Showing papers by "James J. Cimino published in 1994"

Coping with changing controlled vocabularies.

Abstract: For the foreseeable future, controlled medical vocabularies will be in a constant state of development, expansion and refinement. Changes in controlled vocabularies must be reconciled with historical patient information which is coded using those vocabularies and stored in clinical databases. This paper explores the kinds of changes that can occur in controlled vocabularies, including adding terms (simple additions, refinements, redundancy and disambiguation), deleting terms, changing terms (major and minor name changes), and other special situations (obsolescence, discovering redundancy, and precoordination). Examples are drawn from actual changes appearing in the 1993 update to the International Classification of Diseases (ICD9-CM). The methods being used at Columbia-Presbyterian Medical Center to reconcile its Medical Entities Dictionary and its clinical database are discussed.

Mapping Clinically Useful Terminology to a Controlled Medical Vocabulary.

Abstract: We have mapped clinically used diagnostic terms from a legacy ambulatory care system to the separate controlled vocabulary of our central clinical information system. The methodology combines elements of lexical and morphologic text matching techniques, followed by manual physician review. Results of the automated matching algorithm before and after partial manual review are presented. The results of this effort will permit the migration of coded clinical data from one system to another. Output from the system after the term review process will be fed back to the target vocabulary via automated and semi-automated means to improve its clinical utility.

Data storage and knowledge representation for clinical workstations

Abstract: The representation of patient information for use in clinical workstations is a complex problem. Ideally, it should be addressed in a way that allows multiple uses of the data, including simple manual review, sharing and pooling across institutions, and as input to knowledge-based decision support systems. To a great extent, this means coding information with controlled medical vocabularies, but it does not mean that all information must be codable before workstations are feasible. This paper defines some of the choices, both current and future, that are available to address the needs of controlled medical vocabularies for representing data and knowledge in clinical workstations and explores some of the implications of those choices.

IAIMS and sharing

Abstract: The Integrated Academic Information Management System (IAIMS) concept is about sharing resources and information, and about improving the decision-making ability of health care professionals by integrating information At Columbia-Presbyterian Medical Center, the IAIMS project has established an information architecture based on common, shared computing and networking resources The institutional computing culture has been changed with increased sharing of information and, consequently, improved quality of information Several classes of information in the areas of clinical, scholarly, administrative, basic research, and core resources have been identified for better understanding of information responsibility Technical problems such as heterogeneity on workstation platforms and lack of universal syntactic and semantic standards for health care information exchange still impede interinstitutional sharing of information