Interoperability with SNOW SHRINE James R. Campbell MD Scott Campbell PhD Jay Pedersen MS Yeshwanth Narayana James McClay MD Nebraska Medicine University of Nebraska Medical Center

I2b2 research network interoperation in SHRINE Hypothesis: We are entering an era of interoperable research network dominance Requires OBSERVATION_FACTs to be CONCEPT_CDed with relevant, historically complete standard terminologies/ontologies (or mapped from local terms) Shared deployment of standard ontology set as i2b2 metadata across all network spokes which references all coded content Adapter mappings for networked query support

ONC Terminology Model for Semantic Interoperability Demographics: LOINC Problem list: SNOMED CT Encounter and billing diagnoses: (ICD-9-CM), ICD-10-CM Lab results (observables): Lab LOINC Physical findings: LOINC Medication orders: RxNORM Medication dispense & administration records: NDC Procedures: ICD-10-PCS, CPT, HCPCS

Fall 2017 SCILHS (ARCH) metadata analysis 40% or better of medication fact data was not accessible with SCILHS ontology; historical meds were missing entirely Laboratory metadata referenced no more than 10% of UNMC facts, rendering the data useless ICD-10-CM out of date RxNorm, NDC and LOINC ontology builds from UNMC evaluated by JK and agreed as useful for ARCH; I have no update on ARCH deployment

SNOW SHRINE

SNOW SHRINE Metadata 2018 Metadata concepts 20180330 20181001 ICD-10-CM 92073 93522 LOINC (lab/pathology) 1662 1880 RxNorm 107693 109154 NDC 517620 527401 SNOMED CT Conditions N/A 124503 Procedures(CPT, ICD*) 250833 LOINC (clinical) 334

ACT network cooperation Met with Michelle Morris (UPitt) who is technical lead and data harmonization team repeatedly UNMC shared Snow SHRINE lab ontology set which they used to seed their own effort Shared medication metadata and found their approach to be similar but extracted from UMLS and therefore incomplete No commitment for collaboration on ontology layer which would conceivably save many GPC sites dual employment of SHRINE