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Optimizing Medication Use through Health Information Technology
Published in Salvatore Volpe, Health Informatics, 2022
Troy Trygstad, Mary Ann Kliethermes, Anne L. Burns, Mary Roth McClurg, Marie Smith, John Easter
The Unified Medical Language System (UMLS) is sponsored by the National Library of Medicine (NLM) and has focused its efforts of late on enabling interoperability between often disparate proprietary and non-proprietary classification systems embedded within electronic medical and other health records systems. In addition to classifying diseases and procedures, relationships are defined between terms to create ontological structures. The Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), maintained by the International Health Terminology Standards Development Organization (IHTSDO), and RxNorm, produced by the (NLM) itself, are probably the most well-known and widely used ontologies in the US healthcare system, with the latter being used to classify pharmaceuticals to aid interoperable functions such as electronic prescribing and computerized physician order entry systems.
Opportunities and Challenges for Digital Health Advancement
Published in Connie White Delaney, Charlotte A. Weaver, Joyce Sensmeier, Lisiane Pruinelli, Patrick Weber, Deborah Trautman, Kedar Mate, Howard Catton, Nursing and Informatics for the 21st Century – Embracing a Digital World, 3rd Edition, Book 1, 2022
Gillian Strudwick, Sanaz Riahi, Nicholas R. Hardiker
Nurse researchers were quick to recognize the potential of more contemporary approaches to terminology development. The International Classification for Nursing Practice (ICNP) (Coenen, 2003), a product of the International Council of Nurses, was perhaps the first terminology for nursing to deploy description logic in its development. Description logics are formal knowledge representation languages that are used to describe and reason on concepts or entities within a particular domain (Meditskos et al., 2017), in this case, nursing practice. Since its first release version, ICNP has been underpinned by the de facto description logic standard, Web Ontology Language (OWL). A similar approach has been taken more recently by Systematized Nomenclature of Human and Veterinary Medicine SNOMED International, to support the development of SNOMED Clinical Terms CT (SNOMED CT, 2020), a more comprehensive multidisciplinary terminology for health and social care (the World Health Organization (WHO), has also deployed OWL to support the development of the foundation for the 11th revision of the International Classification of Diseases (ICD 11) (ICD-11, 2019)).
Healthcare Data Organization
Published in Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam, Introduction to Computational Health Informatics, 2019
Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam
SNOMED CT consists of a coding scheme, classifications and terminologies: 1) reference terminology relating to other concepts and 2) interface terminology for the ease of information entry and display. The coding scheme includes: 1) a simple abbreviation of a clinical term; 2) an identity code of the term and 3) simple, concise and consistent meaning of the abbreviation. It allows for: 1) retrieval of information related to the specific or related code using a structured relationship between the concepts; 2) aggregation of information based upon specific requirements; 3) alternative user-friendly synonymous ways of expressing the same term and 4) support for different language groups, clinical disciplines and specialties. It supports multiple dictionaries to express the meaning and synonyms.
Characteristics of patients with major depressive disorder switching SSRI/SNRI therapy compared with those augmenting with an atypical antipsychotic in a real-world setting
Published in Current Medical Research and Opinion, 2021
David M. Kern, M. Soledad Cepeda, Ruby C. Castilla-Puentes, Adam Savitz, Mila Etropolski
Patient demographics (age and gender) were captured on the index date. Comorbid conditions, psychiatric symptoms and the Charlson Comorbid Index15 were captured during the one-year pre-index period, which included the index date. One diagnosis code for the comorbidity of interest was required during this time frame. Comorbidities were defined according to the Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) classification system, which maps various diagnostic languages, including ICD-9-CM and ICD-10-CM, to a single standardized set of concepts. Medication use in the one-year pre-index period, not including the index date, was captured according to the RxNorm ingredient and for specific treatment classes of interest (anxiolytics, hypnotics/sedatives, anticonvulsants, stimulants, lithium). Additionally, the type of SSRI/SNRI filled during the 90 days prior to the index treatment change was captured and compared between cohorts.
Pan-Canadian asthma and COPD standards for electronic health records: A Canadian Thoracic Society Expert Working Group Report
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2018
M. Diane Lougheed, Ann Taite, Julia ten Hove, Alison Morra, Anne Van Dam, Francine M. Ducharme, Madonna Ferrone, Andrea Gershon, Donna Goodridge, Brian Graham, Samir Gupta, Christopher Licskai, Ana MacPherson, Gemma Styling, Itamar E. Tamari, Teresa To
Although terminology/nomenclature was initially deemed beyond the scope of this initiative, we have collaborated with data standard experts from Canada Health Infoway and eHealth Ontario, to augment earlier ACM cross-referencing work and identified PRESTINE data elements for which existing SNOMED© and/or LOINC© standards exist.9 While post-coordination in SNOMED© (a compositional process that combines two or more concepts to provide clarity and explicitly to clinical data) can improve mapping results, it relies on adherence to descriptive logic rules that are complex and not intuitive.9 As such, we did not attempt it but plan to collaborate with experts from Canada Health Infoway in the future to examine the use of pre- and post-coordination, as well as alignment with other health terminologies. Furthermore, through Canada Health Infoway, we will request new concepts and changes to SNOMED CT© Canadian Edition and LOINC© for core data elements not matched.
Use of SNOMED CT® and LOINC® to standardize terminology for primary care asthma electronic health records
Published in Journal of Asthma, 2018
M. Diane Lougheed, Nicola. J. Thomas, Nastasia. V. Wasilewski, Alison. H. Morra, Janice. P. Minard
Two of the reference terminology standards that have emerged as “gold standards” are: Systematized Nomenclature of Medicine-Clinical Terms (now known as SNOMED CT®) and Logistical Observation Identifier Names and Codes (LOINC®). SNOMED CT® is a controlled licensed medical terminology providing a common language supporting clinical documentation and analysis. SNOMED CT® is owned and maintained by SNOMED International, a not-for-profit organization. It is endorsed as the clinical terminology standard by the United States, Canada, the United Kingdom, Australia, and New Zealand and is in use in over 50 countries around the world [6]. Updated every 6 months, the current version contains 321.901 active concepts, each representing a single clinical thought. Concepts are arranged in hierarchical order from the more general to the more granular. Descriptive synonyms attached to the concept offer alternative ways of capturing the same meaning, enabling users the ability to search and record clinical information in a variety of ways while representing a common meaning. Attribute relationships join concepts that are related in meaning, providing a richer array of compositional ability [6].