A collaborative Web tool to manage Subsets, Cross Mapping, Extension and others RefSets using a new methodological workgroup framework and Release Format 2 Lechuga Suárez, L. (1); Parralejo Buendía, M. (1); Navalón Cebrián, R. (1); Severiano Peña, S. (2); Serrano Balazote, P. (1) (1) Competence Centre for EHR. Madrid Region of Spain. University Hospital of Fuenlabrada. (E-mail:
[email protected] or
[email protected]) (2) Competence Centre for EHR. Madrid Regional Health System
INTRODUCTION AND BACKGROUND The Spanish Madrid Region and the Spanish Ministry of Health, Social Affairs and Equality are developing SNOMED-CT Subsets, Cross Mappings, preferred translations, extensions and others RefSets. Allergies, Clinical Alarms Subsets, Substances and Medical Products Cross Mappings, Procedures and Diagnostics RefSets with extensions have been proposed.
Terminologies must be validated by a multidisciplinary group of experts
OBJETIVE • To allow multidisciplinary domain experts, technologists, managers and linguists validate and incorporate new concepts in the RefSets proposed (subsets, cross mappings, preferred translations and extensions). • To develop a collaborative Web tool 2.0 for Madrid Regional Health System. • Based 100% on SNOMED-CT Release Format 2.
METHODOLOGY For each subset or mapping the expert must answer questions about the validity of the concepts included in the RefSet: 1) Does the proposed concept or proposed mapping fit with the object of the RefSet? 2) Do you think the concept or mapping has a EHR clinical validity? 3) Is the concept description linguistically valid in a SpanishSpain sense? 4) Is the concept prominent (highlighted) in the EHR? 5) Is the concept correctly mapped?
Terminology Server Statistics Users questionnaire Spanish description
English description
“Highlighted” Alarm
- The application can receive unlimited validations, modifications and new RefSets concepts. - The web system is open in a collaborative way to all experts to read and review the other experts inputs.
Is this always an Alert?
Is it linguistically valid?
No clinical validity
SERTECAM Subset Validation functionality.
CONTRIBUTIONS • More than 50 experts (200 in the second phase) used this tool to evaluate, validate and propose new RefSets concepts. • Six types of Alerts subsets with 3446 concepts have been proposed. Experts contributed with: • 164 new Alert concepts • 294 changes of linguistic Spanish expressions • 952 modifications to "no clinical significance to be included in the EHR” • 75 concepts have been proposed as “highlighted”.
Full agreement of the experts to create the Alerts RefSets for the EHR of the Spanish Madrid Region.
Local Substance Terminology mapping to SNOMED-CT
WHO Inn codes text searching Description of Local medical products containing this active substance
WHO ATC products containing this active substance SNOMED-CT text searching
To add a new synonyms
Type of mapping
SERTECAM new mapping proposal for a local Substance. WHO is the World Health Organitation, INN is International Non Propietary Names and ATC is Anatomical Therapeutic Chemical Classification System
CONCLUSIONS A tool is needed in order to let a multidisciplinary team validate any set of concepts of the EHR terminologies. The proposed collaborative web development improved the efficiency and lead to the agreement of a vast group of domain experts.
BIBLIOGRAPHY 1.SNOMED CT® Technical Implementation Guide. January 2012 International Release (US English) 2.Pettersson M, Wihlborg J, Lövström R, Sundvall E, Nyström M, Karlsson D. Systematizing medical alerts. Stud Health Technol Inform. 2008;136:753-8 3.Rikard Lövström. Swedish Association of Local Authorities and Regions. Medical Alert Information. [October 2012 in http://www.tc215wg3.nhs.uk/docs/isotc215wg3_n426.pdf]. 4.Health informatics — Alert information in health records — Concepts, Information model and visual presentation. TC 251, Wg3. ISO 5.Alerts Specification for the EHR of Spanish Madrid Region. Horus Alerts Group. Madrid 2012. 6.ISO/CD 13940. Health Informatics – System of concepts to support continuity of care. 7.Common Terminology Services Release 2 (CTS 2) Version 1.1 March 22, 2009 8.WHO ATC and INN terminologies (http://www.who.int/classifications/en/)
This project has been supported by the Spanish Ministry of Health, Social Affairs and Equality
