This document describes an ontology-based framework for designing clinical data warehouses. It discusses three semantic layers - system, practice, and phenotype - that are relevant to warehouse design. An ontological framework is proposed that uses several mid-level ontologies like the Basic Formal Ontology, Information Artifact Ontology, Ontology for Biomedical Investigations, and Ontology of General Medical Science to map system data, clinical processes, and patient phenotypes. This framework allows translating system messages into a clinical view of the patient by mapping values to their semantic meaning.

1. Data Warehousing with
Semantic Ontologies
April 13, 2015, Session: 54
Richard E. Biehl, Ph.D. CSQE, CSSBB
Data-Oriented Quality Solutions
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2. Conflict of Interest
Richard E. Biehl, Ph.D.
Ownership Interest: Richard is the sole proprietor of Data-Oriented Quality
Solutions (DOQS), an IT/Quality consulting practice founded in 1988 and
operating out of Orlando, Florida, USA.
Consulting Fees: Richard earns approximately 15% of his income from
consulting engagements that involve the heuristics included in this presentation.
Other: The heuristics in this presentation can be immediately and directly
implemented by attendees. Nothing has been held back that would necessitate
engaging DOQS for implementation.
© HIMSS 2015 2

3. Learning Objectives
1. Demonstrate how the HIT human-machine interface relies on the semantic
abilities of human participants
2. Categorize the three semantic layers relevant to clinical data warehouse
design
3. Employ an ontological framework for mapping and modeling system-
practice-phenotype data
4. Illustrate how semantic ontologies can resolve common problems in
warehousing, using the ICD-9 to ICD-10 conversion problem as an example
5. Propose a reasoning-based warehouse design that can learn on behalf of
human participants who are increasingly overwhelmed by the flow of big data
3

4. Mapping to STEPS™
http://www.himss.org/ValueSuite
We start
here!
4

5. Previous HIMSS Presentations
Fundamentals of Data Warehousing in Healthcare
2013 HIMSS Annual Conference, New Orleans
Implementing a Healthcare Data Warehouse
in One year (Or Less)
2012 HIMSS Annual Conference, Las Vegas
Standardizing Data Dimensions of
Healthcare Data Warehouses
2010 HIMSS Annual Conference, Atlanta
Success by Design: Effective Data Quality
Measurements in a Hospital Data Warehouse
2008 HIMSS Annual Conference, Orlando
Data
Quality
Data
Dimensions
Project
Management
Warehouse
Design
5

6. “Big Data” is about…
• New data base architectures and performance challenges,
• New analytical paradigms and ways of seeing the world through
data,
• New design patterns for bringing together and using vast amounts of
data,
• New social and ethical challenges that need to be addressed within
all of these new opportunities,
• And all of the everyday mundane issues of systems and software
engineering that we’ve always been challenged to address, writ
large.
6

7. The Central Challenge
• “Big Data” increases the urgency of having strong control over our
information.
• The human-machine interface relies on the semantic abilities of the
human participant.
• We need to engineer controlled semantics into our systems…
• We want systems that can reason and learn on behalf of the human
participant that is increasingly overwhelmed by the volume and flow
of big data.
X
7

8. Semantic Layers in a
Biomedical Data Warehouse
• System
– What is in the dataset or message?
• Practice
– What is the provider doing or thinking?
• Phenotype
– What’s right or wrong with the patient?
8

9. An Ontological Framework
Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology of
General Medical
Science (OGMS)
Ontology for
Biomedical
Investigation (OBI)
Hypotheses
& Conclusions
Observations
Biomedical SemanticsBiomedical
Syntax
Biomedical Epistemology
9

10. Continuant Occurrent
Entity
Basic Formal Ontology
10

11. Independent
Continuant
Continuant
Spatial
Region
Dependent
Continuant
Specifically
Dependent
Continuant
Generically
Dependent
Continuant
Quality
Realizable
Entity
Disposition Function Role
Material
Entity
Object
Boundary
Site
Object
Aggregate
Object
Fiat
Object Part
Basic Formal Ontology
11

