About Terminology Services
- One source of truth for all terminologies used throughout the system.
- An easy-to-use interface for authoring items such as local hospital and bed
codes, as well as other codes that don’t exist in Hillrom's standard catalogs
(for example, group and map terminologies) that involve:
- Defining, creating, and managing relationships between concepts, and
- Creation of value sets that define specific concepts (for example, immune compromised)
- Run-time API calls that perform mappings as data is received into the system, with the benefit that Hillrom does not need to maintain mapping tables in our code.
- Automatic updates to standard catalogs, where codes are added and deprecated in regular cadences by their governing bodies. Hillrom does not have to query, diff, or account for changes in these massive mapping files on a weekly, monthly, or biannual basis.
- An easy-to-use workflow for clinicians to approve changes to clinical content prior to publishing to production and propagating throughout the system.
Codes, concepts and terminologies must be normalized since simple translation tables and human-powered manual mapping cannot keep up with rapidly evolving standard and local terminologies. Terminology services offer the following advantages:
Goal of Interoperability - HIT systems working together to advance the effective delivery of healthcare and to break down existing silos.
How do we do that?Through a process whereby data is normalized into a standard format to ensure that it means the same thing to all components and systems that interface with each other—for both incoming and outgoing data. The figure below illustrates how terminology services are currently used by Hillrom today:
As shown in the diagram above, external terms from different Electronic Medical Record (EMR) applications can be represented in a variety of standard code systems (for example, ICD-10-CM, ICD-9-CM, SNOMED CT, LOINC, RxNorm) as well as non-standard, proprietary, or local terms. Terminology services enable mappings of these terms to standard reference terminology targets to achieve semantic normalization. Terminology services also facilitate a transparent rule-based approach to defining element sets (for example, collections of terms that define a clinical concept) and an efficient incremental update process, as reference terminologies evolve over time. In the above diagram, EMR terms from a variety of code systems might be ingested into Hillrom, understood as standard reference terminologies, and rolled up to a clinical concept that can be used for decision support or analytics.
Glossary of terms
Term - A term is the lowest level data point used in terminology services. Each term contains a unique identifier (or description).
Catalog - A catalog is a group of terms collected under one name and usually grouped together by one of six domain types.
Element - An element (which can also be called a value set) is a collection of terms that define a clinical concept. An element then becomes a published set of codes that roll up to a clinical concept.
Element Set - An element set is a collection of related elements that are grouped together and then managed, published, and distributed as related content. For example, the Hillrom Patient Risk Surveillance element set contains all risk context and risk factors.
Map - A map defines a cross-reference relationship that converts a set of terms from a source catalog to equivalent terms in a target catalog.
- ICD-10 - Diagnostic codes (of which there are 68,000+ codes)
- CPT - Procedures
- LOINC - Labs, results, and observation values (for example, vitals)
- SNOMED - Broad coverage of most medical concepts
- MDC - Medical devices
- CVX/MVX - Vaccines
- RxNorm - Specific medication codes, down to dose/strength
- NDC - Packaging-level codes for medications
- Local Codes - Hospital specific