Terminology Services

in the

OpenHIE

Agenda

• Terminology Services Overview

• Terminology Services in Rwanda

• Distributed Terminology System (DTS)

• Next Steps

OpenHIE Architecture

Health Interoperability Layer

…

Components

• A Terminology Server is:

– a networked, software component

– that centralizes terminology knowledge (e.g. national

and international standards)

– and provides terminology services to other network

applications.

What Is a Terminology Server?

Terminology Servers

• Terminology Servers are used:

– By informaticians to create, extend, localize, and

map terminologies

– By interface applications to translate data elements

between applications

– By clinical applications to select, standardize and

analyze clinical data

Examples of Terminology Services

• Term/name normalization:

What is SNOMED CT name for “heart attack”?

• Code translation

What is the ICD-9 code for Myocardial Infarction?

• Grouping and aggregation

Is Myocardial Infarction a Cardiac Disease?

• Clinical knowledge

What drug treats Myocardial Infraction?

• Local information

Add L227 as the local code for Serum Calcium.

Myocardial Infarction

410.91

Yes

Streptokinase

Okay

Terminology Services Interfaces

Health Professional

TerminologistApplication API

Browse

Edit

LoadSDO

Health Interoperability Layer

Rwanda Requirements

• Central Repository

• Code System Support

• Program (API) Interface

• Terminologist Interface

• Health Professional Interface

Rwanda Requirements

• Central Repository

– DTS on Ubuntu, MySQL

• Code Systems

Code System Support

• ICD-10 and LOINC from Apelon

• ICD-10 subset (ICD10RW)

• LOINC Ontylog Extension (Rwandan Maternal Health)

– Subset of LOINC

– New codes for LOINC (LOINCRW)

– RWCS (Rwandan Code Space)

• Uses OpenMRS Concept IDs

• Rwandan Administrative Units

• RHEA RapidSMS Codes

Planned Code Systems

• ICHI

• DM+d

• ATC

• UMDNS

Rwanda Requirements

• Program (API) Interface

– using the DTS API

– Functionality exposed via Web Service

– Integration with HIE

• Terminologist Interface

– DTS Editor

• Health Professional Interface

– JEMBI-developed Browser

Health Professional Interface

Health Professional Interface

• https://github.com/jembi/ts-browser

• RHEA Test Instance available at

http://ts.jembi.org

What is DTS?

• An enterprise terminology server used to :

– Acquire & maintain standards

– Integrate and manage local code sets

– Map/interrelate terminologies

– Deploy in applications

• Originally developed as an Apelon commercial

product, but now open source

• Downloaded over 4500 times worldwide

DTS Components

• Knowledge Base (Content)

• Server

• Client API

• GUI applications

• Utilities and samples

• Subscription content service

• Commercial software support

DTS 4

• Comprehensive revision of DTS

• Addresses emerging enterprise requirements

for creating, maintaining and deploying

terminologies

• Alpha releases available at

http://www.ApelonDTS.org

17

DTS 4 Features

• Enterprise Architecture

• Integrated Version Management

• Additional Metadata on Code Systems and Subsets

• Enhanced Subsets

• New DTS Browser

• Expanded DTS Editor Architecture

18

DTS 4 Architecture

Jboss (Application Server)DTS Server WAR (J2EE Application)

DTS Server (EJB)

JDBC DTS Entity Beans

DTS Query Stateless Session Beans DTS Data Model

DTS Query Local Interface

DTS Query Web Service Interface

DTS Query Remote Interface

DTS Browser

J2EE App

DTS Client APIs

DTS Editor

Java Web Service Client

DTS Database (Oracle, SQL Server, MySQL)

Modular Classifier Web Service

DTS 4 Architecture

Content Management

Content Subscription

DTS.Net Client APIs Java App

.Net App

.NET Web Service Client

Java App

Next Steps: Use Cases

• Develop detailed use-cases /requirements for the

for the components:

– Platform: OS/database?

– Program Interface – what APIs? what functions?

– Terminologist Interface – what functions?

– Health Professional Interface – what functions?

– Code System Support – which terminologies?

Medical terminology in practice