12. Basic Formal Ontology
Occurrent
Processual
Entity
Spatiotemporal
Region
Temporal
Region
Process
Aggregate
Process
Fiat
Process Part
Processual
Context
Processual
Boundary
12

13. Basic Formal Ontology
13
HIMSS10
HIMSS13

14. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
What is in the
dataset or
message?
14

15. Independent
Continuant
Specifically
Dependent
Continuant
Generically
Dependent
Continuant
Material
Information
Bearer
Information
Content Entity
Information
Carrier
Dependent
Continuant
Continuant
Basic Formal
Ontology (BFO)
Information Artifact
Ontology (IAO)
15

16. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology for
Biomedical
Investigation (OBI)
What is in the
dataset or
message?
What is the
provider doing
or thinking?
16

17. Independent
Continuant
Specifically
Dependent
Continuant
Age
Basic Formal
Ontology (BFO)
Ontology for
Biomedical
Investigations (OBI)
Dependent
Continuant
Continuant
Organism
Diagnosis
Generically
Dependent
Continuant
Patient
Role
Biological
Sex
Role
Quality
Alive
17

18. Process
Performing a
diagnosis
Performing an
assessment
Collection of
specimen
Administration
of material
Processual
Context
Hospital
Encounter
Office Visit
Occurrent
Basic Formal
Ontology (BFO)
Ontology for Biomedical
Investigations (OBI)
Process
Aggregate
Laboratory
Test
Medication
Course
Transplant
Surgery
18

19. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology of
General Medical
Science (OGMS)
Ontology for
Biomedical
Investigation (OBI)
What is in the
dataset or
message?
What is the
provider doing
or thinking?
What’s right or
wrong with the
patient?
19

20. Object
Aggregate
Organism
Population
Continuant
Extended
Organism
Object Organism
Basic Formal
Ontology (BFO)
Ontology for General
Medical Science
(OGMS)
Occurrent
Process
Disease
Course
Pathological
Bodily
Process
Processual
Context
Lifespan
Process
Aggregate
20

21. Independent
Continuant
Extended
Organism
Specifically
Dependent
Continuant
Disease
Occurrent
Processual
Entity
Disease
Course
Pathological
Bodily Process
Sign or
Symptom
Continuant
Extended Organism
experiences
Disease Course
instance of a
Disease
resulting from a
Disorder
with disposition toward
Pathological Bodily Process
which produces
Pathological
Anatomical Structure
recognized as
Sign or Symptom
Disorder
Pathological
Anatomical
Structure
Process
Aggregate
Basic Formal
Ontology (BFO)
Ontology for General
Medical Science
(OGMS)
21

22. Independent
Continuant
Specifically
Dependent
Continuant
Disorder
Disease
Basic Formal
Ontology (BFO)
Ontology for General
Medical Science
(OGMS)
Dependent
Continuant
Continuant Extended
Organism
Occurrent
Processual
Entity
Disease
Course
Diagnostic
Process
Pathological
Bodily
Process
Diagnosis
Generically
Dependent
Continuant
Information
Content Entity
Pathological
Anatomical
Structure
Sign or
Symptom
experiences
Age
Ontology for
Biomedical
Investigations (OBI)
Organism
Performing a
diagnosis
Diagnosis
Patient
Role
Biological
Sex
Alive
Role
Quality
Material
Information
Bearer
Information
Carrier
Information Artifact
Ontology (IAO)
22

23. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology of
General Medical
Science (OGMS)
Ontology for
Biomedical
Investigation (OBI)
Hypotheses
&
Conclusions
Observations
Biomedical Epistemology
Biomedical Semantics
Biomedical
Syntax
23

24. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology of
General Medical
Science (OGMS)
Ontology for
Biomedical
Investigation (OBI)
Biomedical Semantics
Biomedical
Syntax
Raw
message
Data from a clinical
process about a
patient
A clinical view
of the patient
Inbound messages (e.g., CCD) are
mapped as field-level information
artifacts back to the clinical processes
that evaluated the patient.
The contents of those messages –
the values of those information
artifacts – are then mapped into a
clinical picture of the patient.
The three mid-level ontologies are mapped to each other through the common BFO
framework. The values in the messages end up being at a different ontological level than
the semantic meaning of those values, allowing for translation, harmonization, and quality
control to intervene as systems data in messages is translated into clinical data in
systems.
top level
mid-level
24

25. Information
Artifact Ontology
(IAO)
Basic Formal Ontology (BFO)
Ontology of
General Medical
Science (OGMS)
Ontology for
Biomedical
Investigation (OBI)
Biomedical Semantics
Biomedical
Syntax
top level
mid-level
domain
-level
SNOMED, ICD, CPT, RxNORM, LOINC, MeSH, etc.
25

26. Ontology-Based Design
•Source ETL analysis & mapping
•Warehouse logical database design
•Post-load spider processing
•Conducting queries & analysis
26

27. <ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="urn:hl7-
org:v3“xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc“><realmCode
code="US"/><typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/><!-- US
General Header Template --><templateId root="2.16.840.1.113883.10.20.22.1.1“ /><templateId
root="2.16.840.1.113883.10.20.22.1.2"/><id extension="TT988"
root="2.16.840.1.113883.19.5.99999.1"/><code codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC" code="34133-9“ displayName="Summarization of Episode
Note"/><title>Community Health and Hospitals: Health Summary</title><effectiveTime
value="201209150000-0400"/><confidentialityCode code="N"
codeSystem="2.16.840.1.113883.5.25"/><languageCode code="en-US"/><setId
extension="sTT988“ root="2.16.840.1.113883.19.5.99999.19"/><versionNumber value="1"/>
<component><structuredBody><component><section><templateId
root="2.16.840.1.113883.10.20.22.2.5"/><templateId
root="2.16.840.1.113883.10.20.22.2.5.1"/><code code="11450-4"
codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC“ displayName="PROBLEM
LIST"/><title>PROBLEMS</title><entryRelationship typeCode="SUBJ"
inversionInd="true“><observation classCode="OBS" moodCode="EVN“><templateId
root="2.16.840.1.113883.10.20.22.4.31"/><code code="445518008“
codeSystem="2.16.840.1.113883.6.96“ displayName="Age At Onset"/> <statusCode
code="completed"/> <value xsi:type="PQ" value="57" unit="a"/>
</observation></entryRelationship></entry></section></component><structuredBody></compon
ent></clinicalDocument>
Age at Onset
57 years
27

28. section
<type> " CD" <codeSystem> “2.16.840.1.113883.6.96”
<displayName> “Pneumonia”
value
<code> " 233604007"
statusCode <code> “completed”
effectiveTime
Low <value> " 20080103" High <value> "20080103"
<code> "409586006"
<codeSystem> “2.16.840.1.113883.6.96”
<displayName> “Complaint”
code
id <root> "ab1791b0-5c71-11db-b0de-0800200c9a66"
templateId <root> "2.16.840.1.113883.10.20.22.4.4"
observation
<classCode> “OBS"
<moodCode> “EVN"
entryRelationship
<typeCode> “SUBJ"
<title> “PROBLEMS"
<codeSystemName> " CD"
<codeSystem> “2.16.840.1.113883.6.1”
<displayName>“PROBLEM LIST”
code
<code> "11450-4"
templateId
<root> "2.16.840.1.113883.10.20.22.2.5"
templateId
<root> "2.16.840.1.113883.10.20.22.2.5.1“
entry
<typeCode> “DRIV"
act
id <root> "ec8a6ff8-ed4b-4f7e-82c3-e98e58b45de7"
templateId <root> "2.16.840.1.113883.10.20.22.4.3”<classCode> “ACT"
<moodCode> “EVN"
<code> “CONC"
<codeSystem> “2.16.840.1.113883.5.6”
<displayName>“Concern”
code
statusCode <code> “completed”
effectiveTime
Low <value> " 20080103" High <value> "20080103"

