Linking Health IT Systems, EHRs and Patient Portals to Reliable Health Information

MedlinePlus Connect & MedlinePlus.gov

MedlinePlus Connect Free service for patient portals, EHRs, or health IT systems to link to patient health information from MedlinePlus.gov

MedlinePlus.gov Consumer health information Web site with easy-to-understand information from reputable sources

• Reliable, authoritative• Consumer-friendly• No ads• Updated daily• Strict quality guidelines• English and Spanish• Links to information in

>40 languages• Multimedia, news,

images, encyclopedia, tutorials and more…

Why MedlinePlus.gov?

~1,000 drugs100 supplements

164 tutorials78 anatomy videos139 surgery videos

>40 languages>250 topics>3,300 links

~ 3,500 encyclopedia articles> 2,000 images

15-20 news stories daily

>1,200 links to ClinicalTrials.gov

921 English896 Spanish

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MedlinePlus Connect

Patient portals, EHRs, or health IT systems can deliver consumer health information related to patients’ specific diagnoses, medications, and labs

MedlinePlus Connect

Problem, medication, or lab code-based request

MedlinePlus Connect

Consumer health information targeted response

Clinical systemPatient portal

EHR/Health IT System

Who can implement MedlinePlus Connect?

• Health IT companies and/or developers can activate it in their patient portal, EHR or other systems

• Hospital systems, doctors’ offices, clinics, and health IT purchasers may be able to implement it directly

How easy is it to implement?• Free. No registration or licensing • Integrates into existing health IT systems• HL7 Context-Aware Knowledge Retrieval

(Infobutton) Standard• Available as Web application and Web service • Can be implemented by:

– Health IT companies – Health IT purchasers

Web Application & Web ServiceWeb application: • Responds with an on-demand, formatted

MedlinePlus Connect Web page

Web service: • Returns information in XML• The patient portal or EHR may select

which MedlinePlus links and information to provide within the system

Hello, Jane Smith

Health Summary

Appointments

Test Results

Medications

Messages

Date

Your Health Summary – Conditions

Issue

Asthma

Acute Sinusitis

05/02/2011

09/10/2009

Insurance

Log Out

W e s t M e d i c a l G r o u p

WMG

Depression 04/19/2008

Link to full MedlinePlus topic page

First few lines of the MedlinePlus summary for that topic

Links to additional, related information

Spanish Response for Diagnoses

Web Service

• Returns information in XML• The patient portal or EHR may select

which MedlinePlus links and information to provide within the system

Link to full MedlinePlus topic page

Full MedlinePlus summary for that topic

Links to additional, related information

Request NLM Process for Matching Codes to Patient Content

MedlinePlus Content

Response Languages

Code Type Code System

Problems ICD-9-CM 13,700 codes mapped manually

Health topic pages

English Spanish

SNOMED CT 11,800 codes mapped manually

Lab Tests LOINC 2,100 codes mapped manually

Lab articles English Spanish

Drugs RXCUI RxNorm API & search of MedlinePlus drug information

Drug articles English

NDC

Problem Code Mappings• Multiple problem codes may map to one

MedlinePlus topic

ICD-9-CM SNOMED CT493.00 Extrinsic Asthma Unspecified493.01 Ext Asthma W Status Asthmaticus493.02 Extrinsic Asthma with Exac493.10 Intrinsic Asthma Unspecified493.12 Extrinsic asthma with exacerbation493.20 Chron Obst Asthma Unspecified493.21 Chron Obst Asthma Unspecified W Status Asth493.22 Chronic obst asthma with exacerbation

31387002 Exercise-induced asthma (disorder)55570000 Asthma without status asthmaticus (disorder)57546000 Asthma with status asthmaticus (disorder)195967001 Asthma (disorder)266361008 Non-allergic asthma (disorder)281239006 Exacerbation of asthma (disorder)

• Examples of problem codes mapped to Asthma topic:

One problem code can map to up to 3 MedlinePlus topics

ICD-9-CM• 003.0: Salmonella enteritis

– Foodborne Illness– Salmonella Infections– Gastroenteritis

• 824: Fracture of ankle– Ankle Injuries and Disorders– Fractures

SNOMED CT Core Problem List Subset• 15574005: Fracture of foot (disorder)

– Foot Injuries and Disorders– Fractures

Lab Code Mappings

• Examples of LOINC codes mapped to the Glucose test – blood article

LOINC

2339-0 Glucose [Mass/volume] in Blood41653-7 Glucose [Mass/volume] in capillary blood by Glucometer32016-8 Glucose [Mass/volume] in Capillary blood2345-7 Glucose [Mass/volume] in Serum or Plasma1558-6 Glucose fasting [Mass/volume] in Serum or Plasma

• Multiple LOINC codes may map to one Lab Test article

MedlinePlus Connect for Medications

UsersOrganizations• Buffalo Medical Group• Cleveland Clinic• Halifax Regional Medical

Center• Indian Health Service• Institute for Family Health• New York-Presbyterian

Hospital/Columbia University Medical Center

• Texas Health Resources• University of Utah

Health IT Systems• Aetna’s case management system• AlphaFlexCMS 1.0 • ChiroSuite EHR• ComChart EMR• Dexter Solutions eZDocs• Epic MyChart• MedSoft Patient Portal and

Record 5.0.6• Procentive • Resource and Patient

Management System (RPMS) HER• Rise Health Patient Relationship

Manager• SmartPHR

http://medlineplus.gov/connect

• Technical how to’s • Sample list of users• Demonstration pages• Email list – please join!http://www.nlm.nih.gov/medlineplus/connect/emaillist.html

Other MedlinePlus Resources for Patient Health Content

• MedlinePlus Web Service – Accepts keyword query requests and returns relevant health topics and associated data in XML format http://www.nlm.nih.gov/medlineplus/webservices.html

• XML Files – Full data sets, including MedlinePlus topic names, URLs, associated terms, and summaries describing the topichttp://www.nlm.nih.gov/medlineplus/xml.html