Terminology Service Bureau Vision People Medical professionals who specialize in clinical terminologies Individuals to manage the processes Developers to build the tools Tasks Creation of the MHS Core Ontology Adding terminologies to the core ontology Content Reusable Portable Partitionable Processes Procedures for adding new content Procedures for maintaining the content Procedures for versioning the content Tools Content import/export tools Terminology load and analysis tools Run-time Environment Reference implementation Web services 11 Jan 06 Northrop Grumman Private / Proprietary Level I

Northrop Grumman Private / Proprietary Level I TSB Features Atomic concepts Reference Terminologies (e.g. SNOMED CT) Administrative and billing terminologies (e.g. ICD) Comprehensive concepts User interface terminologies Terms Context for term translation Simple hierarchies Complex hierarchies Unordered sets Pure cross mapping of terminologies Pick lists 11 Jan 06 Northrop Grumman Private / Proprietary Level I

Northrop Grumman Private / Proprietary Level I TSB Features (Part 2) Content is not proprietary Allows business rules to be applied to the mapping process Portability Design is generic based on web services – can be moved as needed Partitionability Design allows for smaller extracts of content into a run-time environment Versioning of Standard Terminologies Concept translation can be done against specific versions or “current” Complex relationships Vertical relationships Horizontal relationships 11 Jan 06 Northrop Grumman Private / Proprietary Level I

Processes, Tools, Run-time Environment TSB Content Management Environment TSB Run-time Environment Client - Applications Terminology Load Services Application Application Application TSB Content Main Database MCO Client API LinkFactory GUI Administration Mid-Tier Server MCO Run-time Web Services TSB Content Release Database TSB Content Export File TSB Content Release Database TSB Content Export Service TSB Content Import Service 11 Jan 06 Northrop Grumman Private / Proprietary Level I

Terminology Service Bureau Purpose Two key requirements create a need for the TSB COTS Integration Strategy Computability/Interoperability across COTS products If you used only one vendor’s products you would not need a TSB TSB is a non-proprietary ontology that creates a bridge which enables integration and interoperability among COTS systems 11 Jan 06 Northrop Grumman Private / Proprietary Level I

Northrop Grumman Private / Proprietary Level I TSB Current Status People Teams are in place and are operational Tasks Content development methodology is operational Content SNOMED CT: 07/2004 MEDCIN: 4Q2004, 2Q2006 PKC: 12-2005, 2Q2006 RxNORM (partial): 4/4/2005 AIEN (partial): 4/2005 NDC (partial): 11/2004 CliniComp (partial): One site – Jan 2006 11 Jan 06 Northrop Grumman Private / Proprietary Level I

TSB Current Status (cont.) Processes Procedures are defined and operational Tools Content management environment is operational Import services Export service Run-time Environment AHLTA Build Release 3.4 11 Jan 06 Northrop Grumman Private / Proprietary Level I