1. Department of Medical Informatics
Access to Health Care Information Resources through Intelligent Controlled Terminologies
James J. Cimino, M.D.
Columbia University
Department of Medical Informatics

2. Overview What needs fixing?
What is an "intelligent controlled terminology?"
How does it assist with access to information resources?

3. What Needs Fixing? Finding the right resource is hard
Using each resource is awkward
It's easy to get overwhelmed

4. Example: Weird Organism
Encountered on lab test result
What resource has the right information?
How do I get to the resource?
How do I ask the question?
What was that organism again?

5. Solution: "Infobuttons"
Button is integrated with clinical system
Knows that Medline has information
Knows how to get to Medline
Knows how to translate organism name
Knows how to query Medline
Result: one-touch Medline search

6. Under the Hood: Intelligent Controlled Terminology
CPMC Medical Entities Dictionary (MED)
Semantic network of 50,000 concepts
Includes definitional information through semantic relationships
Tightly coupled with the Unified Medical Language System

7. Medical Entities Dictionary
Entity
Laboratory
Specimen
Substance
Event
Anatomic
Substance
Plasma
Specimen
Chemical
Diagnostic
Procedure
Substance
Sampled
Carbo-
hydrate
Bioactive
Substance
Plasma
Laboratory
Test
Laboratory
Procedure
Has Specimen
Glucose
Plasma
Glucose
CHEM-7
Substance Measured
Part of

8. How does the Infobutton Work?
Clinical
Information
System
Vocabulary
Server
Web Server
Internet
Clinician
Information Source
Information Source

9. Examples of Infobuttons
Laboratory tests to Medline
Laboratory tests to DXplain
Cholesterol results to guideline
X-ray reports to variety of Web resources
Patient medications to drug references

10. screen shots galore Laboratory tests to Medline Chem20 Question list
Laboratory tests to DXplain
DXplain Diseases (list)
DXplain Disease (result)
List of findings
Differential diagnosis
Cholesterol results to guideline
Does pt have CHD?
Recommendation lipid lowering agent
X-ray reports to variety of Web resources
X-ray report
Findings
Questions
Medline results
Medline abstract
Chorus page
Patient medications to drug references
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11. Advantages of Knowledge-Based Approach
Re-use of terms by multiple applications
Translation of terms between applications
Integration of data from multiple sources
Coordination of patient data with information resource concepts
Ability to support maintenance of the terminology itself

12. Implications for Federal Information Resources
Allow more sophisticated access to resources
Reusability of terminology
Maintenance of terminology