The document discusses terminology services in healthcare. It describes how terminology services provide consistent access to healthcare terminologies, enabling semantic interoperability. Terminologies define the meaning of clinical data and help classify and aggregate this data. Healthcare has developed many terminologies for these purposes. Terminology services can be deployed across organizations to facilitate consistent use and interpretation of terminology content.
The Biggest Barriers to Healthcare InteroperabilityHealth Catalyst
Improving healthcare interoperability is a top priority for health systems today. Fundamental problems around improving interoperability include standardization of terminology and normalization of data to those standards. And, the volume of data healthcare IT systems produce exacerbates these problems.
While interoperability regulations focus on trying to make it easy to find and exchange patient data across multiple organizations and HIEs, the legislation’s lack of fine print and aggressive implementation timelines nearly ensures the proliferation of existing interoperability problems. This article discusses the biggest barriers to interoperability, possible solutions to interoperability problems, and why it matters.
The Biggest Barriers to Healthcare InteroperabilityHealth Catalyst
Improving healthcare interoperability is a top priority for health systems today. Fundamental problems around improving interoperability include standardization of terminology and normalization of data to those standards. And, the volume of data healthcare IT systems produce exacerbates these problems.
While interoperability regulations focus on trying to make it easy to find and exchange patient data across multiple organizations and HIEs, the legislation’s lack of fine print and aggressive implementation timelines nearly ensures the proliferation of existing interoperability problems. This article discusses the biggest barriers to interoperability, possible solutions to interoperability problems, and why it matters.
A presentation about the role of informatics standards in facilitating electronic data interchange, and a framework for service-oriented semantic interoperability among data systems.
From Zero to ATO: A Step-by-Step Guide on the DoD Compliance FrameworkAmazon Web Services
Are you a member of the Department of Defense (DoD) and want to simplify the process to cloud deployment? Learn how you can adopt AWS's utility-based cloud services to process, store, and transmit DoD data.
This presentation is a step-by-step guide from AWS on how to navigate the DoD compliance framework. The guide outlines the planning, deployment, accreditation, and continuous monitoring phases to get you to the cloud.
AWS enables military organizations and their business associates to leverage the secure AWS environment through our attainment of a provisional authority to operate (P-ATO) from the Defense Information Systems Agency (DISA).
A brief presentation outlining the concepts of data quality in the context of clinical data, and highlighting the importance of data quality for population health, health analytics, and other secondary uses of clinical data.
A presentation about the role of informatics standards in facilitating electronic data interchange, and a framework for service-oriented semantic interoperability among data systems.
From Zero to ATO: A Step-by-Step Guide on the DoD Compliance FrameworkAmazon Web Services
Are you a member of the Department of Defense (DoD) and want to simplify the process to cloud deployment? Learn how you can adopt AWS's utility-based cloud services to process, store, and transmit DoD data.
This presentation is a step-by-step guide from AWS on how to navigate the DoD compliance framework. The guide outlines the planning, deployment, accreditation, and continuous monitoring phases to get you to the cloud.
AWS enables military organizations and their business associates to leverage the secure AWS environment through our attainment of a provisional authority to operate (P-ATO) from the Defense Information Systems Agency (DISA).
A brief presentation outlining the concepts of data quality in the context of clinical data, and highlighting the importance of data quality for population health, health analytics, and other secondary uses of clinical data.
Presentation to the Canadian Association of University Teachers' Presidents Workshop on January 15, 2012. Overview of university and college finances in Canada for 2012
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Chapter 12 Page 209Discussion Questions 2. How does a d.docxcravennichole326
Chapter 12 Page 209
Discussion Questions
2. How does a data dictionary influence the design and implementation of an EHR? How does the data dictionary enhance and restrict the EHR?
3. In what circumstances might a clinical infrastructure based on either third-party service providers or mobile applications be desirable? What cautions would we place on these technologies in the same circumstances?
Chapter 12 Page 209
Discussion Questions
2. How does a data dictio
nary influence the design and implementation of an EHR? How does the data
dictionary enhance and restrict the EHR?
