1 00:00:00,000 --> 00:00:00,733 2 00:00:00,733 --> 00:00:02,433 ALL RIGHT, HELLO, EVERYBODY, 3 00:00:02,433 --> 00:00:04,699 WELCOME BACK TO OUR SERIES, I'M 4 00:00:04,700 --> 00:00:07,033 REX ROBISON, HEAD OF TRAINING 5 00:00:07,033 --> 00:00:09,066 AND OUTREACH PROGRAM HERE IN OUR 6 00:00:09,066 --> 00:00:19,099 DIVISION OF NLM. 7 00:00:19,100 --> 00:00:21,433 ALL RIGHT, SO TODAY WE'RE GOING 8 00:00:21,433 --> 00:00:23,633 TO ZOOM OUT AND TAKE A LOOK AT A 9 00:00:23,633 --> 00:00:32,299 BIRDSEYE VIEW OF HEALTH DATA STANDARDS. 10 00:00:32,300 --> 00:00:36,200 WE WILL DO A LOT OF THINGS TODAY 11 00:00:36,200 --> 00:00:37,866 BUT NOT VERY MUCH DETAIL SO IF 12 00:00:37,866 --> 00:00:40,399 THERE IS ANYTHING YOU WANT TO 13 00:00:40,400 --> 00:00:42,500 KNOW ABOUT, HOLD ON TO THAT 14 00:00:42,500 --> 00:00:44,300 THOUGHT AND LET US KNOW AT THE 15 00:00:44,300 --> 00:00:44,933 END. 16 00:00:44,933 --> 00:00:46,533 WE DON'T HAVE A LOT OF TIME TO 17 00:00:46,533 --> 00:00:48,866 GO INTO DEPTH ON TODAY'S TOPICS. 18 00:00:48,866 --> 00:00:49,699 IF YOU HAVE ANY GENERAL 19 00:00:49,700 --> 00:00:54,466 QUESTIONS OR WANT ME TO CLARIFY OR REPEAT 20 00:00:54,466 --> 00:00:57,332 SOMETHING, PLEASE FEEL FREE TO 21 00:00:57,333 --> 00:00:59,366 PUT THAT IN THE CHAT BOX AND 22 00:00:59,366 --> 00:01:00,732 MAKE SURE THE LITTLE THING THERE 23 00:01:00,733 --> 00:01:02,299 SAYS ALL PARTICIPANTS. 24 00:01:02,300 --> 00:01:03,700 IN THE SERIES, WE HAVE ATTEMPTED 25 00:01:03,700 --> 00:01:05,966 TO INTRODUCE THE CONCEPT OF 26 00:01:05,966 --> 00:01:09,699 CLINICAL INFOMATICS TO MAKE THE 27 00:01:09,700 --> 00:01:12,433 SYSTEMS WORK TOGETHER AND MAKE 28 00:01:12,433 --> 00:01:13,433 THINGS INTEROPERABLE. 29 00:01:13,433 --> 00:01:14,999 SO WE CAN SHARE INFORMATION WITH 30 00:01:15,000 --> 00:01:18,366 CLINICIANS, LIBRARIES AND OTHERS 31 00:01:18,366 --> 00:01:20,232 TO IMPROVE HEALTHCARE. 32 00:01:20,233 --> 00:01:22,899 ONE OF THE MAIN REASONS TO PUSH 33 00:01:22,900 --> 00:01:26,566 TO ELECTRONIC RECORDS IS SO ONE 34 00:01:26,566 --> 00:01:29,432 FACILITY CAN SHARE DATA AND 35 00:01:29,433 --> 00:01:29,966 INFORMATION WITH ANOTHER 36 00:01:29,966 --> 00:01:32,032 FACILITY AND AS WE DISCUSSED IN 37 00:01:32,033 --> 00:01:33,966 EPISODE 1, THESE HEALTH SYSTEMS 38 00:01:33,966 --> 00:01:35,766 MAY CONNECT TO OTHER RESOURCES 39 00:01:35,766 --> 00:01:37,466 THAT ARE NOT EVEN A HEALTH 40 00:01:37,466 --> 00:01:39,632 PROVIDER. 41 00:01:39,633 --> 00:01:41,833 AND FINALLY WITHIN A SINGLE 42 00:01:41,833 --> 00:01:45,199 INSTITUTION, THE I.T. SYSTEM CAN 43 00:01:45,200 --> 00:01:47,400 HAVE MULTIPLE COMPONENTS WHICH 44 00:01:47,400 --> 00:01:49,800 COULD BE MADE BY SEVERAL 45 00:01:49,800 --> 00:01:51,766 DIFFERENT COMPANIES. 46 00:01:51,766 --> 00:01:56,366 ALL OF THIS MEANS THAT WE NEED A 47 00:01:56,366 --> 00:01:58,766 RELIABLE WAY TO EXCHANGE 48 00:01:58,766 --> 00:01:59,932 INFORMATION ABOUT PATIENTS. 49 00:01:59,933 --> 00:02:01,666 AS WE DISCUSS THE GOALS OF 50 00:02:01,666 --> 00:02:04,199 INTEROPERABILITY, WE HAVE TO 51 00:02:04,200 --> 00:02:06,566 HAVE A WAY TO EXCHANGE DATA. 52 00:02:06,566 --> 00:02:08,199 FIRST, ONE SYSTEM CAN RECEIVE 53 00:02:08,200 --> 00:02:09,466 DATA FROM ANOTHER. 54 00:02:09,466 --> 00:02:11,799 I THINK IT IS SQUARELY TO FACE 55 00:02:11,800 --> 00:02:14,433 THIS LEVEL SQUARELY IN THE WORLD 56 00:02:14,433 --> 00:02:16,533 OF I.T. SO WE WON'T BE DISCUSSING 57 00:02:16,533 --> 00:02:18,199 THIS. 58 00:02:18,200 --> 00:02:20,666 SECOND, STRUCTURAL INTEROPERABILITY WITH THE 59 00:02:20,666 --> 00:02:28,132 SYNTAX OF THE DATA. 60 00:02:28,133 --> 00:02:30,233 THIRD IS INTEROPERABILITY, THIS 61 00:02:30,233 --> 00:02:32,966 IS CLEAR AND PRECISE MEANING AND 62 00:02:32,966 --> 00:02:33,966 CONTEXT. 63 00:02:33,966 --> 00:02:35,966 EACH OF THESE CORRESPOND TO 64 00:02:35,966 --> 00:02:37,432 DIFFERENT TYPES OF STANDARDS AND 65 00:02:37,433 --> 00:02:38,666 HERE ARE A FEW OF THE STANDARDS 66 00:02:38,666 --> 00:02:40,299 THAT NEED TO BE CONSIDERED. 67 00:02:40,300 --> 00:02:42,866 CONTENT EXCHANGE AND VOCABULARY. 68 00:02:42,866 --> 00:02:45,466 CONTENT EXCHANGE STANDARDS ARE 69 00:02:45,466 --> 00:02:47,466 STANDARDS USED TO SHARE CLINICAL 70 00:02:47,466 --> 00:02:48,499 INFORMATION SUCH AS 71 00:02:48,500 --> 00:02:50,700 PRESCRIPTION, ELECTRONIC 72 00:02:50,700 --> 00:02:52,400 DOCUMENTS. 73 00:02:52,400 --> 00:02:54,500 A CLINICAL SUMMARY OF A PATIENT 74 00:02:54,500 --> 00:02:56,133 RECORD IN ONE EHR SYSTEM TO BE 75 00:02:56,133 --> 00:02:59,866 PASSED TO ANOTHER. 76 00:02:59,866 --> 00:03:04,599 NOT EVERYONE IS INVOLVED WITH 77 00:03:04,600 --> 00:03:06,900 THESE CONTENT STANDARDS BUT WE 78 00:03:06,900 --> 00:03:08,133 USE THEM. 79 00:03:08,133 --> 00:03:09,366 I WILL TALK MORE ABOUT THESE 80 00:03:09,366 --> 00:03:11,199 TYPES OF STANDARDS AT THE END OF 81 00:03:11,200 --> 00:03:12,166 MY PRESENTATION. 