Health Language Blog

How Enterprise Terminology Management Can Be Used for Clinical Alignment

Posted on 02/12/15


Healthcare organizations have deployed myriad healthcare IT systems in recent years, hoping to improve patient outcomes and improve operational efficiencies.

Unfortunately, most of the systems scattered across the healthcare community today are not semantically interoperable. That is, even with EHR certification under “meaningful use”, health IT systems still often use different terminologies to say the same things. 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 addresses the interoperability gap among healthcare applications, ensuring clinical alignment within a healthcare organization. 

The Data Integrity Problem

Clinical alignment essentially means that clinicians, researchers and administrators within a healthcare system are all on the same page when it comes to terminology. If they are not, the result may be inaccurate data resulting in inaccurate billing codes and revenue lost. 

The potential for data integrity issues may be seen in the example of how healthcare systems deal with code groups (also known as “value sets”). Organizations that try to manage code groups on a department-by-department basis have a difficult time determining whether a particular list of codes is complete and correct. They simply may not know whether their codes are accurate or even still active. The impact of this uncertainty on clinical informatics can prove dramatic. Since code groups serve as modular building blocks for quality measures, any inaccuracy in a code group will work its way downstream into data analytics and reporting. Clinicians and management will stop paying attention to reports if they find them to be inconsistent or inaccurate. 

Basing analytics on credible, consistent, and reusable code groups is a proven method to ensure that analytic tools deliver a return on investment (ROI). Code groups can be managed centrally using a terminology management platform like Health Language’s Language Engine. This centralized approach establishes a single standard for concept definitions across a healthcare organization. Some hospitals report having as many as 30 different definitions of diabetes across various departments. The ability to refer to a single definition for each clinical term provides the benefit of clinical alignment: everyone is working with the same definition.

Health systems can also reduce their expenses through enterprise terminology management. When code management activities are centralized rather than replicated across several departments, organizations can dedicate fewer people to the task of creating, updating and maintaining codes. This increase in efficiency generates direct savings in the form of FTE reductions.

Enterprise Terminology: Key Components

Health Language offers an enterprise terminology management platform, which incorporates content standardization and enterprise code management in the same package. The platform’s primary components include:

Content Database

A content database represents the core of Health Language’s terminology management solution. This component, also called a terminology database, provides a comprehensive set of standard and enhanced terminologies, maps, code groups or value sets, and synonym libraries. Health Language’s terminology database includes more than 200 standard and enhanced terminologies.

Language Engine for Modeling Content

Health Language’s Language Engine provides an infrastructure layer that lets organizations model content and embed standard clinical terminology into healthcare software applications. Language Engine enables healthcare systems to view, manage, export, and standardize all clinical content on a single platform. With this feature, users can manage and deliver standard content alongside localized and custom content.  Health Language also offers LEAP Code Group Management, a web-based tool powered by Language Engine. The tool can access, author and maintain clinical concept definitions.

APIs and Integration Layer

Health Language also includes APIs and an integration layer. This feature enables runtime access to a range of clinical terminology services, including searching, access, uploading, downloading, mapping and modeling. The integration layer provides 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.


Applications run on the infrastructure and integration layers. Applications may include third-party systems such as clinical workflow, financial systems and clinical decision support. A key advantage of the enterprise terminology management approach is enabling organizations to embed these clinical terminology services within existing applications to take advantage of a single source of terminology truth. A hospital, for instance, could provide clinicians with the ability to search for problems and diagnoses within an electronic health record or centralize code groups for use in clinical quality measures.

An Enterprise Standard for Terminology

Could your organization's clinical alignment benefit from terminology management? Leave your comments below.

enterprise terminology management


Topics: enterprise terminology management

About the Author

Dr. Steve Ross, MD is a physician informaticist with Health Language, part of Wolters Kluwer Health. Dr. Ross joined Health Language after 16 years as faculty in the University of Colorado Division of General Internal Medicine, researching personal health records and health information exchanges.