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MedlinePlus Connect

Acknowledgement. November 2, 2010 NLM PresentationJoyce Backus, Deputy Chief, Public Services Naomi Miller, Manager, Consumer Health Information Section, Public ServicesStephanie Dennis, Public Services. Objectives. At the end of the session you will have An understanding the connection between

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MedlinePlus Connect

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    1. MedlinePlus Connect Claire Hamasu Associate Director Breezing Along with the RML November 2010

    2. Acknowledgement November 2, 2010 NLM Presentation Joyce Backus, Deputy Chief, Public Services Naomi Miller, Manager, Consumer Health Information Section, Public Services Stephanie Dennis, Public Services

    3. Objectives At the end of the session you will have An understanding the connection between the American Recovery and Reinvestment Act and MedlinePlus Connect An understanding of the components used to connect the EHR to relevant information in MedlinePlus Ideas on how to use this opportunity

    4. First a Background Story

    5. One of the Actions Encourage Use of Electronic Health Records Improve quality Efficiency Patient safety

    6. Regional Extension Centers (RECs) Support and serve health care providers Provide training and support services in adopting EHRs Offer information and guidance to help with implementation Give technical assistance as needed

    7. To Ensure Objectives Meaningful Use - Stage 1 Centers for Medicare and Medicaid Services (CMS) Incentives - $2 million+

    8. Meaningful Use Criteria for Consumer Health Information Identify patient-specific education resources and provide those to the patient as appropriate

    9. From EHR to Relevant Information

    10. Personal Health Record - Topic

    11. Infobutton Page to MedlinePlus

    12. Infobutton Page - Spanish

    13. Personal Health Record - Drug

    14. InfoButton Page - MedlinePlus

    15. Flexibility Vocabularies: Problem Codes (Diagnoses) ICD-9-CM: 11,000 codes SNOMED CT CORE: 5,000 codes Medication Codes RXCUI NDC Support HL7 Infobutton standard Problem Codes linking to English or Spanish Medication Codes linking to English

    16. Mapping Methods Automated (assistance from Lister Hill vocabulary experts) When it was good, it was very, very good When it was bad, it was horrid (e.g., mapped Microscopic examination of specimen from female genital tract to Physical Therapy) Manual Can be more accurate but Requires labor and sometimes research

    17. Mapping to MedlinePlus: Many to One 493: Asthma 493.00: Extrinsic Asthma Unspecified 493.01: Ext Asthma W Status Asthmaticus 493.02: Extrinsic Asthma with Exac 493.10: Intrinsic Asthma Unspecified 493.12: Extrinsic asthma with exacerbation 493.20: Chron Obst Asthma Unspecified 493.21: Chron Obst Asthma Unspecified 493.22: Chronic obst asthma with exacerbation 493.81: Exercise Induced Bronchospasm 493.82: Cough Variant Asthma 493.9: Asthma NOS 493.90: Asthma Unspecified 493.91: Asthma Unspec with Status Asth 493.92: Asthma Unspecified with Exac

    18. Mapping to MedlinePlus: One to Many ICD-9-CM 003.0: Salmonella enteritis Foodborne Illness Salmonella Infections Gastroenteritis 824: Fracture of ankle Fractures Ankle Injuries and Disorders SNOMED CT 15574005: Fracture of foot (disorder) Fractures Foot Injuries and Disorders

    20. Mapping scenarios

    21. Mapping guidelines Map only where there are clear, solid, unambiguous matches ICD code V44.0 tracheostomy status. The only place where MedlinePlus had information on tracheostomy was a topic called Critical Care. But a person may have a tracheostomy as an outpatient. NLM did not map to the topic. But once NLM created the topic Tracheal Disorders and the tracheostomy information was on that page, NLM mapped V44.0 to Tracheal Disorders.

    22. Mapping guidelines

    23. M+ Connect Use (Early Adopters) Jan – Sept 30, 2010: Beta Web service accessed >33,000 times (Problem Codes only)

    24. Using the feedback loop to create M+ Connect matches Examine search logs for no matches Most common code: V70.0, Routine physical examination. Created topic Health Checkup. Develop topics as find gaps while mapping ICD and SNOMED There was no good place to map ureter problems. Created topic Ureteral Disorders. Refine existing M+ topics for greater accuracy/specificity Giant cell arteritis was included on page on Polymyalgia Rheumatica. This wasn’t really correct. Split into two separate pages.

    25. New Clinical Topics on MedlinePlus

    26. How to get from here to there? EHR: PAXIL 20 MG OR TABS, NDC: 00029-3211-13    M+ Drug Monograph: Paroxetine Consulted with experts - MeSH, MMS, Lister Hill Answer is RxNorm Process for Drugs

    27. Process for Drugs

    28. Technical Information Diagnoses Health Level 7 (HL7) Standard ICD-9-CM SNOMED CT CORE Drugs RxNorm Concept Unique Identifier (RXCUI) National Drug Code (NDC)

    30. MedlinePlus Connect Listserv Listserv@list.nih.gov Message Body: Subscribe MedlinePlus Connect your first name your last name For developers and users

    31. Moving Forward Piloting with early adopters Lab tests for future release Add XML Web Services

    32. What ways do you suggest for health sciences librarians to follow up on this opportunity?

    33. …meaningful use of certified EHR technology should result in health care that is patient centered, evidence-based, prevention-oriented, efficient, and equitable.

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