82 00:03:12,166 --> 00:03:14,266 THE VOCABULARY STANDARDS ARE THE 83 00:03:14,266 --> 00:03:20,199 STANDARDIZED NOMENCLATURE USED 84 00:03:20,200 --> 00:03:23,333 TO DESCRIBE PATIENTS SYMPTOMS, 85 00:03:23,333 --> 00:03:24,966 ALLERGIES AND SO MUCH MORE. 86 00:03:24,966 --> 00:03:27,099 EACH RECORD IN THE EHR WILL 87 00:03:27,100 --> 00:03:29,466 INCLUDE THAT PATIENTS' CLINICAL 88 00:03:29,466 --> 00:03:29,866 PROBLEM. 89 00:03:29,866 --> 00:03:32,399 IT WOULDN'T BE ADVISABLE TO 90 00:03:32,400 --> 00:03:34,166 STORE MEDICAL DIAGNOSIS IN THE 91 00:03:34,166 --> 00:03:37,266 TEXT FIELD GIVEN ONE PERSON MAY 92 00:03:37,266 --> 00:03:41,166 DESCRIBE THE CONDITION AS 93 00:03:41,166 --> 00:03:43,999 DIABETES WHILE ANOTHER MAY SAY 94 00:03:44,000 --> 00:03:45,433 DIABETIC. 95 00:03:45,433 --> 00:03:46,966 IT IS BETTER IN SUCH A CASE TO 96 00:03:46,966 --> 00:03:49,099 USE A CODE SUCH AS A NUMBER 97 00:03:49,100 --> 00:03:50,800 TO REPRESENT THE DIAGNOSES. 98 00:03:50,800 --> 00:03:53,100 NLM IS MOSTLY CONCERNED WITH THE 99 00:03:53,100 --> 00:03:55,100 VOCABULARY STANDARDS THAT ALLOW 100 00:03:55,100 --> 00:03:58,600 FOR SEMANTIC INTEROPERABILITY BUT OF 101 00:03:58,600 --> 00:04:01,200 COURSE WE NEED TO USE THE OTHER 102 00:04:01,200 --> 00:04:03,266 STANDARDS TOO. 103 00:04:03,266 --> 00:04:03,632 FOR EXAMPLE, MEDLINEPLUS CONNECT ACCEPTS CODES FROM SEVERAL DIFFERENT VOCABULARIES 104 00:04:03,633 --> 00:04:06,699 THE REQUEST ITSELF HAS TO BE 105 00:04:06,700 --> 00:04:09,866 FORMATTED USING THE HL7 VERSION 106 00:04:09,866 --> 00:04:13,132 3 STANDARD FOR INFO BUTTONS SO ANY HEALTH IT SYSTEM CAN 107 00:04:13,133 --> 00:04:15,333 SEND US A QUERY AS LONG AS THEY 108 00:04:15,333 --> 00:04:16,866 FOLLOW THE STANDARD. 109 00:04:16,866 --> 00:04:18,799 WE DON'T HAVE TO HAVE ANYMORE 110 00:04:18,800 --> 00:04:19,666 COORDINATION. 111 00:04:19,666 --> 00:04:22,132 THE TWO ARE COMPLETELY 112 00:04:22,133 --> 00:04:22,766 INDEPENDENT. 113 00:04:22,766 --> 00:04:29,066 ALL RIGHT, SO WHERE DO THESE 114 00:04:29,066 --> 00:04:31,099 STANDARDS COME FROM AND WHO 115 00:04:31,100 --> 00:04:33,833 DECIDES HOW WE USE THEM? 116 00:04:33,833 --> 00:04:36,866 BROADLY SPEAKING, LOTS OF PEOPLE 117 00:04:36,866 --> 00:04:39,099 DEVELOP TERMINOLOGIES AND WAYS OF DOING THINGS, BUT IT 118 00:04:39,100 --> 00:04:41,466 TAKES A CONSENSUS, OR AT LEAST A LAW FOR ANY ONE OF THOSE 119 00:04:41,466 --> 00:04:42,532 TO BECOME A STANDARD THAT 120 00:04:42,533 --> 00:04:43,966 EVERYONE IS EXPECTED TO USE. 121 00:04:43,966 --> 00:04:45,832 HL7 IS INTERESTING BECAUSE IT IS 122 00:04:45,833 --> 00:04:47,733 AN ORGANIZATION WHOSE ENTIRE 123 00:04:47,733 --> 00:04:49,733 MISSION IS TO DEVELOP A STANDARD 124 00:04:49,733 --> 00:04:52,166 THAT EVERYONE ELSE WILL USE SO 125 00:04:52,166 --> 00:04:54,866 MANY OF THE TERMINOLOGIES THAT 126 00:04:54,866 --> 00:04:58,566 BECOME STANDARD ARE BY 127 00:04:58,566 --> 00:05:00,032 INTERNATIONAL AND NATIONAL 128 00:05:00,033 --> 00:05:01,899 SYSTEMS LIKE WHO. 129 00:05:01,900 --> 00:05:03,400 MEANWHILE, IT IS OFTEN THE 130 00:05:03,400 --> 00:05:04,400 GOVERNMENT THAT ESTABLISHES 131 00:05:04,400 --> 00:05:05,800 WHICH STANDARDS WILL BE USED. 132 00:05:05,800 --> 00:05:06,733 IN THE U.S. GOVERNMENT, THERE 133 00:05:06,733 --> 00:05:08,766 ARE SEVERAL ENTITIES THAT WORK 134 00:05:08,766 --> 00:05:09,599 ON THIS. 135 00:05:09,600 --> 00:05:11,933 FIRST OF ALL, LAWS PASSED BY 136 00:05:11,933 --> 00:05:13,299 CONGRESS MAKE SENSE OF THE 137 00:05:13,300 --> 00:05:14,400 STANDARD BUT THE EXECUTIVE 138 00:05:14,400 --> 00:05:16,800 BRANCH WILL SET THEM AND HOW 139 00:05:16,800 --> 00:05:18,233 MUCH FUNDING THEY HAVE TO DO. 140 00:05:18,233 --> 00:05:19,599 THE OFFICE OF THE NATIONAL 141 00:05:19,600 --> 00:05:23,800 COORDINATOR FOR NATIONAL MEDICAL 142 00:05:23,800 --> 00:05:29,700 TECHNOLOGY, ONC, THE DEPARTMENT 143 00:05:29,700 --> 00:05:31,266 IN THE OFFICE OF HEALTH AND 144 00:05:31,266 --> 00:05:32,599 HUMAN SERVICES WHO IS 145 00:05:32,600 --> 00:05:34,266 RESPONSIBLE FOR THE HEALTH DATA 146 00:05:34,266 --> 00:05:36,732 EXCHANGE AND PLAYS A BIG ROLE 147 00:05:36,733 --> 00:05:37,966 THERE. 148 00:05:37,966 --> 00:05:42,432 THE WEBSITE, HEALTHIT.GOV IS A 149 00:05:42,433 --> 00:05:44,299 GREAT RESOURCE. 150 00:05:44,300 --> 00:05:45,533 I WANT TO POINT OUT THAT MUCH OF 151 00:05:45,533 --> 00:05:47,899 THE MATERIAL IN THIS 152 00:05:47,900 --> 00:05:49,566 PRESENTATION ARE FROM SLIDES ON 153 00:05:49,566 --> 00:05:50,799 THE ONC WEBSITE. 154 00:05:50,800 --> 00:05:52,733 MEANWHILE, AGENCIES SUCH AS 155 00:05:52,733 --> 00:05:55,633 THE CENTERS FOR MEDICARE OR MEDICAID SERVICES (OR CMS) 156 00:05:55,633 --> 00:05:57,133 ARE ALSO INVOLVED. 157 00:05:57,133 --> 00:05:59,933 YOU MAY HAVE HEARD OF MEANINGFUL 158 00:05:59,933 --> 00:06:01,933 USE OR MACRA, WHICH ARE PROGRAMS TO INCENTIVIZE THE USE OF EHRS. 159 00:06:01,933 --> 00:06:03,899 THESE ARE CMS PROGRAMS. 