3. In what circumstances might a clinical infrastructure based on either third
-
party service providers
or mobile applications be desirabl
e? What cautions would we place on these technologies in the same
circumstances?
Chapter 12 Page 209
Discussion Questions
2. How does a data dictionary influence the design and implementation of an EHR? How does the data
dictionary enhance and restrict the EHR?
3. In what circumstances might a clinical infrastructure based on either third-party service providers
or mobile applications be desirable? What cautions would we place on these technologies in the same
circumstances?
Chapter 12 Technical Infrastructure to Support Healthcare
Scott P. Narus
No single off-the-shelf system today can support all needs of the healthcare environment. Therefore it is critical that the technical architecture be capable of supporting multiple system connections and data interoperability.
Objectives
At the completion of this chapter the reader will be prepared to:
1.Describe the key technical components of electronic health records and their interrelationships
2.Define interoperability and its major elements
3.Contrast networking arrangements such as regional health information organizations (RHIOs), health information exchanges (HIEs), and health information organizations (HIOs)
4.Provide information about newer technical models such as cloud computing and application service providers (ASPs)
5.Synthesize current challenges for informatics infrastructure
Key Terms
Application service provider (ASP), 205
Architecture, 197
Clinical data repository (CDR), 198
Cloud computing, 205
Data dictionary, 201
Health information organization (HIO), 204
Infrastructure, 197
Interface engine (IE), 203
Knowledge base, 202
Master person index (MPI), 199
Regional Health Information Organization (RHIO), 204
Service-oriented architecture (SOA), 207
Abstract
This chapter introduces the technical aspects of electronic health records (EHRs) and the current infrastructure components. Complementing the functional components discussed elsewhere, this chapter introduces terms such as clinical data repository, master person index, interface engine, and data dictionary and other technical components necessary for EHRs to function. Recent material about national efforts related to the infrastructure and electroni ...
Healthcare Integration | Opening the Doors to CommunicationBizTalk360
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Abstract. Enhancing the outputs of the Clinical Decision Support systems (CDS) is a permanent concern for many research communities, which have to deal with an abundance of entities, data, structures, methods, application, tools, and so on. In the few past decades, there were theorized and standardized tech- nologies that could help researchers to obtain better results. The paper presents a method to enrich the inputs of the CDS through a semantic integration of sev- eral medical knowledge sources, by using the Topic Maps standard, in order to obtain more refined medical recommendations. Future research directions and challenges are summarized and conclusions are issued.
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology
Pushing the limits of ePRTC: 100ns holdover for 100 daysAdtran
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The IoT and OT threat landscape report has been prepared by the Threat Research Team at Sectrio using data from Sectrio, cyber threat intelligence farming facilities spread across over 85 cities around the world. In addition, Sectrio also runs AI-based advanced threat and payload engagement facilities that serve as sinks to attract and engage sophisticated threat actors, and newer malware including new variants and latent threats that are at an earlier stage of development.
The latest edition of the OT/ICS and IoT security Threat Landscape Report 2024 also covers:
State of global ICS asset and network exposure
Sectoral targets and attacks as well as the cost of ransom
Global APT activity, AI usage, actor and tactic profiles, and implications
Rise in volumes of AI-powered cyberattacks
Major cyber events in 2024
Malware and malicious payload trends
Cyberattack types and targets
Vulnerability exploit attempts on CVEs
Attacks on counties – USA
Expansion of bot farms – how, where, and why
In-depth analysis of the cyber threat landscape across North America, South America, Europe, APAC, and the Middle East
Why are attacks on smart factories rising?
Cyber risk predictions
Axis of attacks – Europe
Systemic attacks in the Middle East
Download the full report from here:
https://sectrio.com/resources/ot-threat-landscape-reports/sectrio-releases-ot-ics-and-iot-security-threat-landscape-report-2024/
Alt. GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using ...James Anderson
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The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
The Art of the Pitch: WordPress Relationships and SalesLaura Byrne
Clients don’t know what they don’t know. What web solutions are right for them? How does WordPress come into the picture? How do you make sure you understand scope and timeline? What do you do if sometime changes?
