1. Terminology Services in the OpenHIE

2. Agenda Terminology Services Overview Terminology Services in Rwanda Distributed Terminology System (DTS) Next Steps

3. OpenHIE Architecture Health Interoperability Layer … Components

4. A Terminology Server is : –a networked, software component –that centralizes terminology knowledge (e.g. national and international standards) –and provides terminology services to other network applications. What Is a Terminology Server?

5. Terminology Servers Terminology Servers are used : –By informaticians to create, extend, localize, and map terminologies –By interface applications to translate data elements between applications –By clinical applications to select, standardize and analyze clinical data

6. Examples of Terminology Services Term/name normalization: What is SNOMED CT name for “heart attack”? Code translation What is the ICD-9 code for Myocardial Infarction? Grouping and aggregation Is Myocardial Infarction a Cardiac Disease? Clinical knowledge What drug treats Myocardial Infraction? Local information Add L227 as the local code for Serum Calcium. Myocardial Infarction 410.91 Yes Streptokinase Okay

7. Terminology Services Interfaces Health Professional Terminologist Application API Browse Edit Load SDO Health Interoperability Layer

8. Rwanda Requirements Central Repository Code System Support Program (API) Interface Terminologist Interface Health Professional Interface

9. Rwanda Requirements Central Repository –DTS on Ubuntu, MySQL Code Systems

10. Code System Support ICD-10 and LOINC from Apelon ICD-10 subset (ICD10RW) LOINC Ontylog Extension ( Rwandan Maternal Health ) –Subset of LOINC –New codes for LOINC (LOINCRW) –RWCS (Rwandan Code Space) Uses OpenMRS Concept IDs Rwandan Administrative Units RHEA RapidSMS Codes

11. Planned Code Systems ICHI DM+d ATC UMDNS

12. Rwanda Requirements Program (API) Interface –using the DTS API –Functionality exposed via Web Service –Integration with HIE Terminologist Interface –DTS Editor Health Professional Interface –JEMBI-developed Browser

13. Health Professional Interface

14. https://github.com/jembi/ts-browser RHEA Test Instance available at http://ts.jembi.org http://ts.jembi.org

15. What is DTS? An enterprise terminology server used to : –Acquire & maintain standards –Integrate and manage local code sets –Map/interrelate terminologies –Deploy in applications Originally developed as an Apelon commercial product, but now open source Downloaded over 4500 times worldwide

16. DTS Components Knowledge Base (Content) Server Client API GUI applications Utilities and samples Subscription content service Commercial software support

17. DTS 4 Comprehensive revision of DTS Addresses emerging enterprise requirements for creating, maintaining and deploying terminologies Alpha releases available at http://www.ApelonDTS.org http://www.ApelonDTS.org 17

18. DTS 4 Features Enterprise Architecture Integrated Version Management Additional Metadata on Code Systems and Subsets Enhanced Subsets New DTS Browser Expanded DTS Editor Architecture 18

19. DTS 4 Architecture

20. Next Steps: Use Cases Develop detailed use-cases /requirements for the for the components: –Platform: OS/database? –Program Interface – what APIs? what functions? –Terminologist Interface – what functions? –Health Professional Interface – what functions? –Code System Support – which terminologies?

21. Medical terminology in practice