160 00:06:03,900 --> 00:06:07,000 NLM, YOUR PRESENTER TODAY, IS 161 00:06:07,000 --> 00:06:08,633 THE FEDERAL COORDINATING BODY 162 00:06:08,633 --> 00:06:10,499 FOR CLINICAL TERMINOLOGY STANDARDS 163 00:06:10,500 --> 00:06:11,366 WITHIN THE DEPARTMENT 164 00:06:11,366 --> 00:06:13,166 OF HUMAN AND HEALTH SERVICES. 165 00:06:13,166 --> 00:06:14,066 WE WORK WITH ONC AND OTHER 166 00:06:14,066 --> 00:06:15,599 ORGANIZATIONS ON POLICY ISSUES 167 00:06:15,600 --> 00:06:17,666 BUT ALSO PRACTICAL ISSUES LIKE 168 00:06:17,666 --> 00:06:19,066 HELPING PEOPLE GET ACCESS TO THE 169 00:06:19,066 --> 00:06:20,099 TERMINOLOGIES. 170 00:06:20,100 --> 00:06:24,000 WE'RE MORE INVOLVED IN SOME TERMINOLOGIES THAN OTHERS. I WILL HIGHLIGHT OUR ROLES IN 171 00:06:24,000 --> 00:06:27,666 THE UPCOMING SLIDES AND I'M LEAVING OUT 172 00:06:27,666 --> 00:06:30,099 OTHER RELEVANT AGENCIES SUCH AS 173 00:06:30,100 --> 00:06:32,100 THE FDA AND CDC. 174 00:06:32,100 --> 00:06:33,800 BUT THERE ARE A LOT OF 175 00:06:33,800 --> 00:06:35,833 STANDARDS AND APPLICATIONS FOR HEALTH AGENCIES 176 00:06:35,833 --> 00:06:38,699 AND A LOT OF ACRONYMS. 177 00:06:38,700 --> 00:06:41,666 ALL RIGHT SO LET'S PAUSE AND 178 00:06:41,666 --> 00:06:44,666 HAVE A QUICK REVIEW WITH A SHORT 179 00:06:44,666 --> 00:06:50,399 QUIZ. 180 00:06:50,400 --> 00:06:54,200 SO THAT IT WILL POP UP ON YOUR 181 00:06:54,200 --> 00:06:55,666 SCREEN AND TAKE A MOMENT TO 182 00:06:55,666 --> 00:06:57,932 ANSWER THESE QUESTIONS. 183 00:06:57,933 --> 00:06:59,666 AND THEN WE'LL COME BACK ASK 184 00:06:59,666 --> 00:07:05,466 DISCUSS. 185 00:07:05,466 --> 00:07:07,232 DISCUSS. 186 00:07:07,233 --> 00:07:15,099 THE QUIZ AND THEN WE'LL DISCUSS. 187 00:07:15,100 --> 00:07:16,766 OKAY, TAKE A QUICK LOOK AT 188 00:07:16,766 --> 00:07:23,866 THOSE. 189 00:07:23,866 --> 00:07:25,699 ALL RIGHT, SO FIRST QUESTION, IN 190 00:07:25,700 --> 00:07:28,766 WHAT WAYS DO DATA STANDARDS 191 00:07:28,766 --> 00:07:31,066 FACILITATE INFORMATION SHARING? 192 00:07:31,066 --> 00:07:41,599 AND STANDARDS PART OF A SYSTEM 193 00:07:41,600 --> 00:07:43,166 OR SHARING INFORMATION WITH 194 00:07:43,166 --> 00:07:44,699 ANOTHER, IT IS IMPORTANT TO HAVE 195 00:07:44,700 --> 00:07:45,433 STANDARDS. 196 00:07:45,433 --> 00:07:46,366 THE REQUIRED LEVELS OF 197 00:07:46,366 --> 00:07:48,866 INTEROPERABILITY TO EXCHANGE 198 00:07:48,866 --> 00:07:51,266 INFORMATION, WE NEED ALL OF 199 00:07:51,266 --> 00:07:53,532 THESE. 200 00:07:53,533 --> 00:07:55,133 IF YOU ARE GOING TO EXCHANGE 201 00:07:55,133 --> 00:07:57,199 INFORMATION IN ANY MEANINGFUL 202 00:07:57,200 --> 00:07:59,533 WAY, YOU NEED TO HAVE ALL THESE 203 00:07:59,533 --> 00:08:00,099 LEVELS. 204 00:08:00,100 --> 00:08:01,300 NOW WHAT LEVELS OF 205 00:08:01,300 --> 00:08:05,133 INTEROPERABILITY ARE TERMINOLOGY 206 00:08:05,133 --> 00:08:05,966 STANDARDS IMPORTANT? 207 00:08:05,966 --> 00:08:08,466 SO IT IS REALLY THE SEMANTIC -- 208 00:08:08,466 --> 00:08:11,432 LEVEL, THAT'S KEY. 209 00:08:11,433 --> 00:08:16,099 AND A GREAT WEBSITE TO KEEP 210 00:08:16,100 --> 00:08:19,866 TRACK OF THE HEALTH IT NEWS, THAT'S DEFINITELY HEALTHIT.GOV. 211 00:08:19,866 --> 00:08:22,399 SO YOU CAN CLOSE THAT WINDOW FOR 212 00:08:22,400 --> 00:08:28,433 NOW AND WE'LL MOVE ON. 213 00:08:28,433 --> 00:08:29,933 SO LET'S LOOK AT MEDICAL 214 00:08:29,933 --> 00:08:31,833 TERMINOLOGIES IN MORE DETAIL. 215 00:08:31,833 --> 00:08:33,299 IN OUR SECOND EPISODE IN THE 216 00:08:33,300 --> 00:08:35,466 SERIES, MIKE DAVIDSON TALKED ABOUT MEDICAL 217 00:08:35,466 --> 00:08:37,366 TERMINOLOGIES AS A WAY TO 218 00:08:37,366 --> 00:08:39,766 FACILITATE CLEAR COMMUNICATIONS BY 219 00:08:39,766 --> 00:08:41,966 ELIMINATING OR LIMITING 220 00:08:41,966 --> 00:08:42,732 AMBIGUITY. 221 00:08:42,733 --> 00:08:44,699 WE TALKED ABOUT A FEW OF THEM AS 222 00:08:44,700 --> 00:08:49,933 WE USE MEDLINE PLUS CONNECT. WE LOOKED AT RXNORM IN PARTICULAR. 223 00:08:49,933 --> 00:08:54,766 MIKE ALSO TALKED ABOUT SPECIAL 224 00:08:54,766 --> 00:08:59,466 TERMINOLOGIES THAT MAP TERMINOLOGIES TO EACH OTHER, LIKE THE UMLS AND RXNORM 225 00:08:59,466 --> 00:09:01,266 MIKE ALSO MENTIONED THAT MEDICAL TERMINOLOGIES USE A UNIQUE IDENTIFER, AN OFFICIAL NAME 226 00:09:01,266 --> 00:09:08,932 AND OFTEN THEY INCLUDE SYNONYMS 227 00:09:08,933 --> 00:09:09,999 IN THIS PRESENTATION, I AM 228 00:09:10,000 --> 00:09:14,233 AFRAID WE WILL GLOSS OVER THESE 229 00:09:14,233 --> 00:09:16,266 EXTENSIONS WHICH MAY BE GOOD OR 230 00:09:16,266 --> 00:09:18,366 BAD NEWS FOR YOU, DEPENDING ON 231 00:09:18,366 --> 00:09:18,799 YOUR INTEREST. 232 00:09:18,800 --> 00:09:20,566 IT IS NOT THAT WE DON'T CARE 233 00:09:20,566 --> 00:09:22,366 ABOUT THAT SAY, ICD-10 IS A CLASSIFICATION WHEREAS LOINC IS A VOCABULARY, BUT FROM 234 00:09:22,366 --> 00:09:24,299 THE BIRDS EYE VIEW, THE 235 00:09:24,300 --> 00:09:25,666 DIFFERENCES ARE NOT ALL THAT 236 00:09:25,666 --> 00:09:27,432 IMPORTANT FOR WHAT WE'RE TRYING 237 00:09:27,433 --> 00:09:28,399 TO COVER TODAY. 