Connecting two Health IT systems together is just the first step to making them interoperable. Often the information stored in each system adheres to a different data standard. Thus to make the information useful, it needs to be translated so that each system can understand what the other is saying. Terminology Services is that translator.
Here is a useful analogy. Think of a telephone line that connects one person to another. The line itself is a critical component in allowing people to communicate. But what if one person speaks only English, while the other, only Italian? In this situation the connection is practically useless since neither party would understand what the other is saying.
That is essentially the issue in healthcare. Lab systems store information in a certain way – usually in a data standard called LOINC (Logical Observation Identifiers Names and Codes). Clinical systems, like EHRs, store information in a different way – usually in ICD codes (billing) and SNOMED CT (clinical findings, diagnoses, procedures, etc). Sending an ICD-10 code to a system that only understands LOINC would be completely useless.
What’s needed is a translator that knows how to convert information from one terminology (data standard) to another. That’s what a class of solutions called Terminology Services does. Here is an example, from SNOMED International, of how a Terminology Service works:
I admit, that I only understood the basics of Terminology Services. So, I jumped at the chance to dive deeper with CareCom CEO and Founder, Jacob Boye Hansen as well as Tami Jones, CareCom’s Head of Product Solutions. CareCom offers HealthTerm – a terminology services solution that helps map and normalize clinical data.
Jones surprised me right from her opening statements. I had always operated under the assumption that healthcare organizations strictly adhered to the data standards specific to the system they were using (ie: LOINC for lab systems). Jones quickly pointed out that many organizations use custom codes. This of course, means that a custom mapping is needed in order to translate those unique codes into a universal standard.
Jones also mentioned that organizations that do not use a Terminology Solution often have to resort to spreadsheets to store the data map. I can’t imagine trying to maintain a set of spreadsheets that map data from all the various systems in an organization. It must be a nightmare.
Hansen rightly points out that the key to eliminating these spreadsheets is to have a “single source of truth”, where all the mappings to all the different coding system are stored and easily accessible – not just by people but by the systems that need it.
Towards the end our the interview, Hansen and Jones answer a question that had been nagging me for a while: If there is a set number of standardized coding formats (LOINC, CPT, ICD, etc). then what differentiates one terminology services solution from another?
In the case of HealthTerm, the answer is several unique built-in features like a language translation module (that literally turns English into Spanish or Italian or whatever language you need) and an auto-mapping function that wades through thousands of concepts to find the most likely results to match the mapping a user wants to make.
As more focus is put on achieving full interoperability, healthcare organizations and software makers alike will need to consider adopting Terminology Services Solutions, like HealthTerm, in order to ensure they can unlock the value of the data stored in their systems.
*Carecom is a Healthcare Scene sponsor