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Integrating SNOMED CT with other Meaningful
Use vocabulary standards
(LOINC, RxNorm, HCPCS, CPT-4) and billing
terminologies (NDC, ICD-9, ICD-10) using the UMLS

Tomasz Adamusiak MD PhD

@7omasz
1
Landscape of many standards

2
HIMSS14, February 26, Orlando, FL

ROUNDTABLE ON SEMANTIC
INTEROPERABILITY
3
UMLS
Eruption
SCT:1806006

rash NOS
ICD-10:R21

Cutaneous eruption
SCT:112625008

Exanthema C0015230
4
UMLS

Eruption
Cutaneous NOS
rash eruption
SCT:1806006
SCT:112625008
ICD-10:R21

Exanthema C0015230
5
Dealing with heterogeneous sources

UMLS

MU-oriented

6
Login: showcasedemo
Pass: showcasedemo
Use the link or
google clinminer

Click on demo

7
Demo and
evaluation:
100 000 clinical
avatars
x
90 days
x
genotypeguided warfarin
dosing
8
Clinical Avatars

11 MILLION OBSERVATIONS
(20 TERMS)
Custom UMLS-based terminology server
RxNorm  UMLS
SNOMED CT  UMLS
Medication reconciliation via National Drug
Code (NDC) and RxNorm
https://clinminer.hmgc.mcw.edu/clinminer#ontology/search/31722-331-01
31722-331-01
100 tablets of Warfarin
Sodium 4 MG
Camber Pharmaceuticals

13
Integrated querying and reporting

14
How does it work with real EHR data?

15
Pilot cohort
Transformed
via UMLS

Froedtert

Epic Clarity
reports

ClinMiner

LDS 2/16

16
1.5 million observations (7000 terms)

17
Limitations?

WE NEED BETTER
LOINC – SNOMED CT
MAPPINGS
18
LOINC is more granular

19
CPT maps to SNOMED CT and MedDRA

20
But not to LOINC

21
Some tests map on LOINC part level

22
Endgame in semantic integration

23
Thank you
Mary Shimoyama PhD
Stacy Zacher
Glenn Bushee
Bradley Taylor
Clinical Avatars
Vincent A. Fusaro PhD
Peter J. Tonellato PhD

This project was funded in part by the Advancing a
Healthier Wisconsin endowment at the Medical College of
Wisconsin and the National Center for Research
Resources and the National Center for Advancing
Translational Sciences, National Institutes of
Health, through grant UL1 RR031973. The content is
solely the responsibility of the authors and does not
necessarily represent the official views of the NIH.

Laboratory for Personalized Medicine
Harvard Medical School
24

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Integrating SNOMED CT with other Meaningful Use vocabulary standards (LOINC, RxNorm, HCPCS, CPT-4) and billing terminologies (NDC, ICD-9, ICD-10) using the UMLS