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PubMed2003

Development of an information model for solid organ transplantation.

Information required to manage transplant patients and donors is complex, voluminous and requires the reporting and use of one person's medical information within another person's record. One strategy using a vocabulary model (i.e., LOINC codes with *DONOR specified in the system axes) will lead to problems with combinatorial explosion. After evaluating workflow processes, data collection forms, decision support and functional requirements, we designed and implemented an extendable information model to support the process of care following liver transplantation.

Decision Making, Computer-Assisted↗
PubMed2006

Density codes and shape spaces.

This paper presents an algorithm that allows for encoding probability density functions associated to samples of points of R(n). The resulting code is a sequence of points of R(n) whose density function approximates that of the set of data points. However, contrarily to sampled data points, code points associated to two different density functions can be matched, which allows to efficiently compare such functions. Moreover, the comparison of two codes can be made invariant to a wide variety of geometrical transformations of the support coordinates, provided that the Jacobian matrix of the transformation be everywhere triangular, with a strictly positive diagonal. Such invariances are commonly encountered in visual shape recognition, for example. Thus, using this tool, one can build spaces of shapes that are suitable input spaces for pattern recognition and pattern analysis neural networks. Moreover, a parallel neural implementation of the encoding algorithm is available for 2D image data.

Algorithms↗
PubMed2006

List of new names and new combinations previously effectively, but not validly, published.

The purpose of this announcement is to effect the valid publication of the following new names and new combinations under the procedure described in the Bacteriological Code (1990 Revision). Authors and other individuals wishing to have new names and/or combinations included in future lists should send three copies of the pertinent reprint or photocopies thereof to the IJSEM Editorial Office for confirmation that all of the other requirements for valid publication have been met. It is also a requirement of IJSEM and the ICSP that authors of new species, new subspecies and new combinations provide evidence that types are deposited in two recognized culture collections in two different countries (i.e. documents certifying deposition and availability of type strains). It should be noted that the date of valid publication of these new names and combinations is the date of publication of this list, not the date of the original publication of the names and combinations. The authors of the new names and combinations are as given below, and these authors' names will be included in the author index of the present issue and in the volume author index. Inclusion of a name on these lists validates the publication of the name and thereby makes it available in bacteriological nomenclature. The inclusion of a name on this list is not to be construed as taxonomic acceptance of the taxon to which the name is applied. Indeed, some of these names may, in time, be shown to be synonyms, or the organisms may be transferred to another genus, thus necessitating the creation of a new combination.

Bacteria↗
PubMed2004

Kaiser Permanente's Convergent Medical Terminology.

This paper describes Kaiser Permanente's (KP) enterprise-wide medical terminology solution, referred to as our Convergent Medical Terminology (CMT). Initially developed to serve the needs of a regional electronic health record, CMT has evolved into a core KP asset, serving as the common terminology across all applications. CMT serves as the definitive source of concept definitions for the organization, provides a consistent structure and access method to all codes used by the organization, and is KP's language of interoperability, with cross-mappings to regional ancillary systems and administrative billing codes. The core of CMT is comprised of SNOMED CT, laboratory LOINC, and First DataBank drug terminology. These are integrated into a single poly-hierarchically structured knowledge base. Cross map sets provide bi-directional translations between CMT and ancillary applications and administrative billing codes. Context sets provide subsets of CMT for use in specific contexts. Our experience with CMT has lead us to conclude that a successful terminology solution requires that: (1) usability considerations are an organizational priority; (2) "interface" terminology is differentiated from "reference" terminology; (3) it be easy for clinicians to find the concepts they need; (4) the immediate value of coded data be apparent to clinician user; (5) there be a well defined approach to terminology extensions. Over the past several years, there has been substantial progress made in the domain coverage and standardization of medical terminology. KP has learned to exploit that terminology in ways that are clinician-acceptable and that provide powerful options for data analysis and reporting.

Health Maintenance Organizations↗
PubMed2006

Component-based visual clustering using the self-organizing map.

In this paper we present a new method for visual clustering of multi-component images such as trademarks, using the topological properties of the self-organizing map, and show how it can be used for similarity retrieval from a database. The method involves two stages: firstly, the construction of a 2D map based on features extracted from image components, and secondly the derivation of a Component Similarity Vector from a query image, which is used in turn to derive a 2D map of retrieved images. The retrieval effectiveness of this novel component-based shape matching approach has been evaluated on a set of over 10 000 trademark images, using a spatially-based precision-recall measure. Our results suggest that our component-based matching technique performs markedly better than matching using whole-image clustering, and is relatively insensitive to changes in input parameters such as network size.

Cluster Analysis↗
PubMed2002

The Health Insurance Portability and Accountability Act: implications for the dental profession.

