Health Language Blog

Pillars of an Enterprise Terminology Management Platform

Posted on 01/09/15

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Enterprise Terminology Management is an umbrella term that covers a range of technologies and services that aim to achieve a common goal: help healthcare organizations overcome the interoperability issues associated with multiple, incompatible medical terminologies.

Healthcare IT systems have proliferated in recent years. But as more systems are deployed to improve patient outcomes and boost operational efficiencies, it has become increasingly important for the various systems to communicate with each other. Unfortunately, health data resides in various, typically isolated systems scattered across the healthcare community.

Those systems often use different terminology content sets. The resulting fragmentation hinders communication among systems and makes it difficult for healthcare organizations to create a comprehensive view of clinical data.  

An enterprise terminology management platform can be deployed to address the interoperability gap among healthcare applications. Here are the four pillars -- the must-have features -- of such a platform.

1. Content Database

Platform buyers should consider the quality of a solution’s content database, which represents the core of an enterprise terminology management platform. The content database, also called a terminology database, provides a comprehensive set of standard and enhanced terminologies, maps, code groups or value sets, and synonym libraries. Together, those components help organizations address healthcare IT’s toughest challenges.

A content database should include all relevant standard terminologies such as ICD-9, ICD-10, SNOMED CT®, RxNorm, LOINC® and CPT®. Health Language’s terminology database, for example, includes more than 200 standard and enhanced terminologies. The database should also provide translation maps that harness clinical terminologies to work together in harmony, regardless of differing purposes or differing concept representations. Multilateral maps between various terminology code sets -- ICD-9/ICD-10 to SNOMED CT and ICD-9/ICD-10 to CPT, for instance -- enable workflows and analytics based on a common semantic meaning irrespective of the underlying terminology.

In addition, a content database should also house code groups representing clinical concepts such as myocardial infarction. Such a feature supports the management of business rules such as quality measures, benefit policies and population health cohorts, regardless of the underlying terminology represented in client data models. Another important element: a comprehensive library of provider and consumer-friendly clinical terms and their mappings to terminology standards (sometimes referred to as Interface Terminologies). The library and mappings enable search workflows, bridging gaps between the language clinicians use to create problem lists and consumer-driven healthcare.

2. Content Management Infrastructure

Infrastructure is the next pillar of enterprise terminology management. Content Management interfaces enable users to perform tasks such as acquiring standards bodies updates, importing content, and exporting content. Here, the focus is on allowing organizations to standardize all clinical content on a single platform by automating the task of incorporating standard, localized, and enhanced clinical terminologies into healthcare software application so that the availability of the most accurate and up-to-date content can be assured.

3. Integration

An integration layer is needed to enable runtime access to a range of clinical terminology services, including searching, accessing, uploading, downloading, mapping and modeling. This layer should provide an integration model that exposes the lexicon object model to clients through plain old java objects (POJOs), .NET objects, Enterprise JavaBeans (EJBs) and Web Services using standard Internet technologies such as HTTP and XML.

Other features to note include an administration console with tools to manage run-time services and complete API documentation. The integration layer should be accessible through an application server or embedded in client applications. Functionality such as translating codes between code sets, returning related concepts, and returning the terms used to express a concept should be supported as well.

4. Applications

Applications ride on top of the infrastructure and integration layers. Those applications can include third-party systems such as clinical workflow, financial systems and clinical decision support. The key advantage of this approach is enabling organizations to embed these clinical terminology services within existing applications to take advantage of a single source of terminology truth.  As an example, a hospital could provide clinicians with the ability to search for problems and diagnoses within an Electronic Health Record or centralize code groups (value sets) for use in clinical quality measures.

In addition, Health Language’s enterprise terminology management platform supports its own applications for teams with advanced terminology needs. These applications enable workflows which enable 1) the quick lookup of referential codes as needed, 2) collaboration on searching, creating, and managing mappings of local and standardized content, 3) the management of code groups, and 4) the ability to model and extend terminology content sets.

Looking for an enterprise terminology management platform? Leave your comments below.

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Topics: enterprise terminology management

About the Author

Jason D. Wolfson is the Vice President of Product Management. From upstream strategy identification to the planning & execution processes required to link strategy to operations, Jason is responsible for the systemic, holistic business management of a portfolio of solutions within Wolters Kluwer, Clinical Solutions.