29. observation
<code> "33999-4"
<codeSystem> “2.16.840.1.113883.6.1”
<displayName> “Status”
code
<classCode> “OBS"
<moodCode> “EVN"
templateID <root> “2.16.840.1.113883.10.20.22.4.6”
statusCode <code> “completed”
entryRelationship <typeCode> “REFR"
id <root> “ab1791b0-5c71-11db-b0de-0800200c9a66”
effectiveTime
Low <value> "20080103" High <value> “20090227130000+0500"
<type> " CD" <codeSystem> “2.16.840.1.113883.6.96”
<displayName> “Resolved”
value
<code> " 413322009”
observation
<value> “57” <unit> “a” <type> “PQ”
Value
<code> "445518008"
<codeSystem> “2.16.840.1.113883.6.96”
<displayName> “Age At Onset”
code
<classCode> “OBS"
<moodCode> “EVN"
<root> “2.16.840.1.113883.10.20.22.4.31”
templateID
statusCode
<code> “completed”
entryRelationship <typeCode> “SUBJ" <inversionInd> “true"
act

30. observation
<code> “11323-3"<codeSystem> “2.16.840.1.113883.6.1”
<displayName> “Health Status”
code
<classCode> “OBS"
<moodCode> “EVN"
templateID <root> “2.16.840.1.113883.10.20.22.4.5”
statusCode <code> “completed”
entryRelationship <typeCode> “REFR"
id <root> “ab1791b0-5c71-11db-b0de-0800200c9a66”
effectiveTime
Low <value> " 20080103" High <value> " 20090227130000+0500"
<type> " CD" <codeSystem> “2.16.840.1.113883.6.96”
<displayName> “Alive and well”
value
<code> "81323004”
<codeSystemName> "LOINC"
<codeSystemName> “SNOMED CT"
30

31. Material
Information
Bearer CCD XML
31

32. Information
Content
Entity
Problem
Observation
<code>
Age Observation
<value>
Problem
Observation <start>
Problem
Observation <stop>
Generically
Dependent
Continuant
Material
Information
Bearer CCD XML
32

33. Complaint
(409586006)
Start Time
(398201009)
Stop Time
(397898000)
Information
Content
Entity
Problem
Observation
<code>
Age Observation
<value>
Problem
Observation <start>
Problem
Observation <stop>
isabout
isabout
isabout
Age At Onset
(445518008)
isabout
Generically
Dependent
Continuant
Material
Information
Bearer CCD XML
SNOMED
(Functional
Classes)
33

34. Complaint
(409586006)
Start Time
(398201009)
Stop Time
(397898000)
Information
Content
Entity
Problem
Observation
<code>
Age Observation
<value>
Problem
Observation <start>
Problem
Observation <stop>
isabout
isabout
isabout
Information
Carrier
“2006-03-22” “2006-04-22"
"409586006“
“Complaint”
Age At Onset
(445518008)
isabout
“29”
Specifically
Dependent
Continuant
Generically
Dependent
Continuant
Material
Information
Bearer CCD XML
SNOMED
(Functional
Classes)
34

35. Complaint
(409586006)
Start Time
(398201009)
Stop Time
(397898000)
age_at_onset
date_low
date_high
type
ProblemSchema
:
coded diagnosis
Information
Content
Entity
Problem
Observation
<code>
Age Observation
<value>
Problem
Observation <start>
Problem
Observation <stop>
isabout
isabout
isabout
Information
Carrier
“2006-03-22” “2006-04-22"
"409586006“
“Complaint”
Age At Onset
(445518008)
isabout
“29”
Specifically
Dependent
Continuant
Generically
Dependent
Continuant
Material
Information
Bearer CCD XML
SNOMED
(Functional
Classes)
35

