Slide 1

Cutting costs and improving quality of code system use in EHRs by crowdsourcing?

20th of April 2012

CareCom A/S 20112IntroductionThe use of code systems in healthcare is often not high on the healthcare agenda. However, working with code systems that are not up to date in all systems in e.g. a hospital can have fatal consequences and will definitely increase costs of running the hospital. But even if all systems are using the most recent release of the code systems the code systems themselves may not be completely up to date and this may influence productivity too. The presentation will introduce the concept of crowdsourcing in relation to code systems. How can it be used? How will the use influence cost and quality of code systems? And what types of code systems are the main candidates for crowdsourcing? The presenter will build upon his experience with different code systems and terminologies in e.g. Denmark, Sweden, UK and Canada - and in the EU-project epSOS.

19/04/122

Why do we need to integrate Healthcare?

My points from the Canadian videoWe need to integrate our Healthcare systemsFor the safety of our citizensTo lower cost of Healthcare serviceWe need to have a solid information model as HL7We need to have semantic interoperabilityWe need to understand each other

Quality Databases

TerminologyConcept modelMessagesEHRNationalPatient Registry

Semantic interoperability

Option 15

Browser ModuleSubset ModuleEditing ModuleTranslationModule

Request ModuleWebserviceCTS2Mapping ModuleFile ExportHealthTerm

How do we build this ?

How does it work?

HealthTerm makes a differenceCreation and maintenanceOperations in the clinicAdvanced functionality for control and logging-access control-full history of changes-description logic-advanced control of user privilegesPerformance and easy accessWeb service access to subsets, mapsets, classification browsing and look-ups based on the HL7 CTS2 standardHealthTermNational

Regional

Local

HealthTerm EMRNationalCode systemsPASSYSTEMLABSYSTEM

Enterprise classification broker

Current problems in maintenance.Its very costly to maintain terminologies and code systemsThe change of eg. SNOMED CT and ICD is slowThe maintenance is not done by the people that are using it on an every day basisThe large job of creating translations and mappings to local codesThe need for fast implementation of new codes

How can we change this?Can we make a system where we move the current maintenance to the crowd ?Make the clinicians create new codes, mapping and translationMake the clinicians rate others work to ensure the qualityShare the content between us in real time open content

A danish crowdsource caseWe need to produce Danish layman terms for the clinical terms used all around in healthcare todayTerms from codesystem Clinical acronymsWe will index free text and translate into layman termsWe will use a mobile app to crowdsource the translationsWe will make it possible for the citizens to report clinical terms which they found difficult to understand

HealthTerm communitywww.healthterm.com will open 2. quarter this yearFocus on sharing guidelines and favorite lists of code systemsCreating synonyms and rate theseLets see what is next

Clinicians in DenmarkClinicians in Japan

Cliniciansin USHealthTerm Community

Clinicians in Korea

HealthTerm Crowdsouring

Option 214

Questions?

Contact info:jbh@carecom.eu

Accession to epSOS Terminology Server BTranslation of displayName E to displayName BCreation of local Document B*

Transformation ICD-10 4-digit to 3-digits codesAccession to epSOS Terminology Server ATranslation of displayName A to displayName ECreation of pivot Document E*

* Initial 4-digits code with displayName A are kept into CDA documents E and B and are still available

Document A

Country A

epSOS Terminology server A

Document E

Document B

NCP B

Country B

NCP A

epSOS Terminology server B

CDALanguage AICD-10 4-digits codes

CDAEnglishICD-10 3-digits codes

CDALanguage BICD-10 3-digits codes

Local document A is coded with ICD-10 4-digit codes and sent to NCP A