1. Concept to Codes Approach

2. Visual Representation PSMA Code 1 Code 2 PSMA Code 1 Code 2 LOINC Code 624-7 Code 6460-0 LOINC Code 624-7 Code 6460-0 SNOMED CT Code DE-14213 Code DE-10100 SNOMED CT Code DE-14213 Code DE-10100 ICD 9 Code 486.00 Code 481.00 ICD 9 Code 486.00 Code 481.00 ICD 10 Code J 18.9 Code J 18.1 ICD 10 Code J 18.9 Code J 18.1 Vocabulary Standards & Codes: Each standard has multiple ways to represent the same concept. UMLS (Value Set Repository) Clinical Concepts (unique per hospital, larger hospital system might share one) Clinical Concepts (unique per hospital, larger hospital system might share one) Sounds like Rich wants to standardize this portion, the process of mapping from the vocabulary codes to the clinical concepts. A A Question: Is the query on the vocabulary concepts (A) and codes OR the clinical concepts (B)? Depending on this answer the CIM will have to be developed taking this into consideration? B Map Vocabulary Codes to Clinical Concept Dictionary

3. Visual Representation Query A Clinical Concept to Codes UMLS (Value Set Repository) PSMA Code 1 Code 2 PSMA Code 1 Code 2 LOINC Code A Code B LOINC Code A Code B SNOMED CT Code XYZ Code ABC SNOMED CT Code XYZ Code ABC ICD 9 Code 45 Code 87 ICD 9 Code 45 Code 87 ICD 10 Code 124 Code 89 ICD 10 Code 124 Code 89 Clinical Concepts (unique per hospital, larger hospital system might share one) Clinical Concepts (unique per hospital, larger hospital system might share one) Map Clinical Concept Dictionary to Vocabulary Codes Clinical Concepts Query is Received Query Request based on Clinical Concepts Information Requestor (Role: Query Source) Provider/Provider Organization (Role: Data Source) Clinical Concepts are Mapped from the Clinical Concept to Data in System Data is Identified Data is Formatted to Answer Query Data is mapped to Clinical Concepts Clinical Concepts Query Request is formatted Query Results are Sent to Requestor Query Expression

4. Query A Workflow Diagram 4 Need for Clinical Query is Defined Query is Created Against Concept Dictionary Query is Expressed in these Concepts Query is Transmitted to Data Sources Results of Query are Obtained Data Source Receives Query Data Source Maps Query Concepts to Local Concepts Data Source Maps Query Concepts to Standard Vocabularies Codes Data Source Maps Standard Vocabulary Codes to Local Concepts Query is Run Against Source’s Data Relevant Results are Returned Using Defined Format Data Source Query Source

5. Visual Representation Query B Codes to Clinical Concepts UMLS (Value Set Repository) PSMA Code 1 Code 2 PSMA Code 1 Code 2 LOINC Code A Code B LOINC Code A Code B SNOMED CT Code XYZ Code ABC SNOMED CT Code XYZ Code ABC ICD 9 Code 45 Code 87 ICD 9 Code 45 Code 87 ICD 10 Code 124 Code 89 ICD 10 Code 124 Code 89 Clinical Concepts (unique per hospital, larger hospital system might share one) Clinical Concepts (unique per hospital, larger hospital system might share one) Map Vocabulary Codes to Clinical Concept Dictionary Coded Data Query is Received Query Request based on Coded Data Information Requestor (Role: Query Source) Provider/Provider Organization (Role: Data Source) Coded Data are Mapped from the Clinical Concepts Concept is Identified Concept is Formatted to Answer Query Clinical Concepts are Mapped to Coded Data Coded Data Query Request is formatted Query Results are Sent to Requestor Query Expression

6. Query B Workflow Diagram 6 Need for Clinical Query is Defined Query is Created Against Concept Dictionary Query is Expressed in these Vocabulary Codes Query is Transmitted to Data Sources Results of Query are Obtained Data Source Receives Query Data Source Maps Query Standard Vocabulary Codes to Local Concepts Query is Run Against Source’s Data Relevant Results are Returned Using Defined Format Data Source Query Source Query Concepts are Mapped to Standard Vocabulary Codes