servicios terminológicos

Terminology Service

Jussara Rötzsch

Based on: Ian McNicoll

Christopher Chute

What do we need?

Information Models

An EHR that is• Independent of implementation technology• Independent of clinical system developer• Enables access to multiple clinical applications• Designed for longevity and re-use

Content Specifications

Terminology

Query

Messaging

March, 2009 3© 2002‐2009, Health Level

Seven, Inc.

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,

...)

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 reliably

1.4


Seven, Inc.

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


Seven, Inc.

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”


Seven, Inc.

CTS API

Application

Service

Interface

Data

CTS

. . .


Seven, Inc.

CTS API

CTS

MS AccessTables

Application

Service

Interface

Data

HL7VocabBrowser

HL7 Terminology

Server

Find codes having “*myelitis”

Select * from VOC_concept_designationWHERE text like ‘%myelitis’


Seven, Inc.

CTS API –

Different Client, Same Service

IHC

Picklist

Tool

MS AccessTables

Application

Service

Interface

Data

HL7 Terminology

Server

Find codes having “*icillin”

Select * from VOC_concept_designationWHERE text like ‘%icillin’

CTS


Seven, Inc.

CTS API –

Different Server, Same Client

IHC

Picklist

Tool

SNOMEDCT

OracleTables

Application

Service

Interface

Data

APELONDTS


Select * from conc_reprWHERE text like ‘%icillin’

AND ...

CTS


Seven, Inc.

CTS API –

Distributed Services

IHC

Picklist

Tool

Internet Service

Application

Service

Interface

Data


<msg><soap....><filter=“*icillin”...</msg>

CTS

WebPortal


Seven, Inc.

Common Terminology Services

Message Processing ApplicationMessage Processing Application

VocabularyVocabularyVocabulary

Message Processing Application

Message API

Vocabulary API

OpenEHR (Ocean)Terminology Server

MultipleLanguages &

subsets

Maintenance

Use cases

Terminology Server

SNOMED-CT UKextensionEnglish

Ocean TerminologyServer

• Stores named queries• Caches complex queries• Caches saved between

sessions

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

Blood groups – raw views

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

ABO Blood Groups 3‐layer tree

• The hierarchy of ABO blood groups

Navigate

Select

Terminology Query language• <?xml version="1.0" encoding="utf‐8" ?>• <ots:query • xmlns:ots="urn:xmlns:oceaninformatics.biz:schema:OTSQuerySchemav2"• name="BloodTypev2"• language="en‐us" • terminology="Snomed" • cacheMode="Permanent">• <childNodes>• <concept conceptId="112143006"• operation="Navigate">• <childNodes>• <relatedConcept operation="Navigate"• relationship="116680003">• <childNodes>• <relatedConcept operation="Select"• relationship="116680003">• </relatedConcept>• </childNodes>• </relatedConcept>• </childNodes>• </concept>• </childNodes>• </ots:query>

Start at ABO blood group

Iterate down the IS_A relationship

Make all nodes with an IS_A relationshipselectable

Set root to Navigate

ABO Blood Groups 3‐layer tree restructured

Placeholder

Navigate

Select

Placeholder

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"• name="BloodTypev2"• language="en‐us" • terminology="Snomed" • cacheMode="Permanent">• <childNodes>• <placeHolder text="Blood Types">• <childNodes>• <concept conceptId="112143006"• operation="Passthrough">• <childNodes>• <relatedConcept operation="Navigate"• relationship="116680003">• <childNodes>• <placeHolder text="Rh subtypes">• <childNodes>• <relatedConcept operation="Select"• relationship="116680003">• <constraints>• <lexicalConstraints>• <lexicalConstraint matchRule="MustMatch">• <searchString>*Rh*</searchString>• </lexicalConstraint>• </lexicalConstraints>• </constraints>• </relatedConcept>

Placeholder

Navigate

Placeholder

Select

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

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

Q&A

[email protected]

servicios terminológicos

Health & Medicine