All these questions and more will be explored as we talk about matching clients’ needs with what your agency offers without pulling teeth or pulling your hair out. Practical tips, and strategies for successful relationship building that leads to closing the deal.
Transcript: Selling digital books in 2024: Insights from industry leaders - T...BookNet Canada
The publishing industry has been selling digital audiobooks and ebooks for over a decade and has found its groove. What’s changed? What has stayed the same? Where do we go from here? Join a group of leading sales peers from across the industry for a conversation about the lessons learned since the popularization of digital books, best practices, digital book supply chain management, and more.
Link to video recording: https://bnctechforum.ca/sessions/selling-digital-books-in-2024-insights-from-industry-leaders/
Presented by BookNet Canada on May 28, 2024, with support from the Department of Canadian Heritage.
PHP Frameworks: I want to break free (IPC Berlin 2024)Ralf Eggert
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This talk is aimed at encouraging a more independent approach to using PHP frameworks, moving towards a more flexible and future-proof approach to PHP development.
Dr. Sean Tan, Head of Data Science, Changi Airport Group
Discover how Changi Airport Group (CAG) leverages graph technologies and generative AI to revolutionize their search capabilities. This session delves into the unique search needs of CAG’s diverse passengers and customers, showcasing how graph data structures enhance the accuracy and relevance of AI-generated search results, mitigating the risk of “hallucinations” and improving the overall customer journey.
Epistemic Interaction - tuning interfaces to provide information for AI supportAlan Dix
Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
As machine learning integrates deeper into human-computer interactions, the concept of epistemic interaction emerges, aiming to refine these interactions to enhance system adaptability. This approach encourages minor, intentional adjustments in user behaviour to enrich the data available for system learning. This paper introduces epistemic interaction within the context of human-system communication, illustrating how deliberate interaction design can improve system understanding and adaptation. Through concrete examples, we demonstrate the potential of epistemic interaction to significantly advance human-computer interaction by leveraging intuitive human communication strategies to inform system design and functionality, offering a novel pathway for enriching user-system engagements.
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
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The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
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In this work, we equipped AFL, a popular fuzzer, with DIAR and examined two critical Linux libraries -- Libxml's xmllint, a tool for parsing xml documents, and Binutil's readelf, an essential debugging and security analysis command-line tool used to display detailed information about ELF (Executable and Linkable Format). Our preliminary results show that AFL+DIAR does not only discover new paths more quickly but also achieves higher coverage overall. This work thus showcases how starting with lean and optimized seeds can lead to faster, more comprehensive fuzzing campaigns -- and DIAR helps you find such seeds.
- These are slides of the talk given at IEEE International Conference on Software Testing Verification and Validation Workshop, ICSTW 2022.
LF Energy Webinar: Electrical Grid Modelling and Simulation Through PowSyBl -...DanBrown980551
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Then welcome to this PowSyBl workshop, hosted by Rte, the French Transmission System Operator (TSO)!
During the webinar, you will discover the PowSyBl ecosystem as well as handle and study an electrical network through an interactive Python notebook.
PowSyBl is an open source project hosted by LF Energy, which offers a comprehensive set of features for electrical grid modelling and simulation. Among other advanced features, PowSyBl provides:
- A fully editable and extendable library for grid component modelling;
- Visualization tools to display your network;
- Grid simulation tools, such as power flows, security analyses (with or without remedial actions) and sensitivity analyses;
The framework is mostly written in Java, with a Python binding so that Python developers can access PowSyBl functionalities as well.
What you will learn during the webinar:
- For beginners: discover PowSyBl's functionalities through a quick general presentation and the notebook, without needing any expert coding skills;
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3. Control of Health Care Costs ...
Improved Quality of Care ...
Improved Health Outcomes ...
Appropriate Use of HealthTechnology...
Compassionate Resource Management...
> ... depend upon information
> … ultimately Patient Data
4.
5. Terminologies (and ontologies, sort of…)
have been around for a long time in the
healthcare domain.