238 00:09:28,400 --> 00:09:29,900 IF THIS IS A TOPIC YOU WOULD 239 00:09:29,900 --> 00:09:32,866 LIKE TO PURSUE, PLEASE LET US 240 00:09:32,866 --> 00:09:36,366 KNOW AT THE END FOR ANOTHER 241 00:09:36,366 --> 00:09:37,932 WEBINAR. 242 00:09:37,933 --> 00:09:38,966 THE INTERNATIONAL CLASSIFICATION 243 00:09:38,966 --> 00:09:41,766 IS SPONSORED BY WHO. 244 00:09:41,766 --> 00:09:44,166 ICD IS THE MOST COMMONLY USED 245 00:09:44,166 --> 00:09:46,099 TERMINOLOGY WORLDWIDE AND MOST 246 00:09:46,100 --> 00:09:50,333 LIKELY FOR DIAGNOSES AND 247 00:09:50,333 --> 00:09:51,733 STATISTICAL REPORTING. 248 00:09:51,733 --> 00:09:53,733 IN THE U.S., FOR MEDICARE AND 249 00:09:53,733 --> 00:09:57,099 MEDICAID, IT IS REQUIRED FOR 250 00:09:57,100 --> 00:09:57,633 CLAIMS. 251 00:09:57,633 --> 00:10:01,433 THE CM IS FOR BILLABLE ITEMS BUT 252 00:10:01,433 --> 00:10:02,866 ALSO HAS OTHER CHANGES. 253 00:10:02,866 --> 00:10:09,866 IN THE U.S., ICD10 AND ICD-10-CM ARE 254 00:10:09,866 --> 00:10:12,266 OFTEN USED INTERCHANGEABLY IN 255 00:10:12,266 --> 00:10:13,966 COMMUNICATION BUT THEY ARE NOT 256 00:10:13,966 --> 00:10:16,032 REALLY INTERCHANGEABLE. YOU MAY REMEMBER THE FUSS WHEN THE US SWITCHED TO ICD-10 257 00:10:16,033 --> 00:10:17,666 THE U.S. WAS ONE OF THE LAST 258 00:10:17,666 --> 00:10:19,199 COUNTRIES TO SWITCH. 259 00:10:19,200 --> 00:10:24,400 A REVIEWED VERSION OF ICD-11 HAS 260 00:10:24,400 --> 00:10:31,833 JUST BEEN DEVELOPED AT THE WHO 261 00:10:31,833 --> 00:10:33,166 BUT IT WILL BE A FEW YEARS 262 00:10:33,166 --> 00:10:34,399 BEFORE THE U.S. CONSIDERS 263 00:10:34,400 --> 00:10:37,333 SWITCHING AGAIN. 264 00:10:37,333 --> 00:10:39,233 YOU CAN SEE THE CODES THERE, 265 00:10:39,233 --> 00:10:40,466 VERY PARTICULAR. 266 00:10:40,466 --> 00:10:42,566 THESE EXAMPLES SHOW POSSIBLE 267 00:10:42,566 --> 00:10:45,099 PROGRESSIONS OF THE RECOVERY AND 268 00:10:45,100 --> 00:10:46,800 TREATMENT, NOT JUST THE INITIAL 269 00:10:46,800 --> 00:10:47,233 DIAGNOSES. 270 00:10:47,233 --> 00:10:50,699 AGAIN, THESE ARE ROOTED PARTLY 271 00:10:50,700 --> 00:10:52,733 IN STATISTICAL REPORTING AND 272 00:10:52,733 --> 00:10:54,633 PARTLY IN REIMBURSEMENT BUT MANY 273 00:10:54,633 --> 00:10:55,799 FEEL IT IS NOT A GREAT 274 00:10:55,800 --> 00:10:58,366 TERMINOLOGY FOR CODING WITH WHAT 275 00:10:58,366 --> 00:11:04,032 IS GOING ON CLINICALLY. THE ICD-10-CM GOT SOME PUBLICITY WHEN IT CAME OUT A FEW YEARS AGO, BECAUSE IT HAD 276 00:11:04,033 --> 00:11:06,466 CODES FOR WEIRD THINGS LIKE BEING STRUCK BY A CHICKEN OR BEING ON AN EXPLODING JETSKI. 277 00:11:06,466 --> 00:11:11,299 WHY SO SPECIFIC? 278 00:11:11,300 --> 00:11:13,100 IF A DOCTOR OR INSURANCE COMPANY 279 00:11:13,100 --> 00:11:14,466 IS TRYING TO FIGURE OUT YOUR 280 00:11:14,466 --> 00:11:18,466 MEDICAL SITUATION FOR THE ER, A 281 00:11:18,466 --> 00:11:21,232 MORE DESCRIPTIVE CODE WILL BE 282 00:11:21,233 --> 00:11:22,899 MORE HELPFUL EVEN IF THEY ARE 283 00:11:22,900 --> 00:11:24,633 NOT GREATLY USED. 284 00:11:24,633 --> 00:11:28,933 NOW LOOK AT THIS WHICH HAS MORE 285 00:11:28,933 --> 00:11:29,466 CONTEXT. 286 00:11:29,466 --> 00:11:31,899 IT IS NOT JUST THAT IT IS MORE 287 00:11:31,900 --> 00:11:34,933 GRANULAR, ALTHOUGH IT IS IN MANY 288 00:11:34,933 --> 00:11:37,166 AREAS BUT IT ALSO HAS A BROADER 289 00:11:37,166 --> 00:11:37,832 SCOPE. 290 00:11:37,833 --> 00:11:40,366 IT IS USED IN MANY MEDICAL 291 00:11:40,366 --> 00:11:41,766 OFFICES AND ALL OVER THE WORLD 292 00:11:41,766 --> 00:11:45,266 AND THERE IS A U.S. ADAPTATION 293 00:11:45,266 --> 00:11:46,766 OF IT. 294 00:11:46,766 --> 00:11:51,732 WE OVERSEE LICENSING IN THE 295 00:11:51,733 --> 00:11:54,333 U.S., MAKING THE LATEST RE 296 00:11:54,333 --> 00:11:59,599 VERSIONS AVAILABLE AND AT U.S. 297 00:11:59,600 --> 00:12:00,500 AND INTERNATIONAL DISCUSSIONS. 298 00:12:00,500 --> 00:12:02,433 IF YOU WANT TO USE THIS, YOU 299 00:12:02,433 --> 00:12:06,433 SHOULD COME TO OUR WEBSITE. 300 00:12:06,433 --> 00:12:10,466 SO WHAT IS SPECIAL ABOUT SNOMED-CT? 301 00:12:10,466 --> 00:12:13,232 WELL, FOR ONE THING, IT IS A LEGALLY MANDATED STANDARD FOR SOME PARTS OF HEALTH IT SYSTEMS. BUT AS FOR THE 302 00:12:13,233 --> 00:12:16,233 TERMINOLOGY ITSELF, ONE SPECIAL 303 00:12:16,233 --> 00:12:21,766 ASPECT IS THE FACT THAT THE HUNDREDS OF THOUSANDS OF CONCEPTS IN SNOMED ARE ORGANIZED 304 00:12:21,766 --> 00:12:26,899 INTO EXTENSIVE HIERARCHIES. ALSO THERE ARE SEMANTIC RELATIONSHIPS DEFINED BETWEEN THE CONCEPTS. ON 305 00:12:26,900 --> 00:12:33,933 THE NEXT SLIDE WE SEE AN EXAMPLE OF HOW SNOMED-CT CONCEPTS ARE IN A SEMANTIC NETWORK. THIS SLIDE SHOWS 306 00:12:33,933 --> 00:12:40,966 THE SEMANTIC REPRESENTATION FOR PULMONARY TULAREMIA. IT IS A TULAREMIA AND IT IS A BACTERIAL 307 00:12:40,966 --> 00:12:45,232 PNEUMONIA. HENCE THE HIERARCHIES I MENTIONED. PULMONARY TULAREMIA ALSO HAD FINDING SITE OF LUNG 308 00:12:45,233 --> 00:12:48,699 STRUCTURE, HAS AN ASSOCIATED MORPHOLOGY OF INFLAMMATION, AND HAS 309 00:12:48,700 --> 00:12:53,200 CAUSATIVE AGENT OF FRANCISELLA TULARENSIS. KNOWLEDGE CAN BE EMBEDDED IN SNOMED 310 00:12:53,200 --> 00:12:55,333 THROUGH THESE LINKS. 