Succeeding with electronic health records meaningful use means using standard vocabularies--seven to be specific. They include ICD-10-PCS, SNOMED CT, CCD, clinical and dental HCPCS, RxNorm and LOINC.

But different vocabularies may use different names for the same medicine or condition and a big push in meaningful use is standardized data, says Tomasz Adamusiak, M.D., an informaticist and senior scientist at the Human and Molecular Genetics Center at the Medical College of Wisconsin. Consequently, there is a need for semantic interoperability and that is the focus of a roundtable session at HIMSS14 in Orlando.

In simplistic terms, interoperability had a foundational start in health care by linking a cable between two systems, Adamusiak explains. Then came structural interoperability, such as agreeing on communications via Health Level Seven standards, which is where the industry is now. Stage 2 introduces basic semantic interoperability, which is the next step with agreement on a single computer readable language so different computers can understand each other.

Here’s a semantic challenge: A patient may be prescribed two different ibuprofen tablets with different strengths and these tablets will have different codes in RxNorm. So, during medication reconciliation, multiple computers have to recognize both codes are for ibuprofen. Another example: a rash may be termed “Rash NOS” (not otherwise specified) in ICD-10, but termed as “Eruption” in SNOMED, so clinical decision support systems have to understand that.

Adamusiak hopes to engage roundtable attendees in an interactive discussion on understanding semantic interoperability and its roles and challenges in meaningful use and in the overall health care industry. “This is really a critical and overlooked aspect of interoperability,” he says. “We’re only now approaching the real critical part of interoperability where we’re not just exchanging data but understanding each other, and to use the data actually exchanged.”

Roundtable 308, “Semantic Interoperability in Health Information Exchange,” is scheduled at 10 a.m. on Wednesday, Feb. 26 in Room 303A.

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