Open Health Tools
Distributed Terminology System
Presentation
Jack Bowie
SVP Sales and Marketing
Apelon, Inc.
1
Apelon
• Leading provider of healthcare terminology products and
services
• Extensive and unique experience partnering with
national agencies and healthcare enterprises to improve
the quality, comparability & accessibility of clinical
information
• Helps organizations turn terminologies and their use into
business assets
• Develop and refine mission-critical data normalization
processes
Key Achievements
• Twenty years development with the US National Library
of Medicine on the UMLS Metathesaurus
• Supplier of the tools and services used to maintain
SNOMED CT, ICD-9-CM, ICD-10-CM, and NDF-RT
• Supplier of tools and services to national health
organizations: Australia’s NEHTA, Canada Health
Infoway, Hong Kong Hospital Authority, and US FDA,
NCI, NCHS, SSA, VHA
• Leading provider of commercial health data
interoperability solutions: HIEs, EMRs, biotech, and
content providers
Apelon Customers and Partners
Personnel
• Internationally known terminology experts
• Regular contributors to industry standards, publications
and conferences
Apelon Solutions
Terminology
Content
People and
Processes
Applications
and Services
6
Apelon and Open Source
• After many years of commercial availability, Apelon
released the Distributed Terminology System (DTS )
vocabulary server as an open source project in April of
2007
• Since then, DTS has been downloaded over 4000 times
by organizations around the world
• Apelon supports DTS with a full range of commercial
services
7
What is DTS?
• An enterprise vocabulary server used to :
– Acquire & maintain standards
– Integrate and manage local code sets
– Map/interrelate terminologies
– Deploy in applications
Apelon Confidential
Examples of Terminology Services
•
Term/name normalization:
What is SNOMED CT name for “heart attack”?
•
Code translation
What is the ICD-9 code for Myocardial Infarction?
•
Yes
Clinical knowledge
Streptokinase
What drug treats Myocardial Infraction?
•
410.91
Grouping and aggregation
Is Myocardial Infarction a Cardiac Disease?
•
Myocardial Infarction
Local information
Add L227 as the local code for Serum Calcium.
Apelon Confidential
Okay
DTS Components
• Knowledge Base (Content)
• Server
• Client API
• GUI applications
• Utilities and samples
• Subscription content service
• Commercial software support service
Apelon Confidential
Apelon Terminology Model
Apelon
Web
Services
SNOMED
User
Applications
HL7
API
MedDRA
ICD9
Application Developer
DTS
SNOMED
Data Set
Updates
Data Set
Updates
HL7
MedDRA
ICD9
Rx
Dx
Tx
DTS Components
Terminology
Update Service
DTS
Knowledgebase
DTS Vocabulary Server
• Comprehensive
terminology support
DTS API
DTS Applications
• Enterprise quality, highly
scalable repository
User Applications
12
DTS Knowledgebase
– Clinical framework (SNOMED CT)
– Reimbursement code sets w/mappings: ICD, CPT, HCPCS
– RxNorm, NDF-RT and other drug terminology and classification
systems
– Meaningful Use Standards: HL7, CVX, MVX, UNII
– Specialty sets: LOINC, RadLex, NIC, NOC, and NANDA
– Adverse event terminologies MedDRA, COSTART, WHOART
– Mappings to MeSH and UMLS CUIs
– Extensible with local additions
Apelon KB Architecture
Subscription Namespaces
• Derived from industry
sources
SNOMED CT
Apelon
CT to CPT
• Provided by Apelon
• “Read only” in DTS
Local Namespaces
• Customer-specific data
•
•
•
•
Concepts
Properties
Associations (mappings)
Code and Value sets
• Protected during updates
Local
Apelon KB
CPT
DTS Components
Terminology
Update Service
DTS
Knowledgebase
DTS Vocabulary Server
DTS API
DTS Applications
• “Subscription” access to
industry standard terminologies
and thesauri
• Web downloadable differential
updates
• Local content protected during
updates
User Applications
15
Subscription Update Process
SNOMED CT
Apelon
CT to CPT
SNOMED CT
Apelon
DTS
CPT
Apelon
CT to CPT
Local
Apelon KB
Update
Log
• Update exception events, e.g.,
local mappings to retired concepts
CPT
DTS Components
Terminology
Update Service
DTS
Knowledgebase
• High-performance
server
• Extensive functionality
DTS Vocabulary Server
• Java and .NET clients
DTS API
DTS Applications
• Programmatic access
to all functions
User Applications
17
DTS Functionality
• API Services:
– Search (w/spelling correction, stemming, contexts, etc.)
– Navigation and code translation
– Subsetting (extensional and intensional definitions)
– Class/subsumption query
– Workflow
– Localization
• Performance features:
– Connection pooling
– Concept caching
DTS Components
Terminology
Update Service
DTS
Knowledgebase
DTS Vocabulary Server
• User applications have
access to all DTS
functions including
modeling capabilities
DTS API
DTS Applications
User Applications
19
DTS Components
Terminology
Update Service
DTS
Knowledgebase
• DTS Browser
• DTS Editor
DTS Vocabulary Server
• TermWorks Web Services
DTS API
DTS Applications
User Applications
20
DTS Editor
• Browsing/searching
• Vocabulary/code set management (subsets)
• Local additions
– Complete modeling environment
– Add Concepts, Synonyms, properties and associations
(relationships)
• Import/Export
• Workflow
DTS Editor Plug-in Architecture
• The DTS Editor Plug-in architecture is a framework for
customizing and extending the DTS Editor platform with
new features and modules
• Plug-ins have access to common DTS Editor facilities
such as connection services, events, and drag-and-drop
• Plug-ins can used to implement:
– Major new features
– New data presentations
– New data input or output formats
Graphic Viewer
New, customizable, “graphic” views of terminologies
Table Editor
Tabular representation of DTS concepts
Import Wizard
Import data into DTS Namespaces
from XML and CSV data files
Terminology Query Language
Query/export language for DTS knowledgebases,
includes XML export of full Namespace
DTS Roadmap
• Platform Support
– New database support for DB2 (Q4 2010) and MySQL (Q1 2011).
• HL7 CTS2 Interface
– Support for this emerging standard terminology service interface
– Extended versioning support for Namespaces and Concepts
– Expanded Subset functionality for Value Sets
– Additional metadata on Namespaces and Concepts
Medical terminology in practice