integrating snomed ct with other meaningful use vocabulary standards (loinc, rxnorm, hcpcs, cpt-4)...

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Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD- 10) using the UMLS Tomasz Adamusiak MD PhD @7omasz 1

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Presented at SNOMED CT Implementation Showcase held in Washington DC’s metro area, USA on the 10th-11th October 2013. Abstract: http://www.ihtsdo.org/show13/abstract14.pdf

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Page 1: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Integrating SNOMED CT with other Meaningful Use vocabulary standards

(LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Tomasz Adamusiak MD PhD

@7omasz

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Page 2: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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Landscape of many standards

Page 3: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

ROUNDTABLE ON SEMANTIC INTEROPERABILITY

HIMSS14, February 26, Orlando, FL

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Page 4: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Exanthema C0015230

UMLS

rash NOSICD-10:R21

Cutaneous eruptionSCT:112625008

EruptionSCT:1806006

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Page 5: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Exanthema C0015230

UMLS

rash NOSICD-10:R21

Cutaneous eruptionSCT:112625008

EruptionSCT:1806006

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Page 6: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Dealing with heterogeneous sources

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UMLS

MU-oriented

Page 7: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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Click on demo

Use the link or google clinminer

Login: showcasedemo Pass: showcasedemo

Page 8: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Demo and evaluation:

100 000 clinical avatars

x90 days

xgenotype-

guided warfarin dosing

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Page 9: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

11 MILLION OBSERVATIONS (20 TERMS)

Clinical Avatars

Page 10: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Custom UMLS-based terminology server

Page 11: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

RxNorm UMLS

Page 12: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

SNOMED CT UMLS

Page 13: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Medication reconciliation via National Drug Code (NDC) and RxNorm

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31722-331-01100 tablets of Warfarin Sodium 4 MG Camber Pharmaceuticals

https://clinminer.hmgc.mcw.edu/clinminer#ontology/search/31722-331-01

Page 14: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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Integrated querying and reporting

Page 15: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

How does it work with real EHR data?

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Page 16: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Pilot cohort

FroedtertEpic Clarity

reportsClinMiner

LDS 2/16

Transformed via UMLS

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Page 17: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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1.5 million observations (7000 terms)

Page 18: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

WE NEED BETTER LOINC – SNOMED CT MAPPINGS

Limitations?

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Page 19: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

LOINC is more granular

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Page 20: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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CPT maps to SNOMED CT and MedDRA

Page 21: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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But not to LOINC

Page 22: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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Some tests map on LOINC part level

Page 23: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

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Endgame in semantic integration

Page 24: Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS

Thank you

Mary Shimoyama PhD

Stacy Zacher

Glenn Bushee

Bradley Taylor

Clinical Avatars

Vincent A. Fusaro PhD

Peter J. Tonellato PhD

Laboratory for Personalized MedicineHarvard Medical School

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This project was funded in part by the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 RR031973. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.