Query Health Concept-to-Codes (C2C) SWG Meeting #11

1. Query Health Concept-to-Codes (C2C) SWGMeeting #11 February 28, 2012

2. Today’s Agenda

3. C2CPresentation Series http://wiki.siframework.org/C2C+-+Presentation+Summaries+and+Key+Themes

4. C2C Current and Future Tasks Dec 2011– February 2012 Current Tasks Conduct Environmental Scan C2C Output Summary of Various Approaches taken by Organizations Identification of Key Themes and Best Practices Standards Tools Distributed Query Networks List of Constraints to analyze Best Practices for QH within the Technical framework Value Sets Next Steps Feb 2012 - TBD Suggested Inputs Task Team Suggested Outputs Develop Technical Expression of C2C C2C Output Technical Expression of C2C Approach as it Aligns with the Reference Implementation C2C / Technical A Selection of Existing Value Set in Alignment with the QH CEDD Align Proposed Technical Expression with Existing Value Sets and Vocabulary Task Force Recommendations Technical Expression of C2C Approach Technical B Identify and assign Value Sets for a core set of data elements within the Harmonized QH CEDD as part of the Cross Walk Harmonized CEDD and Selected Value Set Clinical CEDD Identified Value Set Representations for core set of DataElement in the CEDD C Reference implementation Guidance for QH Develop Standardized Approach to Access Value Sets (IHE SVS Profiles, HL7 CTS & CTS 2) Value Set Representation Technical D

5. All Recurring Key Themes The below list includes themes across many of the different presentations to date. The next 2 slides address how these may be incorporated into the Technical Expression. • All mappings are Purpose and Goal Specific • Hierarchy within mappings is important to ensure the concepts are appropriately mapped and can be drilled down to a granular level • A centralized Data Dictionary or central Terminology System is used to store mappings and is common practice in many healthcare organizations • As Standards such as ICD9, SNOMED CT, LOINC etc. are modified and updated, ongoing maintenance of mappings can be challenging • Identifying a Best Match OR Alternate/Default Map is necessary since concepts may not always have an exact map • It is important to identify the context of the queries to understand what information is being requested (example - Ordered drug vs. Administered drug) • Ongoing maintenance of mappings is very resource intensive and requires dedicated skilled resources such as Clinicians/ Informaticists • Many mapping tools and resources are publicly available or accessible that can be leveraged by organizations and further developed, refined, and maintained for use • Most Concept Mapping tools maintain data in its original form

6. Recurring Key Themes – Direct impact to Technical Framework The below list includes themes across many of the different presentations to date. The key themes in blue below directly impact the Technical Framework of QH. All others are addressed on the next slide. • All mappings are Purpose and Goal Specific • Hierarchy within mappings is important to ensure the concepts are appropriately mapped and can be drilled down to a granular level • A centralized Data Dictionary or central Terminology System is used to store mappings and is common practice in many healthcare organizations • As Standards such as ICD9, SNOMED CT, LOINC etc. are modified and updated, ongoing maintenance of mappings can be challenging • Identifying a Best Match OR Alternate/Default Map is necessary since concepts may not always have an exact map • It is important to identify the context of the queries to understand what information is being requested (example - Ordered drug vs. Administered drug) • Ongoing maintenance of mappings is very resource intensive and requires dedicated skilled resources such as Clinicians/ Informaticists • Many mapping tools and resources are publicly available or accessible that can be leveraged by organizations and further developed, refined, and maintained for use • Most Concept Mapping tools maintain data in its original form

7. Recurring Key ThemesDo not directly impact Technical Framework However, Important to consider While not all key themes on the last slide may directly impact the Technical Framework, it is important to consider some of the key themes seen in the C2C presentation series (in green below) • All mappings are Purpose and Goal Specific • Hierarchy within mappings is important to ensure the concepts are appropriately mapped and can be drilled down to a granular level • A centralized Data Dictionary or central Terminology System is used to store mappings and is common practice in many healthcare organizations • As Standards such as ICD9, SNOMED CT, LOINC etc. are modified and updated, ongoing maintenance of mappings can be challenging • Identifying a Best Match OR Alternate/Default Map is necessary since concepts may not always have an exact map • It is important to identify the context of the queries to understand what information is being requested (example - Ordered drug vs. Administered drug) • Ongoing maintenance of mappings is very resource intensive and requires dedicated skilled resources such as Clinicians/ Informaticists • Many mapping tools and resources are publicly available or accessible that can be leveraged by organizations and further developed, refined, and maintained for use • Most Concept Mapping tools maintain data in its original form

8. A Technical Expression QH Technical Approach and Integration points to Concept to Codes Areas where the Concept to code integrates with the Technical Approach Query Composition Query Execution • The subsequent slides outline • Key Themes that may align with both Query Composition and Query Execution tasks (1-9) • Alignment of the 4 Tasks on Next Steps to integration points for Query Composition an Execution A B C D

9. A Technical Expression Query Composition C CEDD + VS B Identify VS C CEDD + VS

10. A Technical Expression D Standardized approach to access VS Query Execution – OptionsApplicability of the C2C work depends on the configuration of the data source and the potential execution models listed below • Data Source Option #1: Data Source is using schema based on Query Health CEDD. Vocabularies represent CEDD chosen vocabularies for representing the data elements and the data values • Data Source Option #2: Data Source is using native/local schema. Vocabularies represent local vocabularies and are not mapped to any standards • Data Source Option #3: Data Source is using standards not aligned with Query Health CEDD. Vocabularies could be mapped to code systems which are not what we recommend (for e.g CPT vs SNOMED) and may also mix in local vocabularies