18-09-2015 pag. 1

Mapping of Terminology Standards, a Way for

Interoperability

Position Paper

Sven Van Laere, Frank Verbeke, Frederik Questier,

Ronald Buyl, Marc Nyssen

18 Sept 2015

@ ICTRS, EHST 2015 – Rhodes, Greece

22-9-2015 pag. 2

Location

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Location

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Location

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Explanation

Mapping of Terminology Standards, a Way for

Interoperability

Position Paper

Mapping of Terminology Standards, a Way for

Interoperability

Position Paper

Mapping of Terminology Standards, a Way for

Interoperability

Position Paper

Mapping of Terminology Standards, a Way for

Interoperability

Position Paper

22-9-2015 pag. 6

Position Paper

• Position paper

• Present an arguable opinion about an issue• eHealth, knowledge sharing, …

• State an opinion without the need to present validatedresults• Short report and discussion of ideas

• Facts

• Situations

• Methods

• Procedures

• Results of scientific research

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Terminology standards

• Standards in medical practice

– Exchange of informationCOMMUNICATION STANDARDS

– Documenting and coding of dataTERMINOLOGY STANDARDS

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Interoperability

• Interoperability

Antonio Aguilar

A state which exists between two applicationentities when, with regard to a specific task, oneapplication entity can accept and understanddata from the other and perform that task in anappropriate and satisfactory manner withoutthe need for extra operator intervention.

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Interoperability

• Interoperability in eHealth

Antonio Aguilar

for whom?

- healthcare companiese.g. vendors of clinical systems, administrative IT systems and medical devices

- healthcare providerse.g. GPs, physicians, nurses, technicians, etc.

- IT and administrative staff

- health authorities and governments

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Interoperability

• Interoperability levels

Antonio Aguilar

- functional and syntactic interoperabilitythe ability of two or more systems to exchange information through functionality and defined message structures so that this information is human readable by the receivers

e.g. HL7 v2, DICOM

- semantic interoperabilitythe ability for information shared by systems to be understood at the level of formally defined domain concepts so that the information is computer processable by the receiving systems

e.g. HL7 v3 RIM, SNOMED CT

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Terminology standards

• Interoperability levels

Antonio Aguilar

- functional and syntactic interoperabilitythe ability of two or more systems to exchange information through functionality and defined message structures so that this information is human readable by the receivers

e.g. HL7 v2, DICOM

- semantic interoperability *the ability for information shared by systems to be understood at the level of formally defined domain concepts so that the information is computer processable by the receiving systems

e.g. HL7 v3 RIM, SNOMED CT

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Motivation

• Motivation

–Healthcare with too many standards• ICPC-2

• ICD

• LOINC

–Different levels• ICPC-2 used by GP

• ICD used for billing

• LOINC used for laboratory results

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Motivation

• Motivation

–In the medical history we evolved fromfree text (60-ies) to structured language• Free text

• Codes

• Classifications

• Terminologies

• Nomenclatures de Lusignan

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Motivation

• Motivation

–No continuity in healthcare

1

2

Referral

3

4

GP

Hospital

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Start to invest in putting a bridge between

different terminologies

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Mapping

• How to…

• MappingA linkage between a concept from one standard to another standard based on the equivalence between the two concepts

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Mapping

• How to…

• Mapping rules

• Consider the place in the hierarchy of a terminology standard

• Consider the semantics of a concept

• Consider the relationship with other concepts around a concept

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Mapping

• How to…

• Manual mapping

human knowledge of medical experts, linguists, terminology experts, …

• Semi-automatic mapping

• Computer algorithm identifies candidatemappings based on descriptions

• Human review of the automatic mapping

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Variety of standards

• We know…

• The principles of mapping now

• But…

• How do we deal with the wide variety of standards (ICPC-2, ICD-10, LOINC, NANDA, SNOMED CT,…)

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Variety of standards

𝑁 ∙ (𝑁 − 1)

2𝑁

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What RT to choose?

• Choose most comprehensive• SNOMED CT

• 310,000 concepts

• Support pre- and post-coordination

• Still under evaluation

• Assess-CT project

http://www.assess-ct.eu/

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What RT to choose?

•Another option• UMLS

• However some semantic differences…

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What RT to choose?

•Another option•UMLS semantic problems compared to

SNOMED CT• Substance/product

• Aspirin (substance)

• Aspirin (product)

• Morphologic abnormality / clinical finding• Glomus tumor (morphologic abnormality)

• Glomus tumor (disorder)

• … https://www.nlm.nih.gov/research/umls/Snomed/snomed_represented.html

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New ideas

• Is this idea of mapping new?NO

• Then what is new?• The idea of using one single reference

terminology• The idea that we should start mapping to one

single reference terminology• Reference terminologies can lead to (semantic)

interoperability between care providers• … leading to CDS eventually

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Message to take home

•Start contributing to mappings

•Start using a referenceterminology

•Don’t wait until another starts

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References

• Aguilar, A. 2005. Semantic Interoperability in the Context of e-Health. In CDH Seminar ’05, Galway, Ireland.

• ASSESS-CT. 2015. ASSESS CT - Assessing SNOMED CT for Large Scale eHealth Deployments in the EU. Available from: http://www.assess-ct.eu

• de Lusignan, S. 2005. Codes, classifications, terminologies and nomenclatures: definition, development and application in practice. Informatics in Primary Care, 13(1), 65-70.

• IHTSDO. 2014. Mapping to SNOMED CT. Discussion and Guidance on Mapping Based Solutions Design for Migration or Transformation. Available from: https://csfe.aceworkspace.net/sf/go/doc10065

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