Coding / classification / query is an integral part of
the practice of medicine
Shared electronic records is an emerging need
▪ PMR
Defines the meaning of data
i.e. changes data to information through
instantiation of semantic rules
6. A structured terminology is
composed of concepts along
with synonymous terms,
properties and various
relationships, especially a
taxonomy
Relationships
Taxonomy (is-a)
Partonomy (part-of)
Etiology (caused-by)
Therapy (treated-by)
Position (located-in)
7. Concepts represent unique ideas
Codes uniquely identify concepts
Terms refer to concepts
Typically
Humans communicate concepts using terms
Computers communicate concepts using codes
Concepts are language independent; terms are dependent
8. Humans and computers
select, apply and transform concepts, codes and terms
Across human languages
Across contexts (geographic, medical specialty, etc.)
Across applications
Example scenario
English term entered by clinician
Term is encoded in SNOMED
Code is recorded in Electronic Health Record
Record is retrieved
Record is transmitted to another application in another institution
Code is extracted
Term is requested e.g.,
▪ Spanish term
▪ Consumer term
9. Provide consistent meaning
Promote shared understanding
Facilitate communication with humans
Enable comparison and integration of data
Essential for interoperation among systems,
applications and institutions
Crucial for Electronic Health Record (EHR) sharing
and portability
10. Structured terminologies are needed in
healthcare for
Data integration
Decision support
Clinical guidelines
Medical error reduction
12. WithoutTerminology Standards...
Health Data is non-comparable
Aggregation is difficult if not impossible
Health Systems cannot Interchange Data
Linkage to Decision Support Resources not Possible
13. One of the fundamental goals of computerized
medical information is that of precise, accurate and
unambiguous communication.
Structured terminologies provide the semantics of
the concepts being conveyed in an electronic message
or record (syntax is another discussion altogether).
14. Being able to predictably access terminological
content is still necessary.
Example
Need to receive a SNOMED-CT disorder code, and
▪ Validate the code against the SNOMED-CT vocabulary
▪ Query against properties of the code (determine the grouping or
aggregation of the code, e.g.What type of disorder is this?)
▪ What drugs can be used to treat this disorder
▪ Translate this code for our insurance systems.
Problem
How do we ensure that our operations with vocabulary are
consistent across domains?
15. External terminological resources vary considerably
in both content and structure.
User requirements of terminology differ (real time
decision support, billing applications…)
Storage formats may differ (relational database,
XML, RDF, MIF…)
This is whereTerminology Services comes in.
16. A terminology server is
a (networked) software component
centralizes terminology content access and
reasoning
provides (complete, consistent and effective)
terminology services for other network applications
17. By informaticists
to create, maintain, localize and map
terminologies
By clinical applications and their users
to select and record standardized data
By integration engines
to facilitate mapping terminology elements
between applications
18. The means by which applications (clinical) can
Define the common business functions for
terminology applications
Utilize and interoperate among standard and local
terminologies
Benefit from terminology model “knowledge”
Are provided by terminology server software,
which
Centralize or federate terminology content and
represents it in a consistent format
Communicates with other network applications (e.g.,
to translate and normalize data elements)
19. Provides a common platform for terminology
updates
Provides tools to develop and maintain terminology
content, including mappings that connect concepts in
different terminologies, use-specific subsets, and
local extensions to existing standards.
Implement terminology as an asset of the
organization
20. Term/name normalization:
What is the SNOMED CT name for heart attack?
Myocardial
Infarction
Code translation:
What is the ICD-9 code for Myocardial Infarction?
410.9
Grouping and aggregation:
Is Myocardial Infarction a Cardiac Disease?
Yes
Clinical knowledge:
What drug treats Myocardial Infarction?
Streptokinase
Local information:
Add L227 as the local code for Serum Calcium.
OK
21. YATN: yet another terminology service 1996
Mayo, Kaiser, LexicalTechnology
MetaPhrase – LexicalTechnology 1998
UC Davis JTermTerminolgy service 1998
LQS: Lexicon Query Services; 3M 1998
Apelon DTS
Mayo Autocoder: UI toYATN suite 2000
CTS: CommonTerminology Services 2003
LexGrid: superset CTS, ref. implementation – 04
CTS 2 – DSTU Ballot March 2009
22. An HL7 ANSI Standard interface specification for
querying and accessing terminological content.
