What's in a class? Lessons learnt from the ICD - SNOMED CT harmonisation.

The upcoming ICD-11 will be harmonized with SNOMED CT via a common ontological layer (CO). We provide evidence for our hypothesis that this cannot be appropriately done by simple ontology alignment, due to diverging ontological commitment between the two terminology systems. Whereas the common ontology describes clinical situations, ICD-11 linearization codes are best to be interpreted as diagnostic statements. For the binding between ICD codes and classes from the ontological layer, a query-based approach is favoured.

Comparing existing national and international classification systems of surgical procedures with the CEN/ISO 1828 ontology framework standard.

Among different standardization strategies for biomedical terminologies the European Standard Body CEN TC 251 followed by ISO TC 215 have stated that it was not possible to convince the different European or international member states using different national languages to agree on a reference clinical terminology or to standardize a detailed language independent biomedical ontology. Since 1990 they have developed since an approach named the Categorial Structure that standardises only the terminologies' model structure. The methodology for the Categorial Structure development and a comparison of the different existing classification systems based on this ontology framework is presented as a step towards increased interoperability between biomedical terminologies through conformity to a minimum set of ontological requirements.

Foreign currency-related translation complexities in cross-border healthcare applications.

International cross-border private hospital chains need to apply the standards for foreign currency translation in order to consolidate the balance sheet and income statements. This not only exposes such chains to exchange rate fluctuations in different ways, but also creates added requirements for enterprise-level IT systems especially when they produce parameters which are used to measure the financial and operational performance of the foreign subsidiary or the parent hospital. Such systems would need to come to terms with the complexities involved in such currency-related translations in order to provide the correct data for performance benchmarking.

Using the CEN/ISO standard for categorial structure to harmonise the development of WHO international terminologies.

Semantic interoperability (SIOp) is a major issue for health care systems having to share information across professionals, teams, legacies, countries, languages and citizens. The World Health Organisation (WHO) develops and updates a family of health care terminologies (ICD, ICF, ICHI and ICPS) and has embarked on an open web-based cooperation to revise ICD 11 using ontology driven tools. The International Health Terminology Standard Development Organisation (IHTSDO) updates, translates and maps SNOMED CT to ICD 10. We present the application of the CEN/ISO standard on categorial structure to bind terminologies and ontologies to harmonise and to map between these international terminologies.

A deployment and Research Roadmap for Semantic Interoperability: the EU semantic health project.

The purpose of this EU funded project is to describe a short and medium term Research and Deployment Roadmap for Semantic Interoperability in e-health. It started by defining 4 levels and 3 dimensions for Semantic Interoperability. The vision is to reconcile the needs for the direct patient care safety, biomedical and clinical research and for public health by the reuse of direct care data: from gene to individuals and populations. The methodology is presented and preliminary results and milestones for the short and the long term are set. We conclude by statements on the main characteristics and needs of the roadmap to sustain better health for individual and populations in the changing EU health care systems.

Standards and biomedical terminologies: the CEN TC 251 and ISO TC 215 categorial structures. A step towards increased interoperability.

Among different biomedical terminologies standardisation strategies the European Standard Body CEN TC 251 followed by the ISO TC 215 have stated that it was not possible to convince the different European or international member states using different national languages to agree on a reference clinical terminology or to standardise a detailed language independent biomedical ontology. Since 1990, they have developed an approach named categorial structure as a step standardising only the terminologies model structure. The methodology and the review of the different existing categorial structures are presented as a step towards increased interoperability between biomedical terminologies thanks to conformity to a minimum set of ontological requirements.

An Ontology driven collaborative development for biomedical terminologies: from the French CCAM to the Australian ICHI coding system.

The CCAM French coding system of clinical procedures was developed between 1994 and 2004 using, in parallel, a traditional domain expert's consensus method on one hand, and advanced methodologies of ontology driven semantic representation and multilingual generation on the other hand. These advanced methodologies were applied under the framework of an European Union collaborative research project named GALEN and produced a new generation of biomedical terminology. Following the interest in several countries and in WHO, the GALEN network has tested the application of the ontology driven tools to the existing reduced Australian ICHI coding system for interventions presently under investigation by WHO to check its ability and appropriateness to become the reference international coding system for procedures. The initial results are presented and discussed in terms of feasibility and quality assurance for sharing and maintaining consistent medical knowledge and allowing diversity in linguistic expressiveness of end users.