36. type
Complaint
date_high
2006-04-22
date_low
2006-03-22
Problem:
480.0
Pneumonia due
to adenovirus
Complaint
(409586006)
Start Time
(398201009)
Stop Time
(397898000)
age_at_onset
date_low
date_high
type
ProblemSchema
:
coded diagnosis
Information
Content
Entity
Problem
Observation
<code>
Age Observation
<value>
Problem
Observation <start>
Problem
Observation <stop>
isabout
isabout
isabout
Information
Carrier
“2006-03-22” “2006-04-22"
"409586006“
“Complaint”
Age At Onset
(445518008)
isabout
“29”
Specifically
Dependent
Continuant
Generically
Dependent
Continuant
Material
Information
Bearer CCD XML
age_at_onset
29
SNOMED
(Functional
Classes)
36

37. Information Artifact Ontology (IAO)
//section/templateId /@root="2.16.840.1.113883.10.20.22.2.5.1”
ClinicalDocument/templateId/@root="2.16.840.1.113883.10.20.22.1.2"
//entry/@typeCode="DRIV“
//act/@classCode="ACT“
//@moodCode="EVN“
//templateId/@root="2.16.840.1.113883.10.20.22.4.3
" //code
//effectiveTime
//low
//high
@code
@value
//entryRelationship/@typeCode="SUBJ“
//observation/@classCode="OBS"
//@moodCode="EVN“
//templateId/@root="2.16.840.1.113883.10.20.22.4.4"
@value
@codeSyste
m
//code
@code
@codeSystem
//value @code
@ codeSystem
@type
Information
Content
Entity Information
Carrier
"CONC"
"20070103"
"20070103"
"2.16.840.1.113883.5.6
"409586006"
"2.16.840.1.113883.6.96"
“233604007
”" 2.16.840.1.113883.6.96
“CD”
Concern
Complaint
Problem
List
Pneumonia
//entryRelationship/@typeCode=“SUBJ“
@inversionInd“true"
//observation/@classCode="OBS"
//@moodCode="EVN“
//templateId/@root="2.16.840.1.113883.10.20.22.4.31" //code
@code
@codeSystem
"445518008 "
"2.16.840.1.113883.6.96"
//value @unit
@type
@value
“a”
“PQ
“57”Age at Onset
57 years
Summarization
of Episode
Note
37

38. Concern
Complaint
Resolved
Age at Onset
57 years
Active
Problem List
Asthma
Pneumonia
Status
Alive &
Well
Health
Status
38

39. Concern
Status
Problem
List
Resolved
Age at Onset
57 years
Summarization of
Episode Note
Class with
related value
Class with
embedded attribute
value
Classes can include
classes below them in
the ICE mappingsMetadata Layer
Defines the meaning of
the entryRelationship at
the next highest layer
Contains
entryRelationships with
variable meaning
39

40. Concern
Resolved
Active
Status
Concern
Resolved
Active
Status
Status
enRel
enRel
40

41. Concern
Resolved
Age at Onset
57 yearsActive
Problem List
Asthma
Pneumonia Alive &
Well
StatusComplaint Age Health
Status
StatusComplaint Age Health
Status
Under this scenario, there would no longer be classes or tables for the various LOINC codes
that define the semantics of each <entryRelationship>. They instead become the schema
definition for the <entry> In which they are found.
A schema entry is an IAO
Information Carrier that has
been mapped to a BFO
Generically Dependent
Continuant (GDC).
41

42. Information Artifact
Ontology (IAO)
ClinicalDocument/templateId/@root="2.16.840.1.113883.10.20.22.1.2"
Information
Content
Entity
Information
Carrier
//recordTarget//patientRole
Summarization of
Episode Note
@extension
@root
“MRN1234567”
"2.16.840.1.113883.19.5.2"
//Id
Medical Record
Number (MRN)
(2.16.840.1.113883.19.5.2)
MRN
(398225001)
Patient
Role
Patient-related
Identification code
(422549004)
//section/templateId /@root="2.16.840.1.113883.10.20.22.2.5.1”
Problem
List
Individual
organism
identifier
MRN
CRID
42
Protected