The CTS identifies the minimum set of functional
characteristics a terminology resource must possess for
use in HL7.
The functional characteristics are described as a set of
Application Programming Interfaces (APIs) that can
be implemented to suit.
Each terminology developer is free to implement this
API call in whatever way is most appropriate for them
23. Advantages to this functional approach
No need to force a common terminological structure
on terminology developers.
Decouples terminology from the terminology service.
Terminology users can use whatever technology
appropriate for their needs.
▪ Legacy database
▪ Institutional infrastructure
Provides a common interface and reference model for
understanding
▪ I know what you mean by Code System
▪ I know what to expect when I execute the validateCode()
method
24. 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.
25. The MessageAPI
allow a wide variety of
message processing
applications to create,
validate and translate CD-
derived data types
TheVocabularyAPI
allows applications to query
different terminologies
27. Message Creation Software – Software that is involved in the
creation of HL7 messages.
Message Processing Software – Software that receives, decodes
and acts on the content of standard HL7Version 3 messages.This
process may include validation, translation and inferencing steps.
RIM Modelers –The combination of people and tools that create
and define HL7 Message content.
Software Developers –The people who build the software that
creates, validates and processes HL7Version 3 messages.
VocabularyTranslators – A combination of tools and people that
translate the abstract HL7Version 3 specification into the structure
and terms of actual data processing applications.
28.
29.
30. Allows Client Software to be Developed
Independently from Service Server Software
AllowsTerminology Plug-and-Play
Allows Client Plug-and-Play
Defines a “Functional Contract” between
terminology users and providers
31. Purposely limited functional scope:
read only
terminology access APIs for HL7 (much carryover
to other terminologies)
basic terminology mapping
no versioning support
32.
33. Project of the HL7VocabularyWorkgroup
Developed under the Service OrientedArchitectures
(SOA) and Healthcare Service Specification Project
(HSSP) framework
Expand the scope of functionality to include
▪ Administrative functions
▪ Expanded search capability
▪ Mapping functionality
▪ Authoring / Maintenance
▪ Conceptual model for terminology
34. the purpose of an HL7 SFM is to identify and document the
functional requirements of services considered important to
healthcare.
Accordingly, the CTS 2 service provides a critical component
within the larger context of service specifications in that it
defines
The expected behaviors of a terminology service
A standardized method of accessing terminology content.
35. The major goal of the CTS 2 specification stack is to
provide a standardized interface for the usage and
management of terminologies.
CTS 2 defines the functional requirements of a set of
service interfaces to allow the representation, access,
and maintenance of terminology content either locally,
or across a federation of terminology service nodes.
36. Establish the minimal common structural model for
terminology behavior independent from any specific
terminology implementation
Integrate into CTS 2 the functional coverage outlined in the
existing CTS specification.
Specify both an information and functional model that
addresses the relationships and use of terminology.
Specify the interactions between terminology providers and
consumers
37. Specify how mapping between compatible terminologies
and data models is defined, exchanged and revised.
Specify how logic-based terminologies can be queried about
sub-sumption and inferred relationships.
Engage broad community participation to describe the
dimensions of use and purpose for vocabularies and value
sets.
39. Set of functionality that provides the ability to manage
content
ability to load terminologies
export terminologies
management of notifications
Accessible by service administrators
40. Set of functionality that provides the ability to find concepts
based on some search criteria.
Includes:
capabilities for searching.
querying terminology content .
representing terminology content in the appropriate
formats.
41. Set of functionality that provides the ability to create
and maintain content.
This would include the appropriateAPIs to add, change,
or delete concepts and associations.
42. Set of functionality that provides the ability to map
concepts and the concept's associated attributes
from a source terminology to a concept in a target
terminology.
OR
Create relationships between concepts within a
single code system.
43. Enables a service to be used at different levels,
and allow implementers to provide different levels
of capabilities in differing contexts.
Service-to-service interoperability will be judged
at the profile level and not the service level.
A set of profiles may be defined that cover specific
functions, semantic information and overall
conformance.
44. Specifies the minimal functional coverage necessary for
a service to declare itself as being a conformant CTS 2
service.
