Methods Inf Med 1998; 37(04/05): 551-563
DOI: 10.1055/s-0038-1634542
Original Article
Schattauer GmbH

Standards to Support Development of Terminological Systems for Healthcare Telematics

A. Rossi Mori
1   Reparto Informatica Medica, Istituto Tecnologie Biomediche, CNR,Roma
,
F. Consorti
2   IV Clinica Chirurgica, Italy
,
E. Galeazzi
3   Dottorato in Informatica Medica, Università La Sapienza, Roma, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
15 February 2018 (online)

Abstract

The Technical Committee on “Medical Informatics” of the European Committee for Standardization (CEN{TC251) is supporting developers ofterminological systems in healthcare by a series of standards. The dream of “universal” coding system was abandoned in favor of a coherent family of terminologies, diversified according to tasks; two ideas were introduced: (1) the “categorical structure”, i.e. a model of semantic categories and their relations within a subject field and (2) the “cross-thesaurus”, i.e. a system of descriptors to build a systematic representation (called here “dissection") for each terminological phrase, coherent across diverse terminologies on a given subject field.

The goal is to assure coexistence and interoperability (and reciprocal support for development and maintenance) to three generations of systems: (1) traditional paper-based systems (first generation); (2) compositional systems built according to a categorical structure and a cross-thesaurus (second generation) and (3) formal models (third generation).

Various scenarios are presented, on the exploitation of computer-based terminological systems. The idea of “operational meaning” of terminological phrases within administrative and organizational contexts and the idea of “task-oriented details” are also introduced, to justify and exploit design constraints on terminological systems.