43. “Isabella Jones”
Patient Name
(371484003)
Information
Content
Entity
Information
Carrier
Specifically
Dependent
Continuant
Generically
Dependent
ContinuantrecordTarget
MRN
<id extension>
MRN
(398225001)
SSN
<id extension>
"998991" "111-00-2330"isabout
isabout
Tax ID
(12345654)
patientRole
<name>
Organism
Patient
Role
Continuant
Role
Independent
Continuant
Taxpayer
Role
inheres in
Protected
43

44. “Isabella Jones”
Patient Name
(371484003)
Information
Content
Entity
Information
Carrier
Specifically
Dependent
Continuant
Generically
Dependent
ContinuantrecordTarget
MRN
<id extension>
MRN
(398225001)
SSN
<id extension>
"998991" "111-00-2330"isabout
isabout
Tax ID
(12345654)
patientRole
<name>
Organism
Patient
Role
Continuant
Role
Independent
Continuant
Taxpayer
Role
inheres in
PHI PHI PHI
Protected
44

45. Organism
Patient
Role
Continuant
Role
Independent
Continuant
Biospecimen
derived fromObject
Aggregate
Object
Extended
Organism
inheres in
includes
MRN
(398225001)
Accession
Number
identifies
identifies
extends
Occurrent
Assigning a
centrally
registered Id
Organization
Specimen
Role
inheres
in
participates in
Individual
organism
identifier
Specimen
identifier
Information
Content
Entity
Generically
Dependent
Continuant
MRN
is about
is about
CRID
instantiates
PHI
PHI
Protected
Secure any continuant that identifies something
in which a protected role inheres, or anything
extending or derived from such a continuant.

46. mappingRelation
closeMatch
broadMatch
narrowMatch
relatedMatch
exactMatch
inverseOf
symmetric
symmetric
symmetric
transitive
disjoint
Simple
Knowledge
Organization
System (SKOS)
46

47. LM
L
LMN
XY
closeMatch
1
isA
isA
broadMatch
narrowMatch
Assertion: XY closeMatch1 LM
Known: LM isA L
LMN isA LM
Implied: L narrowMatch XY
LMN broadMatch XY
By inverse rule:
XY broadMatch L
XY narrowMatch LMN
broadMatch
narrowMatch
1 Any ontology edge that has been curated
to closeMatch would have the same
implications.
47

48. LOINC 882-1
“ABO + Rh group,
Blood”
CPT 86901
“Blood typing;
Rh (D)”
CPT 86900
“Blood typing;
ABO”
LOINC 884-7
“ABO + Rh group,
Blood Capillary”
LOINC 34474-7
“ABO + Rh group,
Cord Blood”
CPT to LOINC
48

49. 84.71 ICD-9CM Application of
external fixator device,
monoplanar system
79.21 ICD-9CM
Open reduction
of fracture
without
internal
fixation,
humerus
78.12 ICD-9CM
Application of
external fixator
device,
humerus
0PSD0BZ ICD10PCS
Reposition Left Humeral
Head with Monoplanar
External Fixation Device,
Open Approach
0PSC0BZ ICD10PCS
Reposition Right Humeral
Head with Monoplanar
External Fixation Device,
Open Approach
ICD-9
to ICD-10
49

50. Rosuvastatin
Crestor
Crestor . tradenameOf . Rosuvastatin {broadMatch}
Rosuvastatin . hasTradename . Crestor {narrowMatch}
RxNorm
50

