1. Query Health Concept Mapping Activity November 10, 2011

2. Overview A (very basic) background on concept mapping The problem that the Concept Mapping workstream is trying to solve Five questions for you Any questions for us and general discussion 2

3. Background The majority of healthcare systems maintain their own dictionaries The terms in these dictionaries are not compatible with others –‘PA/Lateral CXR’ vs. ‘2-view chest x-ray’ In order to speak the same ‘language’, we have to: –Agree on the same language –Translate what we say into this agreed upon language –Translate what we hear back into our own language This translation exercise is what is termed ‘concept mapping’ 3

4. County Hospital Private Hospital Community Hospital A Community Hospital B Tertiary Care Center Health Departments Global Patient Index Concept Dictionary Referral Labs, Pharmacies, etc… Provider Directory

5. Concept Mapping Illustrated 5 Other Code Set Code 1 Code 2 Other Code Set 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 UMLS, etc. Clinical Concepts Map Vocabulary Codes ↔ Concept Dictionary

6. The Importance of Concept Mapping… and the problem at hand Query Health will disseminate queries to many data sources It is unlikely that any of these data sources will understand that format natively –Each data source will have to map their own concept dictionary to the concepts expressed by the query –Some larger organizations and information exchanges may already have mappings to standard vocabularies, but many others may not In order to ease the burden of participating in Query Health, how can we facilitate the concept mapping exercise? 6

7. Where the Concept Mapping Activity comes in As part of the Query Health initiative, we suggest undertaking work to discover the best practices in concept mapping The ultimate goal of this effort would be a guide describing these best practices Question 1 Should we undertake this work? 7

8. Question 2 How should we do this study? Semi-structured interviews Structured survey Focused group discussions Literature Review Another methodology 8

9. Question 3 If we use a methodology that collects information from experts (surveys, interviews, FGDs), who should we target? Information Exchange Implementers Creators of tools to facilitate mapping (i.e. RELMA for LOINC) Other groups? From which organizations? 9

10. Question 4 If we perform a literature review, what terms should we include? AND Mapping AND (LOINC or SNOMED or SNOMED-CT or ICD-9 or ICD-10 or ICD-9-CM or ICD-10-CM or ICD-10-PCS or RxNorm or CPT) Other terms 10

11. Question 5 How should we (your support team) proceed before the activity starts in 3-4 weeks? Do nothing; all work from study design onward should be in the Concept Mapping workstream Have the Implementation workgroup approve a study design and the support team should begin collecting data; all data analysis should be done in the Concept Mapping workstream Have the Implementation workgroup approve the study design and the support team should collect data and analyze it; the Concept Mapping workstream can review the analysis Another approach 11

12. Questions and General Discussion 12