Includes capabilities for
searching and query terminology content
representing terminology content in interoperable data
types and structuring terminology content.
45. Provides the functional operations necessary for
terminology administrators to be able to access and
make available terminology content obtained from a
Terminology Provider.
Terminology Administrators are required to interface
withTerminology Provider systems in order to:
obtain the terminology content, then load that
terminology content on localTerminology Servers.
46. Terminology authors require the capability to robustly
query and access terminology content, as well as directly
modify the terminology content.
Intended to provide the functional operations necessary
for terminology authors to analyze and directly edit the
existing terminology content.
50. Problems:
Controlled terminologies are developed with specific
purposes and use cases in mind, and as such are
structured very differently.
The format of any given terminology may range from
a simple flat list of concepts, to more complex poly-
hierarchies. The variety of attributes of the entities of
code systems vary as well.
Even the formats of the identifiers are different
Some concept identifiers being meaningless identifiers,
Others which have explicit or implied meaning.
51. CTS 2 specifies a concept based terminology model
that is capable of representing most varieties of
structured terminologies.
Basic requirements of the CTS 2 terminology model
are illustrated in the CTS 2 Conceptual Model
52.
53. CodeSystem
a resource that makes assertions about a collection of
terminological entities.
described by a collection of uniquely identifiable concepts with
associated, representations, designations, associations, and
meanings
ICD-9 CM, SNOMED CT, LOINC, and CPT
CodeSystemVersion
Generally not static entities and change over time
Enables identification of the versions of the code system
CodeSystemConcept
A Code System Concept defines a unitary representation of a real
or abstract thing within the context of a specific Code System; an
atomic unit of thought.
54. CodeSystemNode:
Represents an individual "node" within a Code System, which is
either a Code System Concept or a Code System Concept Code
CodeSystemConceptCode:
defines a single "code value" that is used to represent
(symbolize) a Code system Concept
There may be more than one Code for a single concept in a
single code system
AssociationType:
In the terminology model, allowable relationship types are
represented by the AssociationType class.
Enables identification of the versions of the code system
55. Designation :
Concept designations are representations of concepts
For example, in SNOMED CT the concept of “fever” has:
▪ the fully specified name of “fever (finding),”
▪ A preferred name of “fever,”
▪ synonyms of “febrile” and “pyrexia.”
These are all designations for the concept of “fever.”
Value Set :
Represents a uniquely identifiable set of concept codes grouped
for a specific purpose.
May range from a simple flat list of concept codes drawn from a
single code system, to an unbounded hierarchical set of possibly
post-coordinated expressions drawn from multiple code systems.
56.
57. Based on the discussed terminology service
criteria, define high level business scenarios
that:
Cover the existing CTS functional capabilities
Extend the CTS functionality into other domains
▪ Administrative functions
▪ Expanded search capability
▪ Mapping functionality
▪ Authoring / Maintenance
58. CTS-1 deliberately avoided issues related to
terminology distribution, versioning and authoring.
CTS-1 focused on static value sets and didn’t fully
address the definition or resolution of value sets that
define post-coordinated expressions.
CTS-1 fails to address many of the maintenance,
versioning and representation requirements
necessary for a truly interoperable terminology
service.
59. CTS-1 was deliberately silent on how the vocabulary
content should be structured.
CTS-2 will enhance the capabilities of the original CTS
specification for sub-setting, mapping and extending
the specification into domains such as terminology
distribution, authoring, and versioning.
60. Terminologies play a crucial role in enabling
semantic interoperability by defining the
meaning of data being communicates
Healthcare has been a leader in the
development of terminologies for use in
classifying and aggregating clinical data.
Terminology Services can be deployed to
provide consistent access to terminology
resources across organizations
Editor's Notes
Instead of specifying what an external terminology must look like, HL7 has chosen to identify the common functional characteristics that an external terminology must be able to provide.the CTS specification describes an Application Programming Interface (API) call that takes a resource identifier and concept code as input and returns a true/false value
There are two distinct layers between HL7 Version 3 message processing applications and the target vocabularies. The upper layer, the Message API, communicates with the messaging software, and does so in terms of vocabulary domains, contexts, value sets, coded attributes and other artifacts of the HL7 message model. The lower layer, the Vocabulary API, communicates with the terminology service software, and does so in terms of code systems, concept codes, designations, relationships and other terminology specific entities.
