Introduction
We have learned in the textbook that the use of standardized medical language across diverse information systems is required for the implementation of a standard electronic health record (EHR) and a national health information infrastructure. Interoperability (i.e., the sharing of healthcare data) is an essential component of a national health information infrastructure, which requires the use of uniform health information standards. This will significantly improve medical care effectiveness, patient safety, cost-effectiveness, and research values. That said, the lack of health information standards has been a key barrier to electronic connectivity in healthcare.
Classification systems, such as International Classification of Diseases, specifically ICD-9-CM, ICD-10-CM, ICD-10-PCS, and ICD-11, group together similar diseases and procedures, and organize related entities for easy retrieval. That said, such classification systems are considered “output” rather than “input” systems and are not intended or designed for the primary documentation of clinical care. Their lack of granularity and failure to define individual clinical concepts and their relationships impact the role they play in a reference terminology. Nonetheless, they are typically used for external reporting requirements or other uses where data aggregation is advantageous, such as measuring the quality of care, monitoring resource utilization, or processing claims for reimbursement.
On the other hand, reference terminologies, such as Systematized Nomenclature of Medicine, e.g., SNOMED-CT®, are “input” systems and codify the clinical information captured in an EHR during the course of patient care. However, their immense size, considerable granularity, complex hierarchies, and lack of reporting rules render them inadequate for serving the secondary purposes unlike classification systems.
That said, the benefits of using a reference terminology, such as SNOMED-CT, increase exponentially if the reference terminology is linked to modern, standard classification systems for the purpose of generating health information necessary for secondary uses. The linkage of terms in different systems to extract information for multiple purposes is accomplished through mapping. Mapping is the process of linking content from one terminology to another or, in this case, a classification system. Assignment (250 points)
I. Application
A. Access the SNOMED CT Browser and the ICD-11 Browser (click on web links below).
ICD-11 for Mortality and Morbidity Statistics at: https://icd.who.int/browse11/l-m/en
SNOMED CT Browser at: https://browser.ihtsdotools.org/index.html?perspective=full&conceptId1=9972008&edition=MAIN/2022-03-31&release=&languages=en
B. Using each tool, explore the following medical problems:
1. Kidney Stones (urolithiasis)
2. Acute Myocardial Infarction
3. Asthma
4. Headache
5. Diabetes mellitus
C. Report your findings. You may tabulate your findings if you wish. (You may limit your report to just five results per medical problem).
II. Review D. Read the attached paper (PDF) published in 2012 in the Journal of the American Medical Informatics Association (JAMIA). Summarize the paper in your own words to highlight:
The main points of the paper
The author’s arguments presented in the paper
The methods employed in the study
The authors’ conclusion(s) made in the paper
III. Reflection E. Visit the I-MAGIC (Interactive Map-Assisted Generation of ICD Codes) Algorithm at https://imagic.nlm.nih.gov/imagic/code/map. This demo simulates a problem list interface, where the user enters SNOMED CT medical terms, which are then used to derive ICD-10-CM codes using the Map.
Search the five medical problems again. Then, report your derived ICD-10-CM codes. (You may limit your report to five results per problem.)
[You will notice that the I-MAGIC Algorithm utilizes the SNOMED CT to ICD-10-CM Map (not ICD-11) in a real-time, interactive manner. That’s OK]
F. In your own words, please reflect on your experience using the SNOMED CT, ICD-11, and I-MAGIC interactive tools. Please, briefly comment on:
Pros or Cons of using each tool
Do you corroborate the arguments made by the JAMIA paper’s authors?
Would a similar semantic alignment between SNOMED CT and ICD-11 (Map) be valuable? Why?
Please, limit your Special Project to a maximum of five double-spaced pages (excluding the title page, tables, and references).