Workflow Lexicons in Healthcare: Validation of the SWIM Lexicon

Abstract

For clinical departments seeking to successfully navigate the challenges of modern health reform, obtaining access to operational and clinical data to establish and sustain goals for improving quality is essential. More broadly, health delivery organizations are also seeking to understand performance across multiple facilities and often across multiple electronic medical record (EMR) systems. Interpreting operational data across multiple vendor systems can be challenging, as various manufacturers may describe different departmental workflow steps in different ways and sometimes even within a single vendor's installed customer base. In 2012, The Society for Imaging Informatics in Medicine (SIIM) recognized the need for better quality and performance data standards and formed SIIM's Workflow Initiative for Medicine (SWIM), an initiative designed to consistently describe workflow steps in radiology departments as well as defining operational quality metrics. The SWIM lexicon was published as a working model to describe operational workflow steps and quality measures. We measured the prevalence of the SWIM lexicon workflow steps in both academic and community radiology environments using real-world patient observations and correlated that information with automatically captured workflow steps from our clinical information systems. Our goal was to measure frequency of occurrence of workflow steps identified by the SWIM lexicon in a real-world clinical setting, as well as to correlate how accurately departmental information systems captured patient flow through our health facility.

Pragmatic Approaches to Interoperability – Surmounting Barriers to Healthcare Data and Information Across Organizations and Political Boundaries

“…Moreover, "understanding data structures and mapping data tables to workflow timestamps was difficult without vendor guidance." 55 The IHE framework does not "provide semantic alignment of data collected in disparate contexts" from different systems. 56 Along with interoperability shortcomings, Query for existing data (QED) has proven to be a difficult task in a cross-community environment.…”

Standard Lexicons, Coding Systems and Ontologies for Interoperability and Semantic Computation in Imaging

“…Synonyms or translations may also be attached to each concept. For example, RID4271 has the preferred name “hepatocellular carcinoma” and the synonyms “HCC” and “hepatoma.” Work has also been done by the Society for Imaging Informatics in Medicine (SIIM) to formalize a lexicon of radiology workflow terms known as SIIM’s Workflow Initiative for Medicine (SWIM) [ 14 ]. Also note that recent collaboration between RSNA and the Regenstrief Institute has led to the LOINC-RSNA Radiology Playbook [ 15 ], a system for naming and coding imaging exams, constructed using RadLex terms.…”

System approach to prevent lost studies and improve radiology report turnaround time

“…Worklist optimisation is one method of improving workflow efficiency and RTAT within academic radiology departments 5 6. Computerised picture archiving and communication system (PACS) worklists7 8 allow studies to be segmented by modality, subspecialty, location, age, ordering provider and multiple other factors depending on the specific software application.…”