1. Concepts & the Concept Dictionary Regional East African Centre for Health Informatics (REACH-INFORMATICS) Lauren Stanisic July 2012 REACH-INFORMATICS, July 2012

2. Outline and Goals for Today  Understand the concept dictionary, and how to develop and use concepts 1.Basic understanding of concept dictionary and concepts 2.Understanding how to define and use concepts 3.Proposing new concepts 4.Building a Form Key REACH-INFORMATICS, July 2012

3. Any questions, before we begin? REACH-INFORMATICS, July 2012

4. 1.Understanding Concepts and the Concept Dictionary REACH-INFORMATICS, July 2012

5. What is a Concept? Basic data elements collected through a medical record system Includes the questions and answers contained in an electronic medical record form REACH-INFORMATICS, July 2012

6. What is a Concept?, cont’d  Can be a question or answer  A variable REACH-INFORMATICS, July 2012

7. Example: What is a Concept? What is the patient’s blood type? (concept id 300) – A+ (concept id 690) – B+ (concept id 694) – AB+ (concept id 1230) – O+ (concept id 699) REACH-INFORMATICS, July 2012

8. Example: What is a Concept? What is the patient’s height? (5090) _________ inches What is the patient marital status? (1054) -Married (5555) -Divorced (1058) -Never Marries (1057) REACH-INFORMATICS, July 2012

9. Example: What is a Concept? Date of Return Visit (5096) ____/ ____/ ______ REACH-INFORMATICS, July 2012

10. What is the Concept Dictionary? Stores all the concepts and their definitions Like a usual dictionary, except contains only the concepts used in the medical record system REACH-INFORMATICS, July 2012

11. ACTIVITY What questions do you have on Concepts and the Concept Dictionary? REACH-INFORMATICS, July 2012

12. ACTIVITY - Can someone volunteer to describe what a concept is, in their own words? - Can someone volunteer to describe what a concept dictionary is, in their own words? REACH-INFORMATICS, July 2012

13. ACTIVITY Everyone brainstorm 2 examples of concepts that would appear in Concept Dictionary, which have not yet been mentioned. REACH-INFORMATICS, July 2012

14. In practice: You are given a medical record paper form, and are told made an electronic form. Where do you start? REACH-INFORMATICS, July 2012

15. Start by… Determining which concepts in the Concept Dictionary match the questions and answers on that form REACH-INFORMATICS, July 2012

16. Searching the Dictionary In OpenMRS, search the dictionary by entering keywords into the search box. Tips: – Check the dictionary to see if concepts already exist – Check for synonyms and abbreviations – Check different spellings – Create new concepts in the dictionary if not existing – Avoid duplicating concepts!!!!! REACH-INFORMATICS, July 2012

17. Searching the Dictionary, cont’d Steps: Click on the “Dictionary” option in the navigation pane (top of home page) REACH-INFORMATICS, July 2012

18. Searching the Dictionary, cont’d Enter the term in search box, and view responses below REACH-INFORMATICS, July 2012

19. Searching the Dictionary, cont’d Put your cursor over the desired option, and click to select it. The option will highlight. REACH-INFORMATICS, July 2012

20. Searching the Dictionary, cont’d Click on the item to read it’s description and determine if it meets your needs. REACH-INFORMATICS, July 2012

21. Searching the Dictionary, cont’d If the item you found meets your needs, “map” that item to the content on your form If there is no existing item to meet your needs, create a new concept REACH-INFORMATICS, July 2012

22. 2.Understanding How to Design and Use Concepts REACH-INFORMATICS, July 2012

23. Creating and Using Concepts In OpenMRS, all concepts must have the following defined: Name Class Datatype Description Concept Id REACH-INFORMATICS, July 2012

24. Creating and Using Concepts, cont’d Some concepts might also have the following: Synonym Short name Coded Answers (only for a coded question) REACH-INFORMATICS, July 2012

25. Concept View in OpenMRS REACH-INFORMATICS, July 2012

26. Concept Primary Name The basic label for the concept Only has one, and it must be unique No abbreviations or acronyms REACH-INFORMATICS, July 2012

27. Concept Synonym Nickname, abbreviations, and acronyms Informal or local names REACH-INFORMATICS, July 2012

28. Example: Primary Name & Synonym Primary Name = Antiretroviral Drugs Synonym = ARVS Primary Name = Tuberculosis Skin Test, Qualitative Synonym = TB Skin Test, Qual REACH-INFORMATICS, July 2012

