Introduction to Terminology Services Open HIE Jack Bowie

Introduction to Terminology Services Open. HIE Jack Bowie, Apelon, Inc. AMIA, 2017

Agenda • What • Why • How • Where

Terminology Services We are here

Terminology Services “The objective of the Terminology Services component is to provide a central resource for the definitional assets of the HIE, i. e. , terminologies, ontologies, dictionaries, code systems, value sets, etc. , that can be used by other HIE components to achieve normalization of clinical data and consistent aggregation and reporting. ” From the OHIE Terminology Services Planning and Implementation Guide

Why Standard Terminologies? • Normalization of clinical data Counting • Consistent aggregation and reporting Grouping

Courtesy of Mary Morgan, LCS, Partners Healthcare

Journal of the American Medical Informatics Association – September 1994

Why Terminology Services? • Today’s HIT environment requires access to multiple “standard” terminologies. • These terminologies are under constant revision. • Maintain the official version of HIE datasets (the “goldstandard” or “single source of truth”) • Eliminate multiple, duplicate, copies of these datasets in the HIE

Terminology Services Interfaces • Originally, interfaces to other OHIE Components were idiosyncratic and proprietary • Hard to use and weren’t portable • Now moving to interfaces drawn from the HL 7 FHIR Specifications • Primary Resources • Code. Systems • Value. Sets • Concept. Maps

Terminology Services Interfaces FHIR Operations: • Existence • Membership • Expansion • Mapping Is ‘ 123 XYZ’ an ICD-10 code? Is ‘ 123 XYZ’ in the HIV Value. Set? Get the codes in the HIV Value. Set. What is the SNOMED code for ‘ 123 XYZ’?

Terminology Services Adoption • Implementations vary greatly in their initial terminology services adoption driven by their specific use-case: • Maternal Health • HIV • Immunization tracking • National organizations vary in their maturity for terminology governance • Use-cases often must support specific terminologies, e. g. , international standards, or historical local dictionaries

National Selections Domain Ethiopia Dx ICD-10 Px local Nepal Nigeria Philippines Rwanda South Africa ICD-10 ICD-10 local CCHI CPT ICD-9 LOINC Local (map to LOINC) local ATC local CVX SNOMED local Lab Rx Devices local Tanzania Thailand UMDNS Billing local Notes: 1. All selections should be considered in development 2. All Code. Systems should be interpreted as national subsets local

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