Sharing of Terminologies

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The profile is under developpment by the ITI committee and can be found under:

Many thanks to the persons involved involved in editing the profile.

Charles Rica (GIP-DMP), Dr. Christel Daniel LeBozec (AP-HP, INSERM, Paris), Nicholas Canu (HL7-France, Phast), Isabelle Gibaud (Syndicat Interhospitalier de Bretagne), Karima Bourquard (IHE-F, GMSIH), François Gareil (Thales), Philippe Launay (AGFA France), Russell Hamm (Apelon, Inc.), Sarah Knoop (IBM), Vassil Peytchev (Epic Systems), Charles Parisot (GE Healthcare), Keith Boone (GE Healthcare), Lori Fourquet (e-Health Sign),Ted Klein (Klein Consulting.Inc), René Spronk (Ringholm GmBH Consulting), Emmanuel Cordonnier (ETIAM), Kevin O’Donnell (Toshiba), Roni Ram (IBM Haifa Research Lab), Yvan Charpentier (NextGen), Gavin O’Brian (NIST), Harry Solomon (GE Healthcare)

1. Proposed Workitem: Sharing of Terminologies

  • Proposal Editor: Ana Estelrich
  • Editor: Christel Daniel (AP-HP, INSERM, Paris), Karima Bourquard (GMSIH), François Gareil (Thales), Jean Delahousse (Mondeca), Norbert Lipszyc (DBmotion), Pierre Zweigenbaum (LIMSI, CNRS), Ana Esterlich (GIP-DMP), Charles Rica (GIP DMP),
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: IT Infrastructure

2. The Problem

Accessing and utilizing terminology resources are a common and necessary function for many healthcare IT applications. Systems that have to share clinical data and information have to share also well defined and unambiguous knowledge of the meaning of these data. To achieve interoperability within and across disparate healthcare IT systems, terminology content (TC) need to be synchronized across the various applications (at a local, or regional, or national, or international level). This requires 1) terminology servers and 2) synchronization services to keep terminologies in healthcare IT client applications aligned with reference terminologies provided by the terminology server. This profile provides a way for a terminology server serving a domain to manage terminology content (TC) and provide terminology services to distribute this terminology content (TC) or subsets of TC to other applications. This profile will be useful to enhance data capture based on reference terminologies, indexation of a narrative document (transforming it in structured document), search engines capabilities within narrative documents. For healthcare professionals, this profile will provide coding support.

Existing issues:

1) terminology content have different level of complexity (from simple lists of terms to description logic-based ontologies)
2) terminology services should be useful for applications providing indexation solutions of structured data but also for applications providing indexation solutions of narrative documents. Such an application may require other resources than terminology content (lexicon, textual synonyms, etc). These are out of scope for this proposal.

3. Key Use Case

Use case 1: An entire terminology content (TC) is sent by the Terminology Repository to subscribing systems (Terminology Consumers). These systems must import the TC.

Use case 2: If a subset of concepts/terms/codes of a TC is added, removed or changed, the full TC is not sent to the Terminology Consumers but only those parts which have changed. Concepts/terms/codes which have been removed from the TC are not to be used by the receiving system any more; they should not be deleted but be flagged as disabled/invalid for backward compatibility reasons. New added codes may be used from the effective date/time given in the transaction.

Use case 3: If a local application needs a new unknown concept/term/code or a new subset (value set) of concepts/terms/codes the Terminology Consumers queries the Terminology Repository for the new code or the new value set.

Use case 4: A terminology system (TS) editor (Terminology Source) (for example SNOMED CT IHT SDO) sends an entire terminology content (TC) or a subset of codes to a Terminology server (Terminology Repository).

4. Standards & Systems

- The CTS defines the minimum set of functions required for terminology interoperability within the scope of HL7’s messaging and vocabulary browsing requirements. The LexGrid model has been selected by HL7 as the vocabulary model in which the HL7 vocabulary will be represented.
- In the IHE Laboratory TF (LAB-TF), the exchange of code sets and associated rules shared by multiple actors is taken care of by a dedicated integration profile called “Laboratory Code Set Distribution” (LCSD) which is based on HL7 V2.X Master Files.

5. Discussion