A Semantically Enriched Architecture for an Italian Laboratory Terminology System

Abstract

This paper presents the architectural solutions and the first implementation results of a terminology service that aims to support Italian health institutions in the deployment of their clinical data in a semantically standardized format while main-taining their internal coding habits unchanged. As a first ex-ample of this general idea, an implementation structure of a translation system in LOINC for laboratory tests is presented. The first prototype of this system is at a testing stage within some clinical institutions of the Ligurian region. In this paper, the workflow of collaboration between the staff of a medical informatics academic laboratory and some hospital analysis laboratories is presented. With this system more than 400 rec-ords relative to clinical tests were coded with the appropriate LOINC code and these translations were inserted into a Com-mon Terminology Services 2 (CTS2) based tool to support fu-ture cooperative maintenance of the coding system. A compari-son with similar implementations in other English and non-English speaking countries is present. The authors thinks that the present example could be easily adopted both at a regional and at a national level in order to form an interconnected la-boratory network towards real semantic interoperabilit

Healthcare Terminology Management and Integration in Italy: Where we are and What we need for Semantic Interoperability

“…It is the case of LexGrid, a community-driven initiative coordinated by the Mayo Clinic Division of Biomedical Statistics and Informatics [15], and of the HL7 CTS2 (Common Terminology Services 2) 8 specifications for the development of standardized terminology services. Regarding this last standard, its most relevant international implementation is by Mayo Clinic Informatics, but similar experiences are known also in France (by PHAST, a non-profit development stan-dards and services organization, that used CTS2 to build the Standard Terminology Services -STS 9 ), Germany (by the University of Applied Science, Dortmund 10 ), Austria (by the Ministry of Health, that used a modified version of the cited Dortmund Terminology Server as central eHealth terminology source in Austria, Austrian Terminology Server 11 , especially for the national federated patient health record "ELGA") and Italy (by the University of Genova [16], and by the Codices company that use it to develop the Distributed Terminology Assets Management system13). In particular in Italy, the raising awareness of the fundamental importance of having an integrated and centralized system for terminologies management is driving the first initiatives related to HL7 CTS2, such as the cited ones, and also the first requirements of some Regions about it.…”

A SOA-Based Platform to Support Clinical Data Sharing

“…A terminological harmonization, with the support of laboratory technicians and supervisors of registers/CDMSs, between local terminology and LOINC was necessary. In this phase, the authors considered and modified an algorithm designed within a previous research collaboration [ 72 ]. The authors decided to adopt the translations between local terminologies and LOINC produced in the previous work as guidance for the new harmonization.…”

Semantics Management for a Regional Health Information System in Italy by CTS2 and FHIR

“…This infrastructure aggregates data according to data semantics. The management of semantics is one of the key aspects of HIEs, because in medical practice terminologies used in different departments, laboratories and institutes are usually diverse and very different from standardized vocabularies, while standardized terminologies, universally recognized for each specific application domain, should be adopted [16][17][18].…”