 
  • REFERENCES

  • 1 Rossi Mori A. Coding systems and controlled vocabularies for hospital information systems. Int J Biom Comp 1995; 39: 93-8.
  • 2 World Health Organization. International Classification of Diseases, 9th revis. Geneva: WHO; 1977
  • 3 Read JD, Sanderson HF, Drennan YM. Terming, encoding, and grouping. In: Greenes RA. et al. eds. Proceedings of MEDINFO 95. Edmonton: Healthcare computing and communication Canada, Inc; 1995: 56-9.
  • 4 National Library of Medicine. MeSH Medical Subject Headings. Bethesda, MD: NIH-NLM (yearly);
  • 5 National Library of Medicine. UMLS Knowledge Sources, 7th experimental edition. Bethesda, MD: NIH-NLM; 1996. see also http://dumccss.mc.duke.edu/standards/termcode/umls.htm
  • 6 Rothwell DJ, Coté RA, Brochu L. (eds.) SNOMED International, Northfield. IL: College of American Pathologists; 1993. see also http://dumccss.mc.duke.edu/standards/termcode/snomed.htm
  • 7 Galeazzi E, Agnello P, Gangemi A. et al. What is a medical term? Terms and phrases in controlled vocabularies and continuous discourses. In: Barahona P, Veloso M, Bryant J. eds. Proceedings of the 12th Congress of the European Federation of Medical Informatics, Lisbon, 22-26 May 1994; 234-9.
  • 8 ISO 1087 Terminology-Vocabulary.
  • 9 ISO/IEC TR 9789 Coding methods and principles.
  • 10 ISO/DIS 3534-1, -2, Statistics – Vocabulary and symbols.
  • 11 ISO 704 Principles and methods of terminology.
  • 12 ISO 2788 Documentation – Guidelines for the establishment and development of monolingual thesauri.
  • 13 ISO 5127/1 Documentation and information – vocabulary – part 1: basic concepts.
  • 14 CEN/TC251/WG2. see http://www.imc.exec.nhs.uk/centc251/wgii/
  • 15 SESAME Compilation of Deliverables c/o P de Vries Robbé, POBox 9101, NL-6500 HB Nijmegen.
  • 16 CEN ENV 12264:1995. Medical Informatics – Categorical structure of systems of concepts – Model for representation of semantics. Brussels: CEN; 1997
  • 17 GALEN and GALEN-IN-USE documentation, available from the main contractor AL Rector, Medical Informatics Group, Dept. Computer Science, Univ. Manchester, Manchester M13 9 PL. UK: (E-mail galen@cs.ac. man.uk see also home page at http://www.es.man.ac.uk/mig/galen
  • 18 Campbell K, Musen MA. Representation of clinical data using Snomed III and conceptual graphs. In: Proceedings of the 16th Symposium Computer Applications in Medical Care. November 1992: 354-8.
  • 19 Friedman C, Johnson S, Cimino J. Conceptual Graph Representation of Radiology Findings – Merged Model. (Version 3, 29 Nov. 1993 for the Canon Group).
  • 20 Rector A. Compositional models of medical concepts: towards re-usable application-independent medical terminologies. In: Barahona P, Christensen JP. eds. Knowledge and Decision in Health Telematics. Amsterdam: IOS Press; 1994: 109-14.
  • 21 Gangemi A, Galanti M, Galeazzi E, Rossi Mori A. Beyond UMLS: computational semantics for medical records. In: Lun KC. et al. eds. MED INFO 92. Amsterdam: Elsevier Science Publishers; 1992: 703-8.
  • 22 Rossi Mori A, Gangemi A, Galanti M. The coding cage. In: Reichert A, Sadan BA, Bengtsson S, Bryant J, Piccolo U. eds. MIE 93. London: Freund Publishing House; 1993: 466-72.
  • 23 CEN ENV 1068:1993. Medical Informatics – Health care information interchange – Registration of coding schemes. Brussels: CEN; 1993
  • 24 CEN/TC251, Directory of the European Standardization Requirements for Health Care Informatics and Programme for the Development of Standards (Version 2.0). Stockholm: 1998. http://www.centc251.org
  • 25 CEN ENV 1828:1995. Health care informatics – Structure for classification and coding of surgical procedures. Brussels: CEN; 1995
  • 26 CEN ENV 1614:1994. Health care informatics – System of concepts for systematic names, classification, and coding for properties, including quantities, in laboratory medicine. Brussels: CEN; 1995
  • 27 CEN prENV 12611:1997. Medical informatics – Categorical structure of systems of concepts – Medical device. Brussels: CEN; 1997
  • 28 Rossi Mori A, Bernauer J, Pakarinen V, et al. Models for representation of terminologies and coding systems in medicine. In: De Moor GJE, McDonald C, Noothoven van Goor J. eds. Progress in Standardization in Health Care Informatics. Amsterdam: IOS Press; 1992: 92-104.
  • 29 Galeazzi E, Rossi Mori A, Consorti F, Errera A. A cooperative methodology to build conceptual models in medicine. In: Pappas C. et al. eds. MIE 97, Medical Informatics Europe. Amsterdam: IOS Press,; 1997: 280-4.
  • 30 Rocha RA, Stanley MH. Coupling Vocabularies and Data Structures: Lesson from LOINC. JAMIA 1996; symp. suppl. 90-4.
  • 31 Price C, et al. Anatomical Characterization of Surgical Procedures in the Read Thesaurus. JAMIA 1996; symp. suppl. 110-4 see also http://dumccss.mc.duke.edu/standards/termcode/read.htm
  • 32 CEN/TC251/PT5-021. Vital signs information representation (Final Document). Brussels: CEN; 1998
  • 33 Mortensen RA. ed. The International Classification for Nursing Practice ICNP with TELENURSE introduction. Copenhagen: The Danish Institute for Health and Nursing Research; 1996
  • 34 Rossi Mori A, Galeazzi E, Consorti F. An ontological perspective on surgical procedures. JAMIA 1996; symp. suppl. 115-9.
  • 35 Sowa JF. Conceptual structures: information processing in mind and machine. Addison Wesley, Reading, MA: 1984
  • 36 ECRI, Universal medical device nomenclature system: product category thesaurus. Plymouth Meeting (PA): ECRI; 1996. see http://dumccss.mc.duke.edu/standards/termcode/ecri.htm
  • 37 Rossi Mori A. Towards a new generation of terminologies and coding systems. In: Brender J. et al. eds. Medical Informatics Europe '96. Amsterdam: IOS Press; 1996: 208-12.
  • 38 NHS Centre for Coding and Classification, The Read Codes Version 3. NHS-CCC-TP1200. July 1994
  • 39 Rystrom L, Rossi Mori A. Development of a standard for the organization of medical device nomenclatures. In: Brender J. et al. (eds.) Medical Informatics Europe *96. Amsterdam: IOS Press; 1996: 259-63.
  • 40 Steve G, Gangemi A. ONIONS Methodology and the Ontological Commitment of Medical Ontology ON8.5. Presented at KAW 96; see http://saussure.irmkant.rm.cnr.it/BCAW/introduction.html
  • 41 Agnello P, Galeazzi E, Rossi Mori A. On the “natural” behavior of medical concepts: an analysis of SNOMED combinations. In: Reichert A, Sadan BA, Bengtsson S, Bryant J, Piccolo U. eds. MIE 93. London: Freund Publishing House; 1993: 473-9.
  • 42 Ingeneri J. Taxonomic vocabularies in medicine: the intention of usage determines different established structures. In: Greenes et al.. eds Proceedings of MEDINFO 1995. Edmonton: Healthcare computing and communication Canada, Inc.; 1995: 136-9.
  • 43 Board of Directors of the AMIA. Standards for medical identifiers, codes, and messages needed to create an efficient computer-stored medical record. JAMIA 1994; 1: 1-7.
  • 44 Averiii RA, Mullin RL, Steinbeck BA, Goldfield NI, Grant T. (1995) The development of the ICD-10 Procedure Coding System (ICD-10-PCS). available from: 3M Health Information Systems, 100 Barnes Road, Wallingford CT 06492.:
  • 45 ESGE/ASGE Minimum Common Terminology for Gastrointestinal Endoscopy (MCTGE). see http://www.hsc.missouri.edu/ASGE/docs/asge.html
  • 46 DICOM: for the standard in general. see http://dumccss.mc.duke.edu/standards/HL7/sigs/image-management/HTML/dicom-home.html on SDM, see http://dumccss.mc.duke.edu/standards/HL7/sigs/image-management/HTML/SNOMEDhome.html
  • 47 Chute CG, et al. The content coverage of clinical classifications. JAMIA 1996; 3: 224-33.
  • 48 Shortliffe EH, et al. Collaborative Medical Informatics Research Using the Internet and the World Wide Web. JAMIA, 1996; symp. suppl. 125-9.
  • 49 IUPAC. see http://dumccss.mc.duke.edu/standards/termcode/iupac.htm
  • 50 LOINC Manual. available at http://dumccss.mc.duke.edu/standards/termcode/loinclab/LOINMANl.DOC
  • 51 LOINC. see http://dumccss.mc.duke.edu/standards/termcode/loinc.htm
  • 52 Rossi Mori A, Gangemi A, Steve G, Consorti F, Galeazzi E. An ontological analysis of surgical deeds. Proceedings AIME 97, 6th Conf. on Artificial Intelligence in Medicine – Europe, Grenoble. Springer-Verlag; 1997
  • 53 Standard Task Force of the American Society for Colon and Rectal Surgeons. Practice parameters for sigmoid diverticulitis – supporting documentation. Dis Colon Rectum. 1995 38. 126-32.