1. Clinical Vocabularies James J. Cimino, M.D. Columbia University

2. March, 1997: The Needs for Coding and Classification Systems Multiple needs for controlled vocabulary Capturing clinical data for multiple purposes (In)adequacy of current systems Some desired characteristics A model for the future

3. Capturing Clinical Data for Multiple Purposes: Now Recode Patient Data Financial Database Collect Patient Data Clinical Repository Collect Patient Data Research Database

4. Recode Patient Data Financial Database Collect Patient Data Clinical Repository Collect Patient Data Research Database Capturing Clinical Data for Multiple Purposes: Future

5. Concept Orientation One meaning meaning per code Clear semantics Meaning never changes Concept permanence

6. Structural Aspects: Don’ts Don’t limit breadth or depth of hierarchy Don’t limit to a strict hierarchy Don’t put meaning in the codes

7. NEC

8. Content: Do’s Do strive for content that matches the needs of the primary creators of the data Do develop a feedback mechanism to include creators and users in content development Do develop a timely, concept-oriented update process

9. Lessons to Learn ICD - Not! SNOMED LOINC