), pp. 387– 420.

    Article  Google Scholar 

  61. Stein J.G. (2001): The Cult of Efficiency. (CBC Massey Lectures Series). House of Anansi:Toronto.

    Google Scholar 

  62. Steyn, M. (2004): Bad Things Come to Those Who Wait. From C Difficile to SARS, Almost All Scandals in Canadian Hospitals Boil Down to The Same Thing: Sick People Waiting Longer in Crowded Rooms in Dirtier Hospitals, Western Standard, Nov. 22, 2004, p. 69.

  63. Timmermans S. and M. Berg (2003): The Gold Standard. The Challenge of Evidence-based Medicine and Standardization in Health Care. Philadelphia: Temple University Press.

    Google Scholar 

  64. University Health Network (2005): University Health Network Wait Time Report Wait Time Summary. April 2005 (5/8/2005).

  65. Vckovski, A. (1999): Interoperability and Spatial Information Theory. In M.F. Goodchild, M. Egenhofer, R. Fegeas and C. Kottman (eds): Interoperating Geographic Information Systems. Boston: Kluwer Academic.

    Google Scholar 

  66. Wiener, C. (2000): Elusive Quest: Accountability in Hospitals (Social Problems and Social Issues). Sommerset, NJ: Aldine Transaction.

    Google Scholar 

  67. Woods, D. (1992): The Power of Maps. New York: Guildford.

    Google Scholar 

  68. Wooton, A. (1975): Dilemmas of Discourse: Controversies About Sociolinguistic.

  69. Young, M. (2005): RIH Adds Staff to Cope with Emergency Waits; [Final Edition], Kamloops Daily News, Apr. 22, 2005, pg. A.5.

Download references

Author information



Corresponding author

Correspondence to Nadine Schuurman.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Schuurman, N., Balka, E. Ontological Context for Data Use and Integration. Comput Supported Coop Work 18, 83–108 (2009).

Download citation

Key words

  • data integration
  • data quality
  • health informatics
  • indicators
  • ontology
  • semantic interoperability