3M Health Information Systems

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3M Health Information Systems
3M Health Information Systems
Data Governance
Disparate Systems
Interoperability
Information Exchange
Reporting
Public Health
Quality Metrics
Research
Data Warehousing
Data Standards
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3M Health Information Systems
Varicella
VZV
HZV
Is A
Has Child
Relationships
Concept
Representation
3M
CPT-4
Context
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What is the 3M Healthcare Data Dictionary?
3M Health Information Systems
What is the 3M Healthcare Data Dictionary?
Controlled Medical Vocabulary
Collection of clinical concepts
Knowledge Base
Relationships among concepts
Medical Information Model
Establishes clinical context
Decision Support
Alerts Analytics
Knowledge Base
(Semantic Network)
Controlled Medical Vocabulary
(Medical Concepts)
Medical
Information
Model
Lab, Rx, Radiology, Dental, Demographics, etc.
2.6 million concepts
17.9 million representations
15.9 million relationships
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3M Health Information Systems
A collection of medical concepts, organized
to support synonyms and other lexical
characteristics

concept: a unique, definable idea or object that has a very specific, known
meaning
Sodium
Lab Result
Lab Test
Chem 4
Potassium
Chloride
Glucose GLUC GLC
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Controlled Medical Vocabulary
3M Health Information Systems
Concept
Representation
Concept
Domain
Concept
Definition
Concept ID
a sensory
perception
a pulmonary
diagnosis
an upper
respiratory
viral infection
Im feeling
cold
Chronic
Obstructive
Lung Disease
I have a
cold
68215 1005480 1005313
Concept-based
COLD COLD COLD
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3M Health Information Systems
Lab, Rx, Radiology, Dental, Demographics, etc.
2.6 million concepts
17.9 million representations
15.9 million relationships
A collection of medical concepts,
organized to support synonyms and
other lexical characteristics
Concept: a unique, definable idea
or object that has a very specific,
known meaning
Lab Test
Chem 4
Sodium
Lab Result
Potassium
Chloride
Glucose
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Concept-based Semantic Network
3M Health Information Systems
Lab Test
Chem 4
Sodium
is-a
Lab Result
Potassium
Chloride
Glucose
is-component-of
Knowledge Base / Relationships
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3M Health Information Systems
Standards Supported by HDD
UMLS
LOINC
NDC
RxNorm
ICD-9-CM
ICD-10-CM
ICD-10-PCS
DRG
APC
APDRG
CPT
HCFA HCPCS
CDT
SNOMED CT
HL7
OMB Race/Ethnicity Standards
Commercial Interface Terminologies
Provider Taxonomy
Revenue Codes

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Recent Additions
HL7 CVX
GEMs
Kaiser Permanente CMT
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Concept Mapping Defined
Process of building links among
concepts to integrate various
vocabularies
Context: the purpose of the map
Are these drugs being mapped for inventory, allergens,
or as clinical drugs?
Matching
technologies/tools/process to
avoid duplicate concepts and
increase consistency and
efficiency
String comparison mapping and semantic mapping
Requires subject matter expertise

Herpesvirus 3, Human
C0042338 (UMLS ID)
3M HDD
Herpes-zoster Virus
Display 2
Chickenpox Virus
Display 1
Varicella-zoster
Virus
11557 (3M HDD ID)
VZV
243 =Ft Hood Lab Interface Context
Healthcare Data
Dictionary
Concept Mapping
SMEs, Expert Tools
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3M Health Information Systems
HDD Mapping Result Rosetta Stone
Manages ongoing updates
from standard terminologies as
well as local additions and
changes from health care
facilities
Translates/transforms an
enterprises data to standards
such as LOINC, so it can be
interpreted by all other systems
using standards
Moves Syntactic
Interoperability to the level of
Semantic Interoperability and
enables Meaningful Use
HDD ID
26277
Protime
Concept
3M HDD ID
26277
LOINC
Code
5902-2
Siemens
Interface
Code
467-73
3M
Long
Name
Protime
3M
Short
Name
PT
Epic
Interface
Code
3650-73
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3M Health Information Systems
Encode with internal identifiers,
translate to standard codes for
external exchange
Encode with the
identifiers of standard
terminologies
*CDR
Patient:
John Doe
Lab Result:
2823-3
2823-3
2823-3
**HDD
Internal code:
8989
LOINC:
2823-3
*CDR=Clinical Data
Repository
*CDR
Patient:
John Doe
Lab Result:
1234
**HDD=Healthcare Data Dictionary
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Exchanging Standard Codes
Two Implementation Strategies

