University of Pittsburgh Department of Biomedical Informatics

Promoting Interoperable Dental TerminologiesJodi Schneider1,2, Tanja Bekhuis1,2, Oluwabunmi Tokede3, Elsbeth Kalenderian3, Heiko Spallek2

1Department of Biomedical Informatics, School of Medicine, University of Pittsburgh

2Center for Informatics in Oral Health Translational Research, School of Dental Medicine, University of Pittsburgh3Harvard School of Dental Medicine

Problem

Patient diagnosis, treatment, and outcomes can be used to:• Measure health care quality, costs of care, and treatment

effectiveness.• Identify disparities in patient care.• Identify risk factors of disease.Standardized terminologies help consolidate data.

Approach

We proposed a plan for a conference of stakeholders, “Toward a Diagnosis Driven Profession” (U13 grant submitted August 12, 2015), with three aims:

1. Increase understanding of Diagnostic Terminologies.

2. Explore their potential logistical and financial impacts on electronic health record vendors, payers/insurers, and providers.

3. Create a working group to develop clinician-friendly interfaces for entering diagnostic terms into electronic health record systems. Di

agnostic terms in

What is a Terminology?

A terminology is “a set of terms representing the system of concepts of a particular subject field” (Shortliffe & Cimino 2006). Using a unique phrasing to refer to a given concept ensures that information can be shared and retrieved effectively.Shortliffe E, Cimino J, editors. Biomedical Informatics 3rd ed. New York: Springer Science+Business Media; 2006.

Diagnostic Terminologies

Several diagnostic terminologies are in development and use, including:

Diagnostic terminologies are intended for integration into electronic records.CC-BY-NC Morgan https://www.flickr.com/photos/meddygarnet/4575870327/

Interface Terminologies

Interface terminologies enable mapping between different terminologies. They are designed to be closer to a user’s natural language.

Procedural Terminologies

To document dental treatment, CDT® Dental Codes - Current Dental Terminology® is used. CDT® is a standard of the American Dental Association. It is very widely used in the United States, especially for insurance and billing purposes, as a HIPAA standard code set.

Issues in Terminologies

Granularity

Flexibility

Interchange/mapping

Clarity of terms

Procedure codes are shown on the right.CC-BY-NC Rob Campbell https://www.flickr.com/photos/roberrific/15367788277/

Funded by Training grant 5T15LM007059-29 from the National Library of Medicine/National Institute of Dental and Craniofacial Research

Diagnosis recorded

Treatment recorded

Outcomes recorded

Effectiveness and quality measured.

Improvements for future patients.

Continuous learning healthcare relies on unified, up-to-date data about patient diagnoses.

Dental health terminologies can describe hierarchies of concepts.Example from SNOWMED-CT, concept: common cold (disorder).CC BY-SA Steschu. https://commons.wikimedia.org/wiki/File:SNOMED_primitive_concept.jpg#/media/File:SNOMED_primitive_concept.jpg