Clinically Harmonized Wellness Concepts Model for Health and Wellness Services

A considerable number of frameworks and platforms are available to model terminologies in the clinical domains, but wellness domain lacks a development framework. The objective of this paper is to develop a clinically influenced and harmonized wellness concepts model (WCM) in order to support diverse wellness applications and services. This model is supported by a novel framework in the wellness domain. In order to develop wellness concepts model, the proposed framework is divided into four processes; start-up and initiation process, WCM modeling and evolution process, WCM production process, and release process. The WCM modeling and evolution process extracts top level hierarchical concepts from the existing published literature using a systematic review process. The framework also extends its scope to evolution using the wellness recommendations guidelines. The evolution process is supported by clinical concepts harmonization with the help of terminology standard, SNOMED CT. We validated the top level hierarchical concepts using a group of experts based on a decision-making method known as the nominal group technique (NGT). In the final decision of the NGT, 14.7% of the hierarchical concepts are eliminated from the model due to their voting score of less than 70% in the expert panel. The top level concepts of the model are cross-validated using structured equation modeling (SEM). The chi-square ( $\chi ^{2}$ ) test and root mean square error of approximation test results demonstrated the acceptable goodness of fit indices for the WCM with respect to experts’ and users’ opinions. In order to fill the gap that existed in wellness and clinical domain, this paper systematically investigated concepts for building a clinically harmonized model called the WCM. The proposed WCM development framework is validated through the NGT and SEM.