311 00:12:55,333 --> 00:12:56,966 THIS REPRESENTATION PROVIDES 312 00:12:56,966 --> 00:12:59,599 SIGNIFICANT POWERS FOR QUERIES BY 313 00:12:59,600 --> 00:13:01,366 ANY OF THESE RELATIONSHIPS. 314 00:13:01,366 --> 00:13:03,066 ANOTHER COMMONLY USED 315 00:13:03,066 --> 00:13:04,866 TERMINOLOGY IS THE CURRENT 316 00:13:04,866 --> 00:13:09,132 PROCEDURAL TERMINOLOGY OR CPT. IT WAS DEVELOPED BY THE AMERICAN MEDICAL ASSOCIATION. 317 00:13:09,133 --> 00:13:13,166 CPT CODES MOSTLY DESCRIBE PROCEDURES 318 00:13:13,166 --> 00:13:16,166 PROCEDURES AND ARE USED FOR BILLING. NOTE THAT THE AMA CHARGES A LICENSING FEE. 319 00:13:16,166 --> 00:13:19,032 FOR SOME SITUATIONS, THAT 320 00:13:19,033 --> 00:13:20,633 MAY BE AN ISSUE. 321 00:13:20,633 --> 00:13:23,333 NLM DOESN'T HAVE AS MUCH DIRECT 322 00:13:23,333 --> 00:13:25,766 INVOLVEMENT WITH CPT SO WE 323 00:13:25,766 --> 00:13:27,466 WON'T BE DISCUSSING IT FURTHER 324 00:13:27,466 --> 00:13:28,199 RIGHT NOW. 325 00:13:28,200 --> 00:13:29,766 NOW FOR A COUPLE OF TERMINOLOGIES MORE FOCUSED 326 00:13:29,766 --> 00:13:30,766 ON MEDICATIONS. 327 00:13:30,766 --> 00:13:35,766 IN HYE CHO ALREADY INTRODUCED YOU TO RXNORM IN ONE OF OUR PREVIOUS SESSIONS, 328 00:13:35,766 --> 00:13:36,999 WE ALREADY KNOW THAT IT IS A 329 00:13:37,000 --> 00:13:39,633 STANDARDIZED CLINICAL DRUG TERMINOLOGY AND 330 00:13:39,633 --> 00:13:41,766 A CURATED COLLECTION OF DRUG NAMES -- RXNORM IS PRODUCED BY THE NLM 331 00:13:41,766 --> 00:13:42,199 AND IS INCLUDED 332 00:13:42,200 --> 00:13:46,633 IN THE UMLS. 333 00:13:46,633 --> 00:13:49,099 IF YOU WOULD LIKE TO KNOW MORE, 334 00:13:49,100 --> 00:13:50,833 REFER BACK TO SESSION 2 IN THIS 335 00:13:50,833 --> 00:13:51,833 SERIES. 336 00:13:51,833 --> 00:13:53,933 WE ALSO HAVE MENTIONED NDC, THE NATIONAL DRUG CODES. NDC CODES ARE 337 00:13:53,933 --> 00:13:56,633 USED BY THE FDA SO THEY HAVE A 338 00:13:56,633 --> 00:13:58,533 LIST OF ALL DRUGS MANUFACTURED 339 00:13:58,533 --> 00:14:00,799 FOR COMMERCIAL DISTRIBUTION. THE INTERESTING THING ABOUT NDCS IS THAT THEY 340 00:14:00,800 --> 00:14:03,200 HAVE THREE PARTS, OFTEN 341 00:14:03,200 --> 00:14:08,066 SEPARATED BY HYPHENS AND 342 00:14:08,066 --> 00:14:10,832 VARIABLE NUMBER OF DIGITS, BUT A TOTAL OF 10 DIGITS, AND/OR NO 343 00:14:10,833 --> 00:14:13,933 HYPHENS SO IT COULD BE A LITTLE TRICKY. ANOTHER INTERESTING THING IS THAT TWO PARTS OF THE CODE ARE 344 00:14:13,933 --> 00:14:19,133 ASSIGNED BY THE COMPANY DOING THE LABELING, SO THOSE PARTS OF THE CODE DON'T 345 00:14:19,133 --> 00:14:22,566 FOLLOW ANY UNIVERSAL SCHEMES, AND FOR MANY YEARS THEY COULD BE REUSED. FROM AN 346 00:14:22,566 --> 00:14:29,299 INFORMATICS STANDPOINT, THESE CAN BE TRICKY TO WORK WITH, BUT THEY ARE USED FOR BILLING REIMBURSEMENT. 347 00:14:29,300 --> 00:14:33,900 NEXT WE HAVE LOINC. IT HAS TWO CATEGORIES OF CODES: LAB TESTS 348 00:14:33,900 --> 00:14:39,333 AND CLINICAL OBSERVATIONS, BUT THE LAB TESTS ARE ITS MAIN APPLICATION IN THE US. LOINC IS FREE. 349 00:14:39,333 --> 00:14:43,766 AND YOU CAN GET IT AND MORE INFORMATION AT LOINC.ORG. LOINC CODES FOR LAB TESTS ARE PARTICULAR 350 00:14:43,766 --> 00:14:48,232 TO THE SUBSTANCE YOU ARE TESTING FOR, HOW THE TEST IS DONE, 351 00:14:48,233 --> 00:14:50,399 AND THE TYPE OF RESULTS, LIKE THE UNITS USED. 352 00:14:50,400 --> 00:14:55,166 HOWEVER THE CODES THEMSELVES DON'T CONVEY ANY OF THIS. 353 00:14:55,166 --> 00:14:58,499 CONTRAST WITH SAY ICD 10, WHERE THE CODES ARE ARRANGED IN 354 00:14:58,500 --> 00:15:01,866 CATEGORIES AND SUBCATEGORIES THAT GET MORE AND MORE SPECIFIC, 355 00:15:01,866 --> 00:15:04,699 NLM HELPS FUND LOINC DEVELOPMENT THROUGHT THE REGENSTREIF 356 00:15:04,700 --> 00:15:10,133 INSTITUTE AT THE INDIANA UNIVERSITY 357 00:15:10,133 --> 00:15:11,666 SCHOOL OF MEDICINE AND SPEAKING 358 00:15:11,666 --> 00:15:13,932 OF NLM, YOU ARE PROBABLY 359 00:15:13,933 --> 00:15:17,466 FAMILIAR WITH THE TERMINOLOGY MADE BY NLM, MESH 360 00:15:17,466 --> 00:15:20,899 AS YOU KNOW, MESH TERMS ARE USED BY THE NLM TO INDEX THE MEDICAL LITERATURE. MESH TERMS ARE USED TO 361 00:15:20,900 --> 00:15:24,366 IMPROVE ACCESS TO ARTICLES BY SUPPLEMENTING TERMS IN THE TITLE AND ABSTRACT 362 00:15:24,366 --> 00:15:28,199 WITH THE BEST CONCEPTUAL MATCHES IN MEDICAL TERMINOLOGY. 