51. Crestor
320864
RxNORM
Crestor Pill
1173053
has_ingredient
ClinicalDrug
Rosuvastatin
301542
OrganicChemical
PharmacologicSubstance
BiologicallyActiveSubstance
Rosuvastatin
calcium
323828
has_form
has_tradename
form_of
precise
_ingredient_of
Rosuvastatin
calcium 5 MG
859423
has_precise
_ingredient
has_ingredient
Rosuvastatin
calcium 5 MG Oral
Tablet 859424
consists_of
consititutes
Rosuvastatin
calcium 5 MG Oral
Tablet [Crestor]
859426
Rosuvastatin
calcium 5 MG
[Crestor]
859423
consists_of
consists_of
has_ingredient
isA
Oral Tablet
has_does_form
has_tradename
has_precise
_ingredient
isA
Crestor Oral
Product
isA
rosuvastatin
Oral Tablet
[Crestor]
isA
The mess!
51

52. Refractory
Migraine
(423894005)
Lower Half
Migraine
(26150009)
Migraine
(37796009)
Vascular
Headache
(128187005)
Headache
Disorder
(340461009)
Headache
(25064002)
has_definitional_manifestation
52

53. Refractory
Migraine
(423894005)
Lower Half
Migraine
(26150009)
Migraine
(37796009)
Vascular
Headache
(128187005)
Headache
Disorder
(340461009)
Headache
(25064002)
has_definitional_manifestation
Headache
(748.0)
Migraine
(346)
Migraine,
unspecified
(346.9)
53

54. Refractory
Migraine
(423894005)
Lower Half
Migraine
(26150009)
Migraine
(37796009)
Vascular
Headache
(128187005)
Headache
Disorder
(340461009)
Headache
(25064002)
has_definitional_manifestation
Migraine
(G43)
Migraine,
unspecified
(G43.9)
Migraine,
unspecified, not
intractable
(G43.909)
Headache
(R51)
Headache
(748.0)
Other migraine
(G43.8)
Lower half
migraine
Cluster
headache
syndrome,
unspecified
(G44.00)
synonymOf
excludes
Migraine
(346)
Migraine,
unspecified
(346.9)
54

55. Refractory
Migraine
(423894005)
Lower Half
Migraine
(26150009)
Migraine
(37796009)
Vascular
Headache
(128187005)
Headache
Disorder
(340461009)
Headache
(25064002)
has_definitional_manifestation
Migraine
(G43)
Migraine,
unspecified
(G43.9)
Migraine,
unspecified, not
intractable
(G43.909)
Headache
(R51)
Headache
(748.0)
Other migraine
(G43.8)
Lower half
migraine
Cluster
headache
syndrome,
unspecified
(G44.00)
synonymOf
excludes
Migraine
(346)
Migraine,
unspecified
(346.9)
55

56. Refractory
Migraine
(423894005)
Lower Half
Migraine
(26150009)
Migraine
(37796009)
Vascular
Headache
(128187005)
Headache
Disorder
(340461009)
Headache
(25064002)
has_definitional_manifestation
Migraine
(G43)
Migraine,
unspecified
(G43.9)
Migraine,
unspecified, not
intractable
(G43.909)
Headache
(R51)
Headache
(748.0)
Other migraine
(G43.8)
Lower half
migraine
Cluster
headache
syndrome,
unspecified
(G44.00)
synonymOf
excludes
Migraine
(346)
Migraine,
unspecified
(346.9)
ICD-10 excludes Lower
Half Migraine from
Migraine, but SNOMED
still includes it.
Have a
migraine?
56

57. Data Warehousing
with Semantic Ontologies
• Inclusion and mapping of BFO, IAO, OBI, and
OGMS ontologies
• Inclusion and mapping of additional domain
ontologies of interest
• Continuous analysis of SKOS consistency and
compliance
• Tailoring of query layer to incorporate governance-
approved semantic mappings and exceptions
57

58. Mapping to STEPS™
http://www.himss.org/ValueSuite
We ended
up here!
We ended
up here!
58

59. Questions
You are welcome to contact me
with questions at any time:
• Richard E. Biehl, Ph.D.
Data-Oriented Quality Solutions
• rbiehl@doqs.com
• LinkedIN: rbiehl
• Twitter: rbiehl
59