3M Health Information Systems
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1 3M Health Information Systems 1
2 Data Governance Disparate Systems Interoperability Information Exchange Reporting Public Health Quality Metrics Research Data Warehousing Data Standards
3 What is the 3M Healthcare Data Dictionary? Relationships Is A Has Child Concept Varicella Representation VZV HZV Context 3M CPT-4
4 What is the 3M Healthcare Data Dictionary? Controlled Medical Vocabulary Collection of clinical concepts Knowledge Base Relationships among concepts Medical Information Model Establishes clinical context Alerts Decision Support Medical Information Model Analytics Knowledge Base (Semantic Network) Lab, Rx, Radiology, Dental, Demographics, etc. 2.6 million concepts 17.9 million representations 15.9 million relationships Controlled Medical Vocabulary (Medical Concepts)
5 Controlled Medical Vocabulary A collection of medical concepts, organized to support synonyms and other lexical characteristics concept: a unique, definable idea or object that has a very specific, known meaning Glucose GLC GLUC Chloride Lab Test Chem 4 Potassium Sodium Lab Result
6 Concept-based Concept Representation Concept Domain Concept Definition a sensory perception I m feeling cold a pulmonary diagnosis COLD Chronic Obstructive Lung Disease an upper respiratory viral infection I have a cold Concept ID
7 Concept-based Semantic Network Lab Test Chem 4 Sodium Lab, Rx, Radiology, Dental, Demographics, etc. Potassium 2.6 million concepts 17.9 Chloride million representations 15.9 million relationships Glucose Lab Result A collection of medical concepts, organized to support synonyms and other lexical characteristics Concept: a unique, definable idea or object that has a very specific, known meaning
8 Knowledge Base / Relationships Chem 4 Sodium Potassium Chloride Glucose Lab Result Lab Test is-component-of is-a
9 Standards Supported by HDD UMLS LOINC NDC RxNorm ICD-9-CM ICD-10-CM ICD-10-PCS DRG APC APDRG CPT HCFA HCPCS CDT SNOMED CT HL7 OMB Race/Ethnicity Standards Commercial Interface Terminologies Provider Taxonomy Revenue Codes
10 Recent Additions HL7 CVX GEMs Kaiser Permanente CMT
11 Concept Mapping Defined Process of building links among concepts to integrate various vocabularies Context: the purpose of the map Are these drugs being mapped for inventory, allergens, or as clinical drugs? Matching technologies/tools/process to avoid duplicate concepts and increase consistency and efficiency String comparison mapping and semantic mapping Requires subject matter expertise Herpesvirus 3, Human C (UMLS ID) 3M HDD Healthcare Data Dictionary Concept Mapping SMEs, Expert Tools Chickenpox Virus Display 1 Varicella-zoster Virus (3M HDD ID) Herpes-zoster Virus Display 2 VZV 243 = Ft Hood Lab Interface Context
12 HDD Mapping Result Rosetta Stone Manages ongoing updates from standard terminologies as well as local additions and changes from health care facilities Translates/transforms an enterprise s data to standards such as LOINC, so it can be interpreted by all other systems using standards Moves Syntactic Interoperability to the level of Semantic Interoperability and enables Meaningful Use Epic Interface Code M Short Name PT LOINC Code HDD ID Protime Concept 3M HDD ID M Long Name Protime Siemens Interface Code
13 Exchanging Standard Codes Two Implementation Strategies Encode with the identifiers of standard terminologies Encode with internal identifiers, translate to standard codes for external exchange **HDD *CDR *CDR Internal code: Patient: Patient: 8989 John Doe John Doe LOINC : Lab Result: Lab Result: *CDR=Clinical Data Repository **HDD=Healthcare Data Dictionary
14 Point-to-Point vs. Centralized Mapping Epic LOINC Epic LOINC Cerner SNOMED Siemens n( n 1) 2 maps SNOMED VS. Cerner HDD HIE HIE Siemens EDW Crimson EDW Crimson RxNorm RxNorm Point-to-Point Mapping for 9 sources = n(n-1)/2 = 36 maps Adding 1 more source adds 9 maps Challenge is not only in the creation, but the maintenance all of these mappings Mapping to a terminology server for 9 sources = n = 9 maps Adding 1 source adds 1 map Centralized maintenance and distribution of content
15 If a Mapping Changes... Epic LOINC Epic LOINC Cerner SNOMED Siemens SNOMED VS. Cerner HDD HIE HIE Siemens EDW Crimson EDW Crimson RxNorm RxNorm Point-to-point mapping is difficult to maintain: 102 sites 5151 fixes Centralized mapping is simple to maintain: 1 fix
16 Architecture Example: Longitudinal Data Repository Interface Engine Presentation Layer 3M All rights reserved. 3M CONFIDENTIAL DO NOT DISTRIBUTE
17 HDD Translation Tool 1 ICD-10 codes from source systems Proven workflow: GEMs w/ references Code analyzer Definition of purpose built maps 2 ICD- ICD-9 10 Clinical Application 1 Purpose Built Maps 3 3 Healthcare Data Dictionary Custom ICD-10 Application Map 5 ICD- ICD-9 10 ICD- ICD-9 10 Financial Application Data Source Data Source Semantic Interoperability Meta data storage Storage or access to all clinical and coded data ICD- ICD-9 10 Ancillary Application Data Repository Data Source 4 ICD-10 codes from source systems ICD- ICD-9 10 Analytics/Reporting
18 Customer Use Case Epic Eclipsys 3M HDD N C I D s EDW
19 Meaningful Use Code Set MU Objective Currently in Stage 2 Stage 2 requirements include eight standards. Quality measure reporting requirements specify the use of Standard terminologies. 3M HDD facilitates the initial mapping and ongoing maintenance. ISO Language Codes Demographics OMB Race and Ethnicity Demographics ICD-10-CM Problem List Clinical Summaries SNOMED CT Problem List Allergies LOINC Lab Test Results Vital Signs Smoking Status RxNorm Medications CVX - Immunizations Clinical Summaries HL7 Pedigree Family Health History
20 HL7 CTS HL7 CTS App Server (3M) EHR & other Applications CDR 3M HDD Interface & Messaging Engines EDW HL7 CTS compliance enables various applications to easily and transparently access a Terminology Server without knowing its internal architecture. 3M HDD supports HL7 CTS v1.2, and can be deployed as a blackbox implementation.
21 HDD Access Open Source version of HDD Differences between HDD Access and Commercial HDD Timeline for release 21
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