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AMIA 2007 Monday, Nov. 12 11:30-1:30 National Library of Medicine National Institutes of Health U.S. Dept. of Health &am

UMLS ® Users Meeting. AMIA 2007 Monday, Nov. 12 11:30-1:30 National Library of Medicine National Institutes of Health U.S. Dept. of Health & Human Services. Welcome & Agenda. NLM Overview and Update Metathesaurus (JW, JK, KWF) MetamorphoSys (KWF) User Education and Outreach (RK, SE)

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AMIA 2007 Monday, Nov. 12 11:30-1:30 National Library of Medicine National Institutes of Health U.S. Dept. of Health &am

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  1. UMLS® Users Meeting AMIA 2007 Monday, Nov. 12 11:30-1:30 National Library of Medicine National Institutes of Health U.S. Dept. of Health & Human Services

  2. Welcome & Agenda • NLM Overview and Update • Metathesaurus (JW, JK, KWF) • MetamorphoSys (KWF) • User Education and Outreach (RK, SE) • IHTSDO (BLH) • Effective Use of UMLS in EHR Systems (BLH) • Questions for users • How do you use the UMLS? • What do you need? • How can we make the UMLS more useful?

  3. Metathesaurus Production

  4. Metathesaurus Sources • Challenges • Frequency and timing of releases • Update cycles of critical vocabularies • Value of dormant sources • Selecting new sources • What sources do you use?

  5. Source data representation • Rationalizing source inversion • Term Types • Toward greater consistency of source analysis and representation • Improved documentation for internal processing and user understanding

  6. Tradeoff in representing sources Individual source transparency Absolute uniformity across all sources

  7. Strings, atoms, TTYs and ATVs • Is a particular source string a name? • If so, it is part of an atom and should appear in the ‘STR’ field of MRCONSO • Otherwise, it may need to go into the ‘ATV’ field of MRSAT • What does the NLM mean by the ‘TTY’ (termtype) field of MRCONSO? • Fundamental aspect of an atom • TTY assignment lies at the intersection of source-asserted data and NLM-asserted data

  8. Inter-terminology Mapping • The UMLS is a valuable resource in the creation and publication of inter-terminology mappings • HHS has given NLM the responsibility for funding, coordinating, and/or performing official mappings between standard clinical terminologies and HIPAA code sets: • SNOMED CT to ICD9CM • general purpose map already in the UMLS • reimbursement specific map - draft of rule-based mappings created, currently under review • LOINC to CPT • 2,000 mappings for lab LOINC available in the UMLS • additional mappings for radiology LOINC currently under review • SNOMED CT to MeSH • to facilitate link from electronic medical record to medical literature • currently being created by NLM editors

  9. MetamorphoSys Transition • MetamorphoSys (MMSys) is the essential tool for subsetting and customizing the Metathesaurus • MMSys needs to balance between providing stable core functions and innovative new features • The solution: a robust core MMSys and well-documented ‘plug-in’ architecture with public APIs for new features • Advantages: • new features will not interfere with core functions • users can also write and share their own plug-ins • Timeline: • MMSys released in 2008AA will remain unchanged for 1 year • First release of the new MMSys in 2009AA

  10. Purpose-specific subsets • The Content View Flag (CVF) field, which is present in all Metathesaurus data files, is a convenient and flexible way of labeling a purpose-specific subset • Examples: the NLP subset, the KP/VA Problem list subset • Clinical Observations Recording and Encoding (CORE) subset project – • to define a subset to support consistent high level encoding of clinical information • based on real clinical data contributed by major health care providers (e.g. Mayo Clinic, Kaiser Permanente, Intermountain Healthcare, Regenstrief Institute) • User contribution of their own subsets (e.g. terms used in a cardiology clinic) is welcome

  11. UMLS Education and Outreach • New Users Page • Online Demos • Step-by-Step pages • Narrated Introduction • UMLS Basics transitioning to online modules • Office hours still available • Getting starting Webcasts

  12. UMLS Community Page

  13. UMLS Webcast page

  14. SNOMED CTownership changed 4/26/2007 • NLM is US Member, with right to distribute SNOMED CT • In UMLS and native format • US represented on IHTSDO Board, General Assembly, & Standing Committees – 15 people (4 US gov’t ) • Working Groups – open to all • IHTSDO 2008 Work Plan • Complementary US priorities for 2008 – in development • US SNOMED CT content request process - one on the list

  15. Effective Use of UMLS in EHR Systems • Overnight integration of vocabulary updates into UMLS concept structure is not feasible yet (perhaps ever?) • Not taking advantage of UMLS in EHR systems is at best unfortunate and can be really counterproductive • How do you handle this issue? • What can NLM do quickly to help?

  16. Discussion Questions • How often should we release the UMLS? When? • Do you use legacy Original Release Format (ORF)? • What Metathesaurus sources do you use? • What translations do you use? • What enhancements would you make to MetamorphoSys? • What subsets do you use or create? Should we reproduce them? • How can we better support you?

  17. Thank you

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