Message Runtime Service fill out the details of a CD-derived attribute. The service, in turn, makes multiple calls to the Vocabulary API service in order to get concept code designations, code system names, release versions, etc.
Each Service’s Functional Model defines the interfaces that the service exposes to its environment, and the service’s dependencies on services provided by other components in its environmentThe manner in which services and interfaces are deployed, discovered, and so forth is outside the scope of the Functional Model
Collection of similar service under one profile
CTS 2 is an interface specification, not an implementation specification. As such, it is intended to facilitate the development of an implementable interoperability mechanism for terminology resources
CTS2 provides for terminology interoperability between organizations. While coded concepts from structuredterminology can unambiguously identify the concept(s) being communicated, a standard way of structuring and communicating those coded entries is required.CTS 2 can be used in an inter-organizational setting where each organization maintains its own security and application specific provisions. CTS 2 will enable consistent access to a high availability or international standard terminology resource, made available to subscribers via a CTS 2 interface.
CTS 2 Conceptual Model describes a logical (analysis level) model with the intent that most - if not all - key attributes that affect terminology behavior have been describedIt is the intent of this model to support both well behaved and more arbitrarily defined code systems.
Code Systems, Concepts and Value Sets have specific version classesAdditionally curation has been supported explicitly byinclusion of a number of classes that permit the versioning of key terminology entitiesIt is a conceptual model derived from business requirements, and as such is rather meant to reflect these requirements and not intended to explicitly provide implementation level detail.Technical specifications must define minimum explicit state models for the purposes of interoperabilityThebasic “default” minimum assumption is that the concept of “active” and “inactive” states is covered, wherebyinactive instances would not show up in normal searchesSeveral classes in the model include an attribute for provenance information, named "provenanceDetails".Technical Specs should include such information as:author, copyright, generation type, source and source type, approval information, whether it is modifiable, and so on.
At a minimum, Code Systems have the following attributes:• An identifier (id) that uniquely identified the Code System. In HL7, this ID is in the form of an ISO OID.• A description (description) that describes the Code System. This may include the code system uses and intent.• Administrative information (administrativeInfo) which is a placeholder to allow for additional information relating to the overall Code System, that is separate from any specific version of the Code System.
AssociationType:It is not a part of a code system, but a separate entity which is used to further characterize associationsAn example for an association type is “subsumption association”.
AssociationType:It is not a part of a code system, but a separate entity which is used to further characterize associationsAn example for an association type is “subsumption association”.
CTS 2 Service: The CTS 2 Service is a specific implementation of the CTS 2 Terminology ServerTerminology User: Subject matter expert, terminologist or terminology enabled application.Terminology Administrator: an actor responsible for ensuring the availability and overall maintenance of the terminology server.Terminology Enabled Application Developer: an actor who is responsible for the development of software applications that make explicit use of controlled terminologiesTerminology Author / Curator:an actor who is responsible maintaining terminology content, including but not limited to, the development of new concepts and associations that may be submitted to the Terminology Provider or the extension of an existing terminology with local conceptsTerminology Human Language Translator: an actor with domain knowledge who is also familiar with the languages and dialects which they are responsible for translatingTerminology Mapper: an actor (human or system) that is responsible for creating or maintaining specialized associations, or "mappings" between concepts from different code systems.Terminology Provider: the individuals or organization that is responsible for the development of Terminology Content.Terminology Value Set Developer:an actor with specific domain knowledge, as well as expertise in controlled terminologies who develop s and maintains domain-or application-specific terminology value sets
HL7 CTS-1 standard serves an important role in defining the common functional characteristics that a terminology service must be able to provide.
HL7 CTS-1 standard serves an important role in defining the common functional characteristics that a terminology service must be able to provide. CTS2 provides the terminology community with a defined set of standards interfaces that can be used to evaluate terminology source structure, terminology source content, and terminology tools.