29. Concept Classes Question Test Drug Diagnosis Symptom Symptom/Finding Anatomy REACH-INFORMATICS, July 2012

30. Concept Classes, cont’d Lab Set Med Set Convenience (Conv) Set Misc REACH-INFORMATICS, July 2012

31. Concept Datatypes Numeric Coded Text Date Time Datetime Boolean N/A REACH-INFORMATICS, July 2012

32. ACTIVITY Describe the concept class and data type you would use for the following items: What is the patient’s weight (kg)? Ibuprofin Diabetes Cough Does the patient know his/her HIV status? False REACH-INFORMATICS, July 2012

33. ACTIVITY What concepts are needed for the following question? Specify their name, synonym, class and datatype. Question: What referrals did the patient receive? — TB Clinic — HIV Clinic — Mental Health REACH-INFORMATICS, July 2012

34. ACTIVITY What concepts are needed for the following question? Specify their name, synonym, class and datatype. Question: What is the patient’s height (cm)? Answer: _______ REACH-INFORMATICS, July 2012

35. ACTIVITY What concepts are needed for the following question? Specify their name, synonym, class and datatype. Question: Date of encounter ____ /_____ /_____ (dd/ mm / yyyy) REACH-INFORMATICS, July 2012

36. Question Sets A parent concept which stores child concept questions Has N/A data type, because not a question – The child concepts are the questions which store data REACH-INFORMATICS, July 2012

37. 3.Proposing Concepts REACH-INFORMATICS, July 2012

38. Proposing Concepts Performed when needed concepts do not yet exist in the dictionary It is good to have a process that works for a group of people, not just one person Ampath uses a simple and careful approach REACH-INFORMATICS, July 2012

39. Proposing Concepts, cont’d Using an Excel Spreadsheet, outline the following items: – Question # – Display of item/text on the paper form – Proposed new concept’s: Name Description Class Datatype Single or Multiple Answer (if coded question) Coded Answers (if coded question) Units (if numeric question) Min/Max Values (if numeric question) Any Other remarks REACH-INFORMATICS, July 2012

40. Best Practice for Proposing Concepts 1.Be certain the concept doesn't already exist in the dictionary. – When searching the dictionary, use partial names to catch misspelled entries – Search for synonyms or local terms REACH-INFORMATICS, July 2012

41. Best Practice for Proposing Concepts, cont’d 2.Be certain you completely understand the item being created — Do research and double check with the person requesting the concept that you have the correct specific definition. — Seek information from medical terminology authorities REACH-INFORMATICS, July 2012

42. Best Practice for Proposing Concepts, cont’d 3.Make sure that you include a standardized representation of the concept, or follow any existing conventions in the dictionary. – For example, standard naming conventions. – Dictionary example: Qual/Quant REACH-INFORMATICS, July 2012

43. ACTIVITY Propose concepts for the following question: What side effects did the patient experience to his/her ARVS (tick all that apply)? – Rash – Swelling – Nausea – Vomit – Diarrhea – Hives REACH-INFORMATICS, July 2012

44. ACTIVITY Propose concepts for the following question: How many siblings does the patient have? Answer: __________ REACH-INFORMATICS, July 2012

45. 4.Building a Form Key REACH-INFORMATICS, July 2012

46. Building a Form Key A Form Key is a way to visualize the elements on a form and the elements they will be “mapped” to in the system Enter the concept IDs for the questions and responses on the form REACH-INFORMATICS, July 2012

47. Building a Form Key, cont’d Steps: For each field on the paper form, search the concept in the dictionary to locate an existing concept. If a concept already exists, it is helpful to mark the concept ID on the paper form or keep a list of form questions IDs and corresponding concept IDs If a concept does not exist, propose the concept on an excel spreadsheet before creating them in the concept dictionary. REACH-INFORMATICS, July 2012

48. Building a Form Key, cont’d Ampath uses the following conventions: – Questions are in red font with yellow background – Sets are in red font with blue background – Responses are in red font – Drug concepts are in green font – Drug ids (only for formularies) are in purple font REACH-INFORMATICS, July 2012

49. Example: Building a Form Key REACH-INFORMATICS, July 2012

50. ACTIVITY Use the REACH Sample Form. Search the concept dictionary and create a form key for this form. Take appropriate actions when new concept(s) must be created. REACH-INFORMATICS, July 2012

51. RECAP: Outline and Goals for Today  Understand how to develop and use concepts and the concept dictionary 1.Basic understanding of concept dictionary and concepts 2.Understanding how to define and use concepts 3.Proposing new concepts 4.Building a Form Key Did we accomplish our goals? REACH-INFORMATICS, July 2012

52. Questions, Complaints, or Compliments? Contact: Lauren Stanisic lstanisic@regenstrief.org REACH-INFORMATICS, July 2012