Terminology Service                  Jussara Rötzsch           Based on: Ian McNicoll               Christopher Chute
What do we need?      Messaging          An EHR that is                         • Independent of implementation           ...
The Problem• Terminology systems vary considerably in both content   and structure.   –   NDF‐RT   –   RxNorm   –   SNOMED...
Real world use of SNOMED CT• Clinicians      – Need to be able to find the term that they need easily      – Need to use S...
Common Terminology Services (CTS)• Purpose is to specify a common Application   Programming Interface (API) to access   te...
Common Terminology Services API• Allows Client Software to be developed   Independently from Service Server Software• Allo...
CTS API                               ... Application   Interface          CTS    Service     Data                        ...
CTS API               HL7Application    Vocab               Find codes having “*myelitis”               Browser   Interfac...
CTS API – Different Client, Same Service                         IHCApplication                        Picklist           ...
CTS API – Different Server, Same Client                             IHC Application                            Picklist   ...
CTS API – Distributed Services                       IHCApplication                      Picklist                Find code...
Common Terminology Services                Message Processing                 Message Processing Application              ...
OpenEHR (Ocean)Terminology Server                         Use cases                           Maintenance                 ...
Terminology Server                                     • Stores named queries                                     • Caches...
ProcessUser determines which part(s) of SNOMED‐CT  hierarchy is of interest (including which  subsets)Can choose to:  – ...
Blood groups – raw views
Blood Groups simple list (all terms)                  • Choose all relevant blood groups                  • Hoist all node...
ABO Blood Groups 3‐layer tree                       • The hierarchy of                          ABO blood groupsNavigate  ...
Terminology Query language•   <?xml version="1.0" encoding="utf‐8" ?>                                                     ...
ABO Blood Groups 3‐layer tree restructured                         PlaceholderPlaceholder                                 ...
ABO Blood Groups 3‐layer tree restructured                         code•     <?xml version="1.0" encoding="utf‐8" ?>•     ...
OTS Features• Terminology support   – Support for multiple terminology        • linking concepts by relationships (hierarc...
OTS Features•   Query language     – XML based     – terminology‐independent     – allows selection or navigation around r...
Q&Ajussara.macedo@openehrfoundation.org
Servicios Terminológicos
Servicios Terminológicos
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Servicios Terminológicos

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Servicios Terminológicos para el (re)uso efectivo de la Información Clínica - Dra. Jussara Macedo

