# The Need for Machine-Processable Agreements in Health Data Management +
## 4 Our Ontological Framework
### An Ontology for Familial Consent  
We present the conceptual domain ontology and not reifying it into a physical one, in order to ease presentation. Our ontology can represent data in the system and allow inferences to be used to understand conflicts within the system. Figure 2 describes the main classes and relationships that are required to represent the concepts inherent in expressing consent for sharing in a genetic information context. The ontology is designed to model both the data being shared but also the workflows of the processes followed by clinicians and patients in sharing test results. It has previously been demonstrated that capturing semantic descriptions of intent can enhance workflow practices [29].  
A genealogical ontology, such as one reused from [29] is not pictured, but essentially defines a set of relationships and proprieties associated with the Person class depicted in Figure 2. The domain also recognises two sub_classes of Person, Patient and Clinician. This introduces the notion of roles within the system; more may become apparent over time. In addition our ontology is modelling groups of users, such as a group of patients taking part in the same study and have a collective right on results, or a team of clinicians. When highlighting conflicts in expressed permissions, or building systems that might make decisions based on data in the system, the roles involved could provide information on priorities, weighting of policies and conflict resolution strategies. For example, when highlighting conflicts, the policies of the patient might be given higher priority than the policy of the clinician to reflect the current legal polemics. Our system is not seeking to automate decision making at this point but rather to highlight conflict, so prioritising is not essential, but could be layered on top of the current ontological structure.  
The class Test Results is a key concept in the ontology. A Test Result may comprise of several Resources. These might be Letters, Full Test Results, Summary Results or Information Resources. These may have specific properties such as being anonymous, that can be referred to in sharing policies. Policies are expressed about sharing Test Results. A Person expresses a Policy that relates_to a Test Result and concerns a Patient. Resources can be anonymous versions of results or summaries. In order to express that only anonymous results should be shared, as illustrated in the previous use cases (Use Case 4), it is necessary to express a sharing policy about an anonymous resource. Properties on the resource entity are used to identify it as anonymous to allow systems built on top of the ontology to highlight which resources are anonymous when users construct their policies.  
Although out of scope of the use cases presented within this paper, our ontology allows the capturing of specific Diagnoses of a Condition that may be related to a Test Result.  
In addition to information specifically about the Test Result, the ontology also allows the representation of data about the sharing of results. A Sharing Event captures the notion of Resources of a Test Result being shared with a Person. This information is required in order to express some of the conditions that might be included as part of a Policy statement, for example that a result should only be shared with a niece once it has been shared with their parent.