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TerminologiesHow do they impact my
world?
Heather [email protected]
Presented at HIMAA Symposium 2008
Feeling Lost?
Photo: Heather Grain
There is light!
• Why does terminology matter?
• What is terminology?• How does it impact
your world• Views through the
window (threat or opportunity).
Photo: Heather Grain
Why Terminology?
Grain, H., Clinical Terminology and Why and the What, in Health Informatics an Overview, E. Hovenga, S. Garde, and C. Hullin, Editors. 2008, Churchill Livingstone: South Melbourne
What you can’t do without Terminology•Clinical decision support•Clinical pathways•Multi-axial retrieval of clinical information
What is a Terminology
•Structured collection of descriptive terms used in clinical practice
•Precise – no ‘other’ or ‘unknown’•Uses Description Logic to describe a
concept in a manner the computer can ‘understand’ and use to support retrieval
A SNOMED-CT concept is definedConcept ID: 21522001Description: 38112013 Abdominal PainFully defined as:Is A
General finding of the abdomen (119415007)Pain of truncal structure (454497018)
Finding Site(abdominal structure(113345001)
Multiple access hierarchies
Grain, H., Clinical Terminology and Why and the What, in Health Informatics an Overview, E. Hovenga, S. Garde, and C. Hullin, Editors. 2008, Churchill Livingstone: South Melbourne
Terminology supportsRetrieval of clinical data based upon context and
clinical knowledgefind me all cases of PAIN (ALL CHILDREN OF
PAIN IN THE FINDING HIERARCHY) – includes headache
Allows clarity of meaning over time, distance and discipline
concept: 21522001Description: 38112013 Abdominal Pain
(finding)
Described using SNOMED-CT V2008/1in field: Triage Assessmentassessed by: 234N Mary Smith
Terminology supportsFully defined unambiguous description of an
individual concept in a logical, machine processable way.
Allows construction of concepts (post-coordination)# humerus
+ Right(laterality) + mid shaft(body structure)
And pre-constructed concepts (pre-coordination)# humerus (fracture + body structure)
International
How does this impact your world!•SNOMED-CT has a different job to ICD-10-
AM•They are in the same family and work to
support some similar tasks.•Will coding continue – there is likely to be a
need for a classification that aggregates data for reporting and analysis into the future.
•Will this be ICD-10-AM Yes – though ICD11 may have a terminological basis that more closely aligns with SNOMED-CT
However!
•There is a move to invest in the use of data and to reduce the costs of data collection.
•This means….▫Automation of coding at discharge can be
achieved for many common processes and is likely to occur sooner rather than later (it is seen, in part at least, as a deliverable of SNOMED-CT and mapping to ICD-10-AM)
▫Greater need for those who can extract and analyse clinical data
National Developments
•Reference Sets: Select appropriate terms (SNOMED-CT Concepts) for use in specific situations – test ordering, medications, alerts
•International participation in IHTSDO – International Health Terminology Standards Development Organisation as a founding member▫ Sharing the load and the learning▫ Building focused capacity
Views of the world•It’s not going to happen for years!
▫Don’t wait or expect a big bang – it’s already happening you just can’t see it yet!
•Options (the green house effect)▫Buy a bigger car (ignore it – ICD-10 is God)▫Invest in solar power production (get on board
and try and influence the result and benefit from it)
▫Wait and see – aware, learning, but waiting to follow others
Which are you?
•Leader•Follower•Extinct!