363 00:15:28,200 --> 00:15:30,433 IT IS USEFUL IN AT LEAST TWO WAYS. 364 00:15:30,433 --> 00:15:34,133 ONE, ITS RICH CACHE OF SYNONYMS ALLOWS AUTHOR AND SEARCHERS TO USE DIFFERENT TERMINOLOGY FOR THE 365 00:15:34,133 --> 00:15:42,399 SAME CONCEPT BUT STILL RETRIEVE RELEVANT LITERATURE, AND TWO: ITS HIERARCHY 366 00:15:42,400 --> 00:15:45,766 ALLOWS INDEXERS TO USE THE MOST SPECIFIC TERM FOR A CONCEPT, ALLOWING FOR HIGH 367 00:15:45,766 --> 00:15:48,632 PRECISION IN SEARCHING BUT AT THE SAME TIME ALLOWS FOR 368 00:15:48,633 --> 00:15:51,299 BROADER SEARCHES TO INCLUDE NARROWER, SPECIFIC TERMS. 369 00:15:51,300 --> 00:15:54,466 KEEP IN MIND MESH IS CREATED IN 370 00:15:54,466 --> 00:15:56,032 RESPONSE TO THE LITERATURE. INDEXERS BRING CONCEPTS THEY FIND IN THE LITERATURE TO THE MESH STAFF. 371 00:15:56,033 --> 00:15:59,933 FOR POSSIBLE INCLUSION IN MESH. AS A RESULT, MESH MAY BE BETTER 372 00:15:59,933 --> 00:16:03,899 OR WORSE FOR PARTICULAR APPLICATIONS. 373 00:16:03,900 --> 00:16:07,566 AND FINALLY FOR TODAY'S TERMINOLOGIES, WE HAVE THE UNIFIED 374 00:16:07,566 --> 00:16:09,099 MEDICAL LANGUAGE SYSTEM. 375 00:16:09,100 --> 00:16:11,800 UMLS IS NOT SO MUCH ANOTHER 376 00:16:11,800 --> 00:16:18,600 TERMINOLOGY BUT A COMPENDIUM OF OVER A HUNDRED CONTROLLED VOCABULARIES IN BIOMEDICINE AND 377 00:16:18,600 --> 00:16:20,900 HEALTH, INCLUDING ALL OF THOSE WE ALREADY SPOKE 378 00:16:20,900 --> 00:16:21,166 ITS GREAT BENEFIT IS THAT IT 379 00:16:21,166 --> 00:16:22,466 PROVIDES MAPPING AND 380 00:16:22,466 --> 00:16:24,532 TRANSLATION FOR DIFFERENT 381 00:16:24,533 --> 00:16:25,166 TERMINOLOGY SYSTEMS. 382 00:16:25,166 --> 00:16:27,932 ON THE SLIDE IS AN EXAMPLE OF 383 00:16:27,933 --> 00:16:38,466 HOW ATRIAL FIBRILLATION COULD BE 384 00:16:38,466 --> 00:16:41,366 REPRESENTED DIFFERENT IN DIFFERENT TERMINOLOGIES, AND TO USE THAT UNDERSTANDING 385 00:16:41,366 --> 00:16:43,566 TO RETRIEVE AND INTEGRATE RELEVANT INFORMATION 386 00:16:43,566 --> 00:16:44,332 FOR USERS. 387 00:16:44,333 --> 00:16:47,066 IT CAN BE USEFUL FOR HUMANS 388 00:16:47,066 --> 00:16:48,266 BECAUSE IT IS A RESOURCE TO 389 00:16:48,266 --> 00:16:49,732 BROWSE AND LEARN ABOUT ALL THE 390 00:16:49,733 --> 00:16:51,333 DIFFERENT SOURCE VOCABULARIES. 391 00:16:51,333 --> 00:16:55,033 THE UMLS IS DESIGNED AND MAINTAINED BY 392 00:16:55,033 --> 00:16:58,033 THE NLM. ANYONE CAN SIGN UP FOR THE UMLS AND GET ACCESS TO ANY AND ALL OF THE CONTENT. 393 00:16:58,033 --> 00:16:59,966 PLEASE NOTE THERE ARE LICENSING 394 00:16:59,966 --> 00:17:02,166 RESTRICTIONS ON HOW YOU USE IT 395 00:17:02,166 --> 00:17:04,266 AND ITS SOURCE VOCABULARIES SO BE SURE TO 396 00:17:04,266 --> 00:17:06,199 READ THE FINE PRINT BEFORE YOU 397 00:17:06,200 --> 00:17:08,866 GET TOO FAR IN YOUR PROJECT. 398 00:17:08,866 --> 00:17:11,166 IN SUMMARY, THIS TABLE SHOWS A ROUGH 399 00:17:11,166 --> 00:17:12,966 OVERVIEW OF THE TERMINOLOGIES WE 400 00:17:12,966 --> 00:17:14,366 HAVE TALKED ABOUT TODAY. 401 00:17:14,366 --> 00:17:18,932 THE NUMBER OF PLUSES INDICATES 402 00:17:18,933 --> 00:17:21,233 SIGNIFICANT USE IN THE U.S. 403 00:17:21,233 --> 00:17:22,899 THERE IS SO MUCH MORE WE COULD 404 00:17:22,900 --> 00:17:24,900 SAY ABOUT THESE WHICH WE DON'T 405 00:17:24,900 --> 00:17:27,433 HAVE TIME TO TALK ABOUT TODAY 406 00:17:27,433 --> 00:17:29,966 BUT I WILL SAY AGAIN LET US KNOW 407 00:17:29,966 --> 00:17:34,366 AT THE END HOW MANY OF THESE YOU 408 00:17:34,366 --> 00:17:36,532 ARE INTERESTED IN FOR THE 409 00:17:36,533 --> 00:17:38,033 FUTURE. 410 00:17:38,033 --> 00:17:40,899 SNOMED IS WIDELY USED IN THE 411 00:17:40,900 --> 00:17:41,533 U.S. 412 00:17:41,533 --> 00:17:43,233 CPT FOR DIAGNOSES. 413 00:17:43,233 --> 00:17:51,266 LOINC DIFFERENT FROM MESH AND 414 00:17:51,266 --> 00:17:55,232 UMLS WHICH IS WIDELY USED IN THE 415 00:17:55,233 --> 00:17:55,666 U.S. 416 00:17:55,666 --> 00:17:58,299 KEEP IN MIND MOST HEALTHCARE 417 00:17:58,300 --> 00:18:00,333 SETTINGS MAY BE USING SEVERAL OF 418 00:18:00,333 --> 00:18:03,033 THESE HAD A ONCE PLUS THEY MAY 419 00:18:03,033 --> 00:18:04,933 HAVE THEIR OWN PROPRIETARY 420 00:18:04,933 --> 00:18:06,033 SUBSET. 421 00:18:06,033 --> 00:18:08,166 UNFORTUNATELY MAPPING BETWEEN 422 00:18:08,166 --> 00:18:10,299 TERMINOLOGIES IS ALWAYS 423 00:18:10,300 --> 00:18:13,400 ACCOMPANIED WITH SOME 424 00:18:13,400 --> 00:18:14,533 INFORMATION AND MAYBE THAT IS 425 00:18:14,533 --> 00:18:16,099 OKAY DEPENDING ON WHAT YOU ARE 426 00:18:16,100 --> 00:18:17,066 TRYING TO DO. 427 00:18:17,066 --> 00:18:18,366 ALL RIGHT, LET'S TAKE ANOTHER 428 00:18:18,366 --> 00:18:21,766 SHORT BREAK FOR ANOTHER LITTLE 429 00:18:21,766 --> 00:18:25,132 QUIZ. 430 00:18:25,133 --> 00:18:31,166 ALL RIGHT, AND I WILL EXCUSE 431 00:18:31,166 --> 00:18:32,766 MYSELF FOR A MOMENT AND GIVE YOU 432 00:18:32,766 --> 00:18:35,132 A FEW SECONDS TO LOOK AT THE 433 00:18:35,133 --> 00:18:36,399 QUIZ. 434 00:18:36,400 --> 00:18:43,833 AND WE'LL REVIEW. 435 00:18:43,833 --> 00:18:45,199 OKAY, SO LET'S SEE. 436 00:18:45,200 --> 00:18:47,400 REVIEW THIS REAL QUICK. 