Panel 3: What level of data granularity, common standards, lexicon elements, and definitions need to

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Panel 3 What level of data granularity, common
standards, lexicon elements, and definitions need
to be developed by the health system community to
meet the needs of an advanced clinical
information system?

• Application of Information Technology to the
  Transformation of Clinical Research and Health
  Care in the 21st Century
• Lansdowne Resort
• October 30-31, 2002
• James J. Cimino
• Columbia University

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Question 1 Standards Today - Current Solutions

• Laboratory - LOINC
• Pharmacy RxNorm
• Messages HL7

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Question 1 Standards Today Barriers

• Lack of/shortcomings in standards
• Diagnoses
• Procedures
• Findings
• Investment in use
• Duplication of effort
• Evaluation

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Question 2 Standard Terminologies Barriers

• Licensing restrictions
• Incorporation into commercial systems
• Dont support data reuse

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Attempting Data Reuse
- Smallpox - Cowpox - Virus, NEC
Virus, NEC
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Question 2 Standard Terminologies Solutions

• Improving content
• Improving licensing
• Evolving to terminology servers

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Question 3 Granularity Whats the Problem?

• General ?????????? Specific
• Research Data Clinical Data

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Research Data More General than Clinical Data
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Question 3 Granularity Whats the Problem?

• General ?????????? Specific
• Research Data Clinical Data

Clinical Data Research Data
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Clinical Data More General than Research Data
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Question 3 Granularity Whats the Solution?

• Support multiple levels of detail
• Support multiple hierarchies
• Improve mapping functions

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Solutions to the Multiple Granularity Problem
Goodpastures Syndrome
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Question 3 Granularity Whats the Solution?

• Support multiple levels of detail
• Support multiple hierarchies
• Improve mapping functions

• Inform data collection

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Question 4 Next Steps

• Evaluation and improvement of standards
• Initiate feedback cycles
• Coordination of terminologies
• Terminology services
• Vendor adoption
• Coordination of data collection