terminology and icpc in epr the belgian challenge: a link between analogue doctors and digital...
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Terminology and ICPC in EPR
The Belgian challenge:
a link between analogue doctors and digital machines in a bilingual
country
M.Verbeke M.D. Ghent University
November 8, 2006 Brussels Workshop on Health Terminologies
Why a national terminology?
Language Terminologies reflect local
Politics Ethics Tradition Religion Social organization Standardization of qualifiers
Different national use of data
Terminology without classification
Like paint without painting or color without picture
November 8, 2006 Brussels Workshop on Health Terminologies
Classifications in health care
Grouping of concepts and analysis of data Primary care ICPC-2-R: covers 80% of the morbidity
Specialist care ICD-10: more granularity
ICF: description of functioning
ICHI: procedures under re-construction
General plan of classifications needed
November 8, 2006 Brussels Workshop on Health Terminologies
Compounds of Belgian bilingual thesaurus
Vocabulary
Bilingual Clinical labels
Classifications
November 8, 2006 Brussels Workshop on Health Terminologies
Vocabulary
Keywords Independent content for each language (Fr/Nl) Patient oriented terms Doctor oriented terms (jargon) Synonyms or equivalent terms Link between thoughts and clinical label Flexible adaptation
November 8, 2006 Brussels Workshop on Health Terminologies
Clinical labels
Concepts: “units of thought” Fixed meaning Bilingual: 100% reciprocity Including procedures Linked by IBUI to vocabulary Long term: all diagnostic and clinical
procedures
November 8, 2006 Brussels Workshop on Health Terminologies
Vocabulary French Vocabulary Dutch
IBUI
Clinical label French = Clinical label Dutch
ICPC
ICDRIZIV/INAMIprocedures
ICF
(ICHI)
n
1
n
1
n
n
Under construction
Double encoded ICPC/ICD
1n1
1
47037
686+39
11363
1510
November 8, 2006 Brussels Workshop on Health Terminologies
Why
Encoded information?
classifications with accurate granularity
Structured information?
EPR structure: enables exchangeable data
November 8, 2006 Brussels Workshop on Health Terminologies
Encoded information (1)
Codes linked to ICPC indexed “EBM Guidelines” and other expert systems Online available
During patient contact
Appropriate guideline
Very accurate information as decision support
Language independent link
November 8, 2006 Brussels Workshop on Health Terminologies
Encoded information (2)
Use of ICPC codes in EPR Prevention module Risk calculator Workflow and automating processes Creation of alerts and warnings Creating views in the EPR with appropriate
information in function of doctors’ need Billing systems
November 8, 2006 Brussels Workshop on Health Terminologies
Encoded information (3)
Enables
Retrieving tool for epidemiological studies
Sharing information with other primary health care
providers or specialists (ICPC-ICD-ICF link)
Retrieving tool for social security and insurance
Evaluating and improving quality of care
November 8, 2006 Brussels Workshop on Health Terminologies
Structured information
Necessary for exchangeable data
Belgian Government provided structural model
Guaranteed for all “labeled” software systems
Episode based information with ICPC philosophy RFE
Procedures
Assessment
Guarantee for correct data use by software system.
November 8, 2006 Brussels Workshop on Health Terminologies
Topics for discussion
National or European terminology
Challenge of multilingual systems in Europe
Importance of appropriate classifications
November 8, 2006 Brussels Workshop on Health Terminologies
Developing teamGhent University
Jan De MaeseneerDiëgo SchransSven DerooseMarc VerbekePaul Van Hove
Brussels UniversityMichel RolandMichel DejongheNadine KacenelenbogenBernard Dendeau
Federal GovernmentMarc BangelsLuc Nicolas