437 00:18:47,400 --> 00:18:50,233 WHICH TERMINOLOGY IS USED IN THE 438 00:18:50,233 --> 00:18:53,266 U.S. FOR LABORATORY TESTS? 439 00:18:53,266 --> 00:18:59,499 THAT WOULD BE LOINC. 440 00:18:59,500 --> 00:19:01,566 OTHERS MAY HAVE SOME LAB TEST 441 00:19:01,566 --> 00:19:05,599 CONTENT BUT LOINC IS THE ONE 442 00:19:05,600 --> 00:19:06,900 USED MOST. 443 00:19:06,900 --> 00:19:07,933 WHICH IS REQUIRED FOR 444 00:19:07,933 --> 00:19:09,466 REIMBURSEMENT IN THE U.S.? 445 00:19:09,466 --> 00:19:12,632 THAT WOULD BE CPT AND ICD AND 446 00:19:12,633 --> 00:19:14,133 WHICH TERMINOLOGY ALLOWS MAPPING 447 00:19:14,133 --> 00:19:16,333 FROM ONE TERMINOLOGY TO ANOTHER? 448 00:19:16,333 --> 00:19:17,999 IS IS BEST ANSWERS HERE ARE 449 00:19:18,000 --> 00:19:28,600 RXNORM AND UMLS. 450 00:19:28,600 --> 00:19:30,233 MAPPING BETWEEN DIFFERENT 451 00:19:30,233 --> 00:19:32,133 TERMINOLOGIES ARE DONE ALL THE 452 00:19:32,133 --> 00:19:44,599 TIME BUT THOSE ARE THE CLOSEST 453 00:19:44,600 --> 00:19:46,266 TWO FOR TERMINOLOGY. 454 00:19:46,266 --> 00:19:47,866 OKAY, I WILL CLOSE THAT. 455 00:19:47,866 --> 00:19:49,832 IN OUR LAST FEW MINUTES, WE WILL 456 00:19:49,833 --> 00:19:51,866 SWITCH GEARS A BIT TO TALK ABOUT 457 00:19:51,866 --> 00:19:53,532 EXCHANGE STANDARDS. 458 00:19:53,533 --> 00:19:54,566 THESE ARE THE SYSTEMS THAT MAKE 459 00:19:54,566 --> 00:19:55,799 IT POSSIBLE TO SHARE INFORMATION 460 00:19:55,800 --> 00:19:57,533 WITH EACH OTHER AND ALTHOUGH 461 00:19:57,533 --> 00:19:59,099 NLM IS LESS INVOLVED, THEY 462 00:19:59,100 --> 00:20:00,566 OFTEN COME UP IN CONVERSATIONS 463 00:20:00,566 --> 00:20:02,099 SO WE WANT TO MAKE YOU AWARE OF 464 00:20:02,100 --> 00:20:02,633 THEM. 465 00:20:02,633 --> 00:20:06,099 ALL OF THESE EXCHANGE STANDARDS WE WILL 466 00:20:06,100 --> 00:20:08,066 BE DISCUSSING COME FROM HEALTH 467 00:20:08,066 --> 00:20:11,732 LEVEL SEVEN, REFERRED TO AS HL7, 468 00:20:11,733 --> 00:20:18,599 THIS IS AN INTERNATIONAL ORGANIZATION FOR EXCHANGING 469 00:20:18,600 --> 00:20:19,733 INFORMATION. 470 00:20:19,733 --> 00:20:22,566 CDA IS A DOCUMENT MARKUP 471 00:20:22,566 --> 00:20:23,832 STANDARD THAT SPECIFIES 472 00:20:23,833 --> 00:20:25,699 STRUCTURE OF CLINICAL DOCUMENTS. 473 00:20:25,700 --> 00:20:27,600 THE SPECIFICATION PERMITS THE 474 00:20:27,600 --> 00:20:29,066 DEFINITION OF MANY DOCUMENTS AND 475 00:20:29,066 --> 00:20:30,999 IDENTIFIES THEM BY ASSIGNED 476 00:20:31,000 --> 00:20:31,766 CODES. 477 00:20:31,766 --> 00:20:33,032 SECTIONS WITHIN THE DOCUMENT CAN 478 00:20:33,033 --> 00:20:35,733 ALSO BE IDENTIFIED BY CODE. 479 00:20:35,733 --> 00:20:38,633 IT IS POSSIBLE FOR A HEALTH I.T. 480 00:20:38,633 --> 00:20:40,366 SYSTEM TO DIFFERENTIATE A 481 00:20:40,366 --> 00:20:41,599 CONSULTATION NOTE FROM A 482 00:20:41,600 --> 00:20:44,700 DISCHARGE SUMMARY IN CDA AND 483 00:20:44,700 --> 00:20:46,966 THEN STORE OR DISPLAY IT AS 484 00:20:46,966 --> 00:20:49,132 APPROPRIATE. 485 00:20:49,133 --> 00:20:51,099 THE MOST COMMONLY USED DATA 486 00:20:51,100 --> 00:20:53,133 INTERCHANGE OR MESSAGING 487 00:20:53,133 --> 00:20:54,699 STANDARD USED IN THE U.S. TODAY 488 00:20:54,700 --> 00:20:57,666 IS THE HL7 TRANSFER STANDARD 489 00:20:57,666 --> 00:20:58,866 KNOWN AS VERSION 2. 490 00:20:58,866 --> 00:21:00,532 THE POPULARITY IS THAT IT IS 491 00:21:00,533 --> 00:21:02,099 EASY TO USE, UNDERSTAND AND 492 00:21:02,100 --> 00:21:02,866 IMPLEMENT. 493 00:21:02,866 --> 00:21:04,266 IT IS PARTICULARLY GREAT WITHIN 494 00:21:04,266 --> 00:21:05,599 A SINGLE ENTERPRISE WHERE 495 00:21:05,600 --> 00:21:07,466 EVERYONE CAN AGREE ON CERTAIN 496 00:21:07,466 --> 00:21:09,932 DETAILS INCLUDING WHAT ELEMENTS 497 00:21:09,933 --> 00:21:12,266 WILL BE EXCHANGED, TERMINOLOGY 498 00:21:12,266 --> 00:21:13,466 TO BE USED AND WHEN THE DATA 499 00:21:13,466 --> 00:21:15,166 WILL BE EXCHANGED. 500 00:21:15,166 --> 00:21:16,332 HOWEVER AS WE EXPAND DATA EXCHANGE 501 00:21:16,333 --> 00:21:18,366 INFORMATION ACROSS BOUNDARIES, 502 00:21:18,366 --> 00:21:20,766 LOCALLY OR INTERNATIONALLY, 503 00:21:20,766 --> 00:21:22,432 THESE ARE NOT IN PLACE SO WE 504 00:21:22,433 --> 00:21:24,833 HAVE VERSION 3. 505 00:21:24,833 --> 00:21:27,666 SOMEONE AT HL7 HAD TO EXPLAIN 506 00:21:27,666 --> 00:21:29,266 THIS TO ME BUT IT IS NOT AN 507 00:21:29,266 --> 00:21:34,699 UPDATED VERSION OF VERSION 2. 508 00:21:34,700 --> 00:21:35,966 IT IS A COMPLETELY DIFFERENT 509 00:21:35,966 --> 00:21:36,599 STANDARD. 510 00:21:36,600 --> 00:21:41,166 IT CAN HAVE SIMILAR STANDARD 511 00:21:41,166 --> 00:21:44,799 EXPLANATIONS BUT IT IS HARDER TO 512 00:21:44,800 --> 00:21:46,400 USE. 513 00:21:46,400 --> 00:21:48,833 ANYONE WHO CAN CONNECT TO THE 514 00:21:48,833 --> 00:21:50,566 SERVER WITH NO FURTHER 515 00:21:50,566 --> 00:21:53,199 COORDINATION NECESSARY. 