Terminology Services in the Open HIE Agenda Terminology

Terminology Services in the Open. HIE

Agenda • Terminology Services Overview • Terminology Services in Rwanda • Distributed Terminology System (DTS) • Next Steps

Open. HIE Architecture … Health Interoperability Layer Components

What Is a Terminology Server? • A Terminology Server is: – a networked, software component – that centralizes terminology knowledge (e. g. national and international standards) – and provides terminology services to other network applications.

Terminology Servers • Terminology Servers are used: – By informaticians to create, extend, localize, and map terminologies – By interface applications to translate data elements between applications – By clinical applications to select, standardize and analyze clinical data

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

Terminology Services Interfaces SDO Load Browse Edit Application API Health Interoperability Layer Health Professional Terminologist

Rwanda Requirements • Central Repository • Code System Support • Program (API) Interface • Terminologist Interface • Health Professional Interface

Rwanda Requirements • Central Repository – DTS on Ubuntu, My. SQL • Code Systems

Code System Support • ICD-10 and LOINC from Apelon • ICD-10 subset (ICD 10 RW) • LOINC Ontylog Extension (Rwandan Maternal Health) – Subset of LOINC – New codes for LOINC (LOINCRW) – RWCS (Rwandan Code Space) • Uses Open. MRS Concept IDs • Rwandan Administrative Units • RHEA Rapid. SMS Codes

Planned Code Systems • ICHI • DM+d • ATC • UMDNS

Rwanda Requirements • Program (API) Interface – using the DTS API – Functionality exposed via Web Service – Integration with HIE • Terminologist Interface – DTS Editor • Health Professional Interface – JEMBI-developed Browser

Health Professional Interface

Health Professional Interface • https: //github. com/jembi/ts-browser • RHEA Test Instance available at http: //ts. jembi. org

What is DTS? • An enterprise terminology server used to : – Acquire & maintain standards – Integrate and manage local code sets – Map/interrelate terminologies – Deploy in applications • Originally developed as an Apelon commercial product, but now open source • Downloaded over 4500 times worldwide

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

DTS 4 • Comprehensive revision of DTS • Addresses emerging enterprise requirements for creating, maintaining and deploying terminologies • Alpha releases available at http: //www. Apelon. DTS. org 17

DTS 4 Features • Enterprise Architecture • Integrated Version Management • Additional Metadata on Code Systems and Subsets • Enhanced Subsets • New DTS Browser • Expanded DTS Editor Architecture 18

DTS 4 Architecture

Next Steps: Use Cases • Develop detailed use-cases /requirements for the components: – Platform: OS/database? – Program Interface – what APIs? what functions? – Terminologist Interface – what functions? – Health Professional Interface – what functions? – Code System Support – which terminologies?

Medical terminology in practice