Access to Health Care Information Resources through Intelligent Controlled Terminologies

1
Access to Health Care Information Resources
through Intelligent Controlled Terminologies

• James J. Cimino, M.D.
• Columbia University
• Department of Medical Informatics

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Overview

• What needs fixing?
• What is an "intelligent controlled terminology?"
• How does it assist with access to information
  resources?

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What Needs Fixing?

• Finding the right resource is hard
• Using each resource is awkward
• It's easy to get overwhelmed

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Example Weird Organism

• Encountered on lab test result
• What resource has the right information?
• How do I get to the resource?
• How do I ask the question?
• What was that organism again?

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Solution "Infobuttons"

• Button is integrated with clinical system
• Knows that Medline has information
• Knows how to get to Medline
• Knows how to translate organism name
• Knows how to query Medline
• Result one-touch Medline search

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Under the HoodIntelligent Controlled Terminology

• CPMC Medical Entities Dictionary (MED)
• Semantic network of 50,000 concepts
• Includes definitional information through
  semantic relationships
• Tightly coupled with the Unified Medical Language
  System

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Medical Entities Dictionary
Medical Entity
Laboratory Specimen
Substance
Event
Plasma Specimen
Anatomic Substance
Diagnostic Procedure
Chemical
Substance Sampled
Bioactive Substance
Carbo- hydrate
Laboratory Procedure
Laboratory Test
Plasma
Has Specimen
Plasma Glucose
Glucose
CHEM-7
Substance Measured
Part of
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How does the Infobutton Work?
Clinical Information System
Vocabulary Server
Web Server
Internet
Clinician
Information Source
Information Source
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Examples of Infobuttons

• Laboratory tests to Medline
• Laboratory tests to DXplain
• Cholesterol results to guideline
• X-ray reports to variety of Web resources
• Patient medications to drug references

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screen shots galore

• Laboratory tests to Medline
• Chem20
• Question list
• Laboratory tests to DXplain
• DXplain Diseases (list)
• DXplain Disease (result)
• List of findings
• Differential diagnosis
• Cholesterol results to guideline
• Does pt have CHD?
• Recommendation lipid lowering agent
• X-ray reports to variety of Web resources
• X-ray report
• Findings
• Questions
• Medline results
• Medline abstract
• Chorus page
• Patient medications to drug references

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Advantages of Knowledge-Based Approach

• Re-use of terms by multiple applications
• Translation of terms between applications
• Integration of data from multiple sources
• Coordination of patient data with information
  resource concepts
• Ability to support maintenance of the terminology
  itself

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Implications for Federal Information Resources

• Allow more sophisticated access to resources
• Reusability of terminology
• Maintenance of terminology