516 00:21:53,200 --> 00:21:55,033 NOW, HOW MANY OF YOU HAVE HEARD 517 00:21:55,033 --> 00:21:57,133 ABOUT FHIR? 518 00:21:57,133 --> 00:22:00,399 IN YOUR PARTICIPANT' WINDOW, 519 00:22:00,400 --> 00:22:02,000 PLEASE CLICK ON THE GREEN CHECK 520 00:22:02,000 --> 00:22:03,900 MARK TO LET ME KNOW IF YOU HAVE 521 00:22:03,900 --> 00:22:06,466 HEARD ABOUT IT OR CHECK THE RED 522 00:22:06,466 --> 00:22:16,299 X IF IT MEANS NOTHING TO YOU. 523 00:22:16,300 --> 00:22:19,266 ALL RIGHT, WELL, SO I AM GLAD 524 00:22:19,266 --> 00:22:20,566 YOU ARE ATTENDING TODAY'S 525 00:22:20,566 --> 00:22:21,799 SESSION. 526 00:22:21,800 --> 00:22:25,866 SO WE WILL HAVE A -- WE DON'T 527 00:22:25,866 --> 00:22:28,432 HAVE THE PARTICIPANTS WINDOW, 528 00:22:28,433 --> 00:22:30,899 HERE, YOU CAN DO THE PULLDOWN AT 529 00:22:30,900 --> 00:22:32,000 THE TOP OF THE SCREEN BUT THANK 530 00:22:32,000 --> 00:22:34,100 YOU FOR THE INPUT. 531 00:22:34,100 --> 00:22:36,300 DEPENDING ON WHAT KIND OF NEWS 532 00:22:36,300 --> 00:22:39,400 YOU FOLLOW, YOU MAYBE HEARD, FOR EXAMPLE, ABOUT APPLE'S NEW 533 00:22:39,400 --> 00:22:41,200 HEALTH RECORDS APP. IT USES 534 00:22:41,200 --> 00:22:43,233 FHIR. 535 00:22:43,233 --> 00:22:46,133 FAST HEALTHCARE INTEROPERABILITY 536 00:22:46,133 --> 00:22:47,933 RESOURCES IS A SET OF STANDARDS 537 00:22:47,933 --> 00:22:49,599 FOR HEALTH INFORMATION EXCHANGE. 538 00:22:49,600 --> 00:22:52,133 FHIR IS TECHNICALLY STILL A 539 00:22:52,133 --> 00:22:55,533 DRAFT STANDARD FOR PACKAGING AND 540 00:22:55,533 --> 00:22:57,333 SENDING HEALTHCARE DATA THAT 541 00:22:57,333 --> 00:23:00,433 MANY ARE PLANNING OR HOPING TO 542 00:23:00,433 --> 00:23:00,866 USE. 543 00:23:00,866 --> 00:23:02,132 IT IS PROBABLY SOMETHING YOU 544 00:23:02,133 --> 00:23:03,599 SHOULD CONSIDER LEARNING MORE 545 00:23:03,600 --> 00:23:05,200 ABOUT AND MAYBE USING. 546 00:23:05,200 --> 00:23:11,366 BECAUSE OF THE LIMITATIONS OF -- 547 00:23:11,366 --> 00:23:14,166 VERSION 2 AND VERSION 3, THEY 548 00:23:14,166 --> 00:23:17,166 ARE USING COMMON WEB STANDARDS 549 00:23:17,166 --> 00:23:20,099 TO MAXIMIZE INTEROPERABILITY AND 550 00:23:20,100 --> 00:23:25,400 MAKE THE ASSEMBLING OF DATA AS 551 00:23:25,400 --> 00:23:26,733 EASY AS POSSIBLE. 552 00:23:26,733 --> 00:23:35,799 YOU HAVE API AND HTTP, HTML. 553 00:23:35,800 --> 00:23:39,133 THINK OF FHIR AS BEING THE RULES 554 00:23:39,133 --> 00:23:43,499 ON HOW TO PUT INFORMATION IN XML 555 00:23:43,500 --> 00:23:46,933 PACKAGES TO SHARE DATA. 556 00:23:46,933 --> 00:23:48,966 THE PACKAGES ARE CALLED 557 00:23:48,966 --> 00:23:49,499 RESOURCES. 558 00:23:49,500 --> 00:23:53,466 THE FHIR RESOURCE FOR A PATIENT 559 00:23:53,466 --> 00:23:56,366 WOULD INCLUDE AN IDENTIFIER AND 560 00:23:56,366 --> 00:23:57,132 A NAME. 561 00:23:57,133 --> 00:23:58,433 THIS JUST GIVES YOU AN IDEA OF 562 00:23:58,433 --> 00:23:59,199 THE STRUCTURE. 563 00:23:59,200 --> 00:24:00,900 THERE IS MORE TO IT, OF COURSE 564 00:24:00,900 --> 00:24:03,633 BUT THE TECHNOLOGICAL PART OF 565 00:24:03,633 --> 00:24:05,533 THIS IS NOT DIFFICULT. 566 00:24:05,533 --> 00:24:08,733 IT IS JUST A PACKAGE TO RELAY 567 00:24:08,733 --> 00:24:10,499 INFORMATION AND ITS SIMPLICITY 568 00:24:10,500 --> 00:24:11,833 IS A GREAT BENEFIT. 569 00:24:11,833 --> 00:24:13,766 AND THAT CONCLUDES OUR BIRDS EYE 570 00:24:13,766 --> 00:24:15,899 TOUR OF ABOUT A DOZEN DIFFERENT 571 00:24:15,900 --> 00:24:17,866 STANDARDS AND IT CONCLUDES THIS 572 00:24:17,866 --> 00:24:22,632 INITIAL MINISERIES OF SEMINARS 573 00:24:22,633 --> 00:24:26,433 IT FOR NLM. 574 00:24:26,433 --> 00:24:29,833 IN CASE YOU HAVEN'T BEEN HERE 575 00:24:29,833 --> 00:24:31,066 FOR PREVIOUS ONES, WE HAVE 576 00:24:31,066 --> 00:24:36,599 LANDED HERE IN FRONT OF OUR 577 00:24:36,600 --> 00:24:37,466 BUILDING. 578 00:24:37,466 --> 00:24:39,232 SO THE GOALS OF THIS SERIES ARE 579 00:24:39,233 --> 00:24:41,366 FOR YOU TO BE ABLE TO USE THE 580 00:24:41,366 --> 00:24:44,566 JARGON, NAME RELEVANT STANDARDS 581 00:24:44,566 --> 00:24:46,932 AND DESCRIBE HOW THEY ARE USED, 582 00:24:46,933 --> 00:24:49,233 DESCRIBE RELEVANT NLM PRODUCTS 583 00:24:49,233 --> 00:24:51,033 AND SERVICES AND IDENTIFY NEW 584 00:24:51,033 --> 00:24:52,499 ROLES FOR LIBRARIANS. 585 00:24:52,500 --> 00:24:54,000 YOU ARE A PLAN IS TO CONTINUE 586 00:24:54,000 --> 00:24:55,100 THESE FOR INFORMATION GO OVER 587 00:24:55,100 --> 00:24:55,766 THE NEXT YEAR. 588 00:24:55,766 --> 00:24:57,432 YOU WILL RECEIVE A IN THE OF NEW 589 00:24:57,433 --> 00:25:00,033 CLASSES VIA THE E-MAIL ADDRESS 590 00:25:00,033 --> 00:25:02,599 YOU USED TO SIGN UP FOR THESE 591 00:25:02,600 --> 00:25:03,833 SERIES. 592 00:25:03,833 --> 00:25:07,833 FUTURE TOPICS COULD INCLUDE MORE 593 00:25:07,833 --> 00:25:10,033 ON THE WEB OR A DEEPER DIVE IN 594 00:25:10,033 --> 00:25:11,633 FHIR. 595 00:25:11,633 --> 00:25:13,499 YOU HAVE GIVEN A FEW IDEAS 596 00:25:13,500 --> 00:25:15,533 THROUGHOUT THIS SERIES AND KEEP 597 00:25:15,533 --> 00:25:18,299 THEM COMING.