Transcript 2003-The Medical Entities Dictionary

The Medical Entities Dictionary
Columbia University
Department of Biomedical Informatics
The Medical Entities Dictionary
Retrieving Results Individually
K#1 = 4.2
K#1 = 3.3
K#2 = 3.2
K#1 = 3.0
K#3 = 2.6
K#1
K#2 K#3
Retrieving Results by Class
K#1 = 4.2
K#1 = 3.3
K#2 = 3.2
K#1 = 3.0
K#3 = 2.6
K
K#1
K#2 K#3
What is in the MED?
• Sunquest lab terms
• Cerner lab terms
• Digimedix drugs
• Cerner Drugs
• Sunquest Radiology
• ICD9-based problem list terms
• Other applications
• Knowledge terms
How Big is the MED?
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•
•
•
•
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Concept-based (77,500)
Multiple hierarchy (115,000)
Synonyms (180,000)
Translations (125,000)
Semantic links (270,000)
Attributes (175,000)
MED Structure
Medical
Entity
Substance
Chemical
Laboratory
Specimen
Anatomic
Substance
Plasma
Carbohydrate
Bioactive
Substance
Glucose
Plasma
Specimen
Event
Diagnostic
Procedure
Laboratory
Test
Plasma
Glucose
Test
Laboratory
Procedure
CHEM-7
Part of
Using the MED
• Translation
– What is the ICD9 Code for …?
– What is the display name for …?
– What is the aggregation class for …?
• Translation Tables
• Class-based questions
– Is Altace an antihypertensive?
– What are all the antibiotics?
• Knowledge queries
– What are the pharmaceutic ingredients of…?
Using the MED
WebCIS
MED
QueryMED
Decision
Support
Translation
Table
Interface
Engine
The MED and Messaging
Clinical
Data
Repository
Ancillary
System
Local
Codes
Interface Engine
Translation
Table
MED
Codes
Other
Subscribers
Case Study: Aggregation for C2000
• Labs have multiple codes for the same tests
• C2000 displays tests in spreadsheets (“buttons”)
• One code per column per button
• Unrecognized codes go into “Miscellaneous”
• Labs are always adding new tests and not telling
• How do we keep the C2000 buttons current?
C2000 Buttons in the MED
The “Lytes” Button
Intravascular Sodium Tests
C2000 Buttons in the MED
Querying for Button Parts
Querying for Button Parts
Operationalizing C2000 Aggregation
• Translation from lab code to MED code is done
by interface engine
• Aggregation from MED code to C2000 button
column (“Intravascular …”) is done by interface
engine
• New lab tests that fall into existing columns are
automatically aggregated
• New lab tests that don’t fall into existing columns
can be identified before ending up in
“Miscellaneous”
Translations with the MED
Intravascular
Gentamicin
Tests
Summary
Reports
Injectable
Gentamicin
Serum
Gentamicin
Level
Gentamicin
Gentamicn
Sensitivity
Test
Decision
Rule
Gentamicin
Toxicity
Drug
Information
Expert
System
The MED and Eclipsys
• Capturing data from ancillary systems
• Aggregation for summary reporting
• Keeping terminologies up to date (e.g.,
for order entry)
• Class-based decision rules
• Multiple hierarchies allowed
• Linking to on-line resources