Thursday, February 3, 2011

Medical Informatics Musing

Not for the first time, I am thinking about the complex world of health care informatics. At the moment I am studying efforts underway to standardize and put into electronic form medical data from personal health records, laboratory and research centers, existing specialized databases and archival hard copy. There are people devoting hundreds of hours to this effort, sometimes on a volunteer basis. And you want to talk about opportunity to do cool things...

Several organizations promote standards for medical terminology and for the most part they are complementary. They have their own histories and apply themselves to different subsets of data. In the United States several federal agencies manage data (in addition to many private and non profit organizations too numerous to list). Examples include the National Library of Medicine, The National Cancer Institute, the Centers for Disease Control and Prevention, The Agency for Healthcare Research and Quality, The Office of the National Coordinator for Health Information Technology. Different data sets, different functions, different structures.  Medical clinicians I have recently spoken to tell me the data gathered, maintained and disseminated by government, non profit and private groups have played an incredibly positive role in improving patient care nationally and internationally.

However, there is still a lot of work to do and much of it hinges around harmonizing data standards and developing the most effective ways to computerize these data as we move forward.

The most widely used international medical terminology set is SNOMED-CT, shorthand for Systemized Nomenclature of Medicine - Clinical Terms. In addition to providing detailed terminology definitions in machine readable form, SNOMED (as it is often called for short) provides a logical structure of relationships between concepts that covers virtually all areas of medicine.

Another large internationally accepted set of medical terminology and structure is LOINC, acronym for Logical Observation Identifiers Names and Codes. The data maintained in LOINC format comes primarily from research labs and is available for use by hospitals, physicians and others.

The third large and highly visible standardization effort is RxNorm, terminology and relationship structure for clinical drugs (to most of us that means prescription drugs) approved for use in the US. As with SNOMED and LOINC, RxNorm defines terms in machine readable format.

These are just the 3 biggest names associated with computerized standardization efforts. And if you think there are a lot of acronyms here, that is just the beginning. I suppose there may be no more acronyms in the medical world than in the computer science world. Just as non computer scientists often find our discussions puzzling and difficult to comprehend, non medical personnel may initially find it eye boggling to wrap their head around medical terminology and standards documents.

I'm in neck deep reading about these standardization efforts right now and it IS fascinating. There is a real coming together of two fields and two worlds here and a huge opportunity for computing and medicine. I am impressed with the enormity of the task needed to bring all these data into harmony with one another. Advances in computing technology and in medicine are each advancing so fast ... cutting edge on both sides.


  1. Love this. I know one of the folks you are talking to, and I'm thrilled to have been able to help in a small way.

  2. Thanks Pete. The more I dig into this the more interesting it gets.