3M Health Information Systems
HDD HIE
Crimson
EDW
Cerner
Siemens
LOINC
SNOMED
Point-to-Point Mapping for 9 sources = n(n-1)/2 = 36 maps
Adding 1 more source adds 9 maps
Challenge is not only in the creation, but the maintenance
all of these mappings
Mapping to a terminology server for 9 sources = n =
9 maps
Adding 1 source adds 1 map
Centralized maintenance and distribution of content
VS.
Epic
Siemens
HIE
Crimson
EDW
2
) 1 ( n n
maps
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LOINC
SNOMED
RxNorm RxNorm
Epic
Cerner
Point-to-Point vs. Centralized Mapping
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Epic
Cerner
Point-to-point mapping
is difficult to maintain:
102 sites 5151 fixes
Centralized mapping is
simple to maintain:
1 fix
VS.
Cerner
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RxNorm RxNorm
Crimson
HIE
HIE
LOINC
LOINC
SNOMED
SNOMED
HDD
EDW
Siemens
Epic
Siemens
EDW
Crimson
If a Mapping Changes . . .
3M Health Information Systems
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Interface Engine
P
r
e
s
e
n
t
a
t
i
o
n

L
a
y
e
r

Architecture Example: Longitudinal Data Repository
3M Health Information Systems
ICD-10
codes
from
source
systems
ICD-
10
ICD-
10
ICD-
10
ICD-
10
ICD-
10
Data Source
Data Source
Data Source
1


Proven workflow: GEMs w/ references
Code analyzer
Definition of purpose built maps


HDD Translation Tool
2
4
Financial
Application
Clinical Application
Ancillary
Application
Data Repository
Analytics/Reporting


Purpose
Built Maps






Semantic Interoperability
Meta data storage
Storage or access to all clinical
and coded data




3 Healthcare Data
Dictionary
3
Custom ICD-10 Application Map
1
ICD-9
ICD-9
ICD-9
ICD-9
ICD-9
5
ICD-10
codes
from
source
systems
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Customer Use Case
3M HDD
EDW
Epic
Eclipsys
N
C
I
D
s
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3M Health Information Systems
Code Set MU Objective
ISO 639-2 Language
Codes
Demographics
OMB Race and Ethnicity Demographics
ICD-10-CM Problem List
Clinical Summaries
SNOMED CT Problem List
Allergies
LOINC Lab Test Results
Vital Signs
Smoking Status
RxNorm Medications
CVX - Immunizations
Clinical Summaries
HL7 Pedigree Family Health History
Currently in Stage 2
Stage 2 requirements include
eight standards.
Quality measure reporting
requirements specify the use of
Standard terminologies.
3M HDD facilitates the initial
mapping and ongoing
maintenance.
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Meaningful Use
3M Health Information Systems
HL7 CTS
3M HDD
HL7 CTS
App Server
(3M)
CDR
EDW
Interface &
Messaging
Engines
EHR & other
Applications
HL7 CTS compliance enables various applications to easily and transparently
access a Terminology Server without knowing its internal architecture.
3M HDD supports HL7 CTS v1.2, and can be deployed as a blackbox
implementation.
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3M Health Information Systems
HDD Access
Open Source version of HDD
Differences between HDD Access and Commercial HDD
Timeline for release
www.HDDAccess.com
21 3M 2013. All Rights Reserved.