Open Health Tools Distributed Terminology System Presentation Jack

Open Health Tools Distributed Terminology System Presentation Jack Bowie SVP Sales and Marketing Apelon, Inc. 1

Apelon • Leading provider of healthcare terminology products and services • Extensive and unique experience partnering with national agencies and healthcare enterprises to improve the quality, comparability & accessibility of clinical information • Helps organizations turn terminologies and their use into business assets • Develop and refine mission-critical data normalization processes

Key Achievements • Twenty years development with the US National Library of Medicine on the UMLS Metathesaurus • Supplier of the tools and services used to maintain SNOMED CT, ICD-9 -CM, ICD-10 -CM, and NDF-RT • Supplier of tools and services to national health organizations: Australia’s NEHTA, Canada Health Infoway, Hong Kong Hospital Authority, and US FDA, NCI, NCHS, SSA, VHA • Leading provider of commercial health data interoperability solutions: HIEs, EMRs, biotech, and content providers

Apelon Customers and Partners

Personnel • Internationally known terminology experts • Regular contributors to industry standards, publications and conferences

Apelon Solutions Terminology Content People and Processes Applications and Services 6

Apelon and Open Source • After many years of commercial availability, Apelon released the Distributed Terminology System (DTS ) vocabulary server as an open source project in April of 2007 • Since then, DTS has been downloaded over 4000 times by organizations around the world • Apelon supports DTS with a full range of commercial services 7

What is DTS? • An enterprise vocabulary server used to : – Acquire & maintain standards – Integrate and manage local code sets – Map/interrelate terminologies – Deploy in applications Apelon Confidential

Examples of Terminology Services • Term/name normalization: What is SNOMED CT name for “heart attack”? • Code translation What is the ICD-9 code for Myocardial Infarction? • Yes Clinical knowledge Streptokinase What drug treats Myocardial Infraction? • 410. 91 Grouping and aggregation Is Myocardial Infarction a Cardiac Disease? • Myocardial Infarction Local information Add L 227 as the local code for Serum Calcium. Apelon Confidential Okay

DTS Components • Knowledge Base (Content) • Server • Client API • GUI applications • Utilities and samples • Subscription content service • Commercial software support service Apelon Confidential

Apelon Terminology Model Apelon SNOMED Web Services HL 7 User Applications API Med. DRA ICD 9 Application Developer DTS SNOMED Data Set Updates HL 7 Med. DRA ICD 9 Rx Dx Tx

DTS Components Terminology Update Service DTS Knowledgebase DTS Vocabulary Server • Comprehensive terminology support DTS API DTS Applications • Enterprise quality, highly scalable repository User Applications 12

DTS Knowledgebase – Clinical framework (SNOMED CT) – Reimbursement code sets w/mappings: ICD, CPT, HCPCS – Rx. Norm, NDF-RT and other drug terminology and classification systems – Meaningful Use Standards: HL 7, CVX, MVX, UNII – Specialty sets: LOINC, Rad. Lex, NIC, NOC, and NANDA – Adverse event terminologies Med. DRA, COSTART, WHOART – Mappings to Me. SH and UMLS CUIs – Extensible with local additions

Apelon KB Architecture Subscription Namespaces • Derived from industry sources SNOMED CT Apelon CT to CPT • Provided by Apelon • “Read only” in DTS Local Namespaces • Customer-specific data • • Concepts Properties Associations (mappings) Code and Value sets • Protected during updates Local Apelon KB CPT

DTS Components Terminology Update Service DTS Knowledgebase DTS Vocabulary Server DTS API DTS Applications • “Subscription” access to industry standard terminologies and thesauri • Web downloadable differential updates • Local content protected during updates User Applications 15

Subscription Update Process SNOMED CT Apelon CT to CPT SNOMED CT Apelon DTS CPT Apelon CT to CPT Local Apelon KB Update Log • Update exception events, e. g. , local mappings to retired concepts CPT

DTS Components Terminology Update Service DTS Knowledgebase • High-performance server • Extensive functionality DTS Vocabulary Server • Java and. NET clients DTS API DTS Applications • Programmatic access to all functions User Applications 17

DTS Functionality • API Services: – Search (w/spelling correction, stemming, contexts, etc. ) – Navigation and code translation – Subsetting (extensional and intensional definitions) – Class/subsumption query – Workflow – Localization • Performance features: – Connection pooling – Concept caching

DTS Components Terminology Update Service DTS Knowledgebase DTS Vocabulary Server • User applications have access to all DTS functions including modeling capabilities DTS API DTS Applications User Applications 19

DTS Components Terminology Update Service DTS Knowledgebase • DTS Browser • DTS Editor DTS Vocabulary Server • Term. Works Web Services DTS API DTS Applications User Applications 20

DTS Editor • Browsing/searching • Vocabulary/code set management (subsets) • Local additions – Complete modeling environment – Add Concepts, Synonyms, properties and associations (relationships) • Import/Export • Workflow

DTS Editor Plug-in Architecture • The DTS Editor Plug-in architecture is a framework for customizing and extending the DTS Editor platform with new features and modules • Plug-ins have access to common DTS Editor facilities such as connection services, events, and drag-and-drop • Plug-ins can used to implement: – Major new features – New data presentations – New data input or output formats

Graphic Viewer New, customizable, “graphic” views of terminologies

Table Editor Tabular representation of DTS concepts

Import Wizard Import data into DTS Namespaces from XML and CSV data files

Terminology Query Language Query/export language for DTS knowledgebases, includes XML export of full Namespace

DTS Roadmap • Platform Support – New database support for DB 2 (Q 4 2010) and My. SQL (Q 1 2011). • HL 7 CTS 2 Interface – Support for this emerging standard terminology service interface – Extended versioning support for Namespaces and Concepts – Expanded Subset functionality for Value Sets – Additional metadata on Namespaces and Concepts

Medical terminology in practice