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Servicios Terminológicos

  1. 1. Terminology Service Jussara Rötzsch Based on: Ian McNicoll Christopher Chute
  2. 2. What do we need? Messaging An EHR that is • Independent of implementation technology • Independent of clinical system developer • Enables access to multiple clinical Query applications • Designed for longevity and re-use TerminologyContent Specifications Information Models
  3. 3. The Problem• Terminology systems vary considerably in both content  and structure. – NDF‐RT – RxNorm – SNOMED‐CT – ICD‐9 and ICD‐10 – CPT – etc• Requirements of terminology vary widely• Implementation decisions of terminology vary widely• Storage formats may differ (relational database, XML,  ...) © 2002‐2009, Health Level  March, 2009 3 Seven, Inc.
  4. 4. Real world use of SNOMED CT• Clinicians – Need to be able to find the term that they need easily – Need to use SNOMED terms correctly – good subsets  are safe – Transparent to the end user• Applications – Need to be able to deploy SNOMED and use it reliably  in their apps – Need to be able to query reliably1.4
  5. 5. Common Terminology Services (CTS)• Purpose is to specify a common Application  Programming Interface (API) to access  terminological content• Client software doesn’t have to know about  specific terminology data structures and/or  how to access them• Server software can plug and play with many  clients © 2002‐2009, Health Level March, 2009 5 Seven, Inc.
  6. 6. Common Terminology Services API• Allows Client Software to be developed  Independently from Service Server Software• Allows Terminology Plug‐and‐Play• Allows Client Plug‐and‐Play• Defines a “Functional Contract” © 2002‐2009, Health Level March, 2009 6 Seven, Inc.
  7. 7. CTS API ... Application Interface CTS Service Data © 2002‐2009, Health Level March, 2009 7 Seven, Inc.
  8. 8. CTS API HL7Application Vocab Find codes having “*myelitis” Browser Interface CTS HL7 Terminology Service Server Select * from VOC_concept_designation WHERE text like ‘%myelitis’ MS Access Data Tables © 2002‐2009, Health Level March, 2009 8 Seven, Inc.
  9. 9. CTS API – Different Client, Same Service IHCApplication Picklist Find codes having “*icillin” Tool Interface CTS HL7 Terminology Service Server Select * from VOC_concept_designation WHERE text like ‘%icillin’ MS Access Data Tables © 2002‐2009, Health Level March, 2009 9 Seven, Inc.
  10. 10. CTS API – Different Server, Same Client IHC Application Picklist Find codes having “*icillin” Tool Interface CTS APELON DTS Select * from conc_repr Service WHERE text like ‘%icillin’ AND ... SNOMED Oracle Data CT Tables © 2002‐2009, Health Level March, 2009 10 Seven, Inc.
  11. 11. CTS API – Distributed Services IHCApplication Picklist Find codes having “*icillin” Tool Interface CTS <msg><soap....><filter=“*icillin”...</msg> Service Web Data Internet Service Portal © 2002‐2009, Health Level March, 2009 11 Seven, Inc.
  12. 12. Common Terminology Services Message Processing Message Processing Application Message Processing Application Application Message API Vocabulary API Vocabulary Vocabulary Vocabulary © 2002‐2009, Health Level March, 2009 12 Seven, Inc.
  13. 13. OpenEHR (Ocean)Terminology Server Use cases Maintenance Multiple Languages & subsets
  14. 14. Terminology Server • Stores named queries • Caches complex queries • Caches saved between sessions Ocean Terminology Server UKEnglish SNOMED-CT extension
  15. 15. ProcessUser determines which part(s) of SNOMED‐CT  hierarchy is of interest (including which  subsets)Can choose to: – Include a node – Exclude a node (pass through) – Exclude a node and all the children of a node  (exclude) – Include the node for navigation only – Hoist the children to be peers of the parent
  16. 16. Blood groups – raw views
  17. 17. Blood Groups simple list (all terms) • Choose all relevant blood groups • Hoist all nodes to be peer with parents This gives a flat list of terms
  18. 18. ABO Blood Groups 3‐layer tree • The hierarchy of ABO blood groupsNavigate Select
  19. 19. Terminology Query language• <?xml version="1.0" encoding="utf‐8" ?> Start at ABO• <ots:query  blood group• xmlns:ots="urn:xmlns:oceaninformatics.biz:schema:OTSQuerySchemav2"• name="BloodTypev2"• language="en‐us"   Set root to• terminology="Snomed"  • cacheMode="Permanent"> Navigate• <childNodes>• <concept conceptId="112143006"• operation="Navigate"> Iterate down the• <childNodes> IS_A relationship• <relatedConcept operation="Navigate"• relationship="116680003">• <childNodes>• <relatedConcept operation="Select"• relationship="116680003">• </relatedConcept>• </childNodes>• </relatedConcept>• </childNodes>• </concept> Make all nodes• </childNodes>• </ots:query> with an IS_A relationship selectable
  20. 20. ABO Blood Groups 3‐layer tree restructured PlaceholderPlaceholder Select Navigate
  21. 21. ABO Blood Groups 3‐layer tree restructured  code• <?xml version="1.0" encoding="utf‐8" ?>• <ots:query • xmlns:ots="urn:xmlns:oceaninformatics.biz:schema:OTSQuerySchemav2" Navigate• name="BloodTypev2"• language="en‐us"  • terminology="Snomed"  • cacheMode="Permanent">• <childNodes>• <placeHolder text="Blood Types">• <childNodes>• <concept conceptId="112143006"• operation="Passthrough"> Select• <childNodes>• <relatedConcept operation="Navigate"• relationship="116680003">• Placeholder <childNodes>• <placeHolder text="Rh subtypes">• <childNodes>• <relatedConcept operation="Select"• relationship="116680003">• <constraints>• Placeholder <lexicalConstraints>• <lexicalConstraint matchRule="MustMatch">• <searchString>*Rh*</searchString>• </lexicalConstraint>• </lexicalConstraints>• </constraints>• </relatedConcept>
  22. 22. OTS Features• Terminology support – Support for multiple terminology • linking concepts by relationships (hierarchies) • property based – Support for terminologies in their native structures – Access to terminologies in any database technology• Queries – Queries may be pre‐defined and made available to all users – Queries based on queries – Provide a high‐level mechanism for identifying concepts relevant  to local requirements
  23. 23. OTS Features• Query language – XML based – terminology‐independent – allows selection or navigation around relevant concepts depending on the  situation. – powerful expressive capabilities across trees, multiple links and iterative structures• Visual interface – hierarchical navigation – rapid text searches – visual specification of queries• Computer Interfaces – Global Web Service interface accessible to all – Class library available for local .NET usage
  24. 24. Q&Ajussara.macedo@openehrfoundation.org
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