HIPAA is generating long-awaited change in the health care world. Administrative, operational, and technical solutions are being created in response to the requirements of HIPAA. The current rules emphasize that the regulations' provisions are scalable and allow all entities, whenever possible, to determine how extensively they will address certain issues. The larger the organization, the more complex the HIPAA strategy must be. Implementation in a small dental practice requires a simple strategy compared to that of a health care plan or clearinghouse. It still takes time and resources for a dental practice to accommodate the numerous HIPAA requirements, however. Although a dentist may find the rules at HHS Web site or other Internet sites, he or she may wish to rely on vendors, consultants, and the guidance of the ADA and other dental organizations to help implement them. The dentist also should keep in mind that HIPAA compliance is an evolutionary process; future modifications are necessary. As a result, some of the information contained in this material may not be accurate by the time this issue in printed. Dentists always should consult sources such as the ADA or HHS Web site to procure current HIPAA information.

Computer Security↗
PubMed2006

Notification that new names and new combinations have appeared in volume 56, part 6, of the IJSEM.

This listing of names published in a previous issue of the IJSEM is provided as a service to bacteriology to assist in the recognition of new names and new combinations. This procedure was proposed by the Judicial Commission [Minute 11(ii), Int J Syst Bacteriol 41 (1991), p. 185]. The names given herein are listed according to the Rules of priority (i.e. page number and order of valid publication of names in the original articles). Taxonomic opinions included in this List (i.e. the creation of synonyms or the emendation of circumscriptions) cannot be considered as validly published nor, in any other way, approved by the International Committee on Systematics of Prokaryotes and its Judicial Commission.

Bacteria↗
PubMed2002

Information model and terminology model issues related to goals.

Goal statements are a significant component of structures that support the process of health care delivery such as practice guidelines, standards of care, critical pathways, disease management plans, patient education plans, and nursing care plans. Although these structures are increasingly computer-based, there has been little attention to the formal representation of goal statements. This is a necessary prerequisite for enabling semantic interoperability. Existing and evolving information model and terminology model standards offer some approaches that may be applicable to goal statements, however, a number of issues require resolution

Goals↗
PubMed2002

Using LOINC to link an EMR to the pertinent paragraph in a structured reference knowledge base.

Intermountain Health Care has integrated the electronic medical record (EMR) with online information resources in order to create easy access to a knowledge base which practicing physicians can use at the point of care. When a user is reviewing problems/diagnosis, medications, or clinical laboratory test results, they can conveniently access a "pertinent paragraph" of reference literature that pertains to the clinical data in the EMR. Using terminology first coined by Cimino1, we call this application the "infobutton." We describe the architectural issues involved in linking our electronic medical record with a structured laboratory knowledge base. The application has been well received as noted by anecdotal comments made by physicians and usage of the application.

Clinical Laboratory Techniques↗
PubMed2003

Contextualizing heterogeneous data for integration and inference.

Systems that attempt to integrate and analyze data from multiple data sources are greatly aided by the addition of specific semantic and metadata "context" that explicitly describes what a data value means. In this paper, we describe a systematic approach to constructing models of data and their context. Our approach provides a generic "template" for constructing such models. For each data source, a developer creates a customized model by filling in the tem-plate with predefined attributes and value. This approach facilitates model construction and provides consistent syntax and semantics among models created with the template. Systems that can process the template structure and attribute values can reason about any model so described. We used the template to create a detailed knowledge base for syndromic surveillance data integration and analysis. The knowledge base provided support for data integration, translation, and analysis methods.

Database Management Systems↗
PubMed2003

Frequency of laboratory test utilization in the intensive care unit and its implications for large scale data collection efforts.

Mapping of local use names to standardized naming schemas such as LOINC" micro is a time consuming and difficult task when done retrospectively or during the configuration of new information systems. We found that a relatively small number of tests and profiles (106 to 205) represent 99% of all testing done in 3 ICUs studied. In addition, all of the lab studies needed for the most commonly used ICU scoring systems fell into the top 23 lab studies and profiles performed in each ICU studied. We have identified a subset of the LOINC database which, because of their frequency of use, should be the focus of efforts to bring naming uniformity to ICU information systems.

Clinical Laboratory Techniques↗
PubMed2004

Detailed clinical models for sharable, executable guidelines.

The goal of shareable, executable clinical guidelines is both worthwhile and challenging. One of the largest hurdles is that of representing the necessary clinical information in a precise and shareable manner. Standard terminologies and common information models, such as the HL7 RIM, are necessary, they are not sufficient. In addition, common detailed clinical models are needed to give precise semantics and to make the task of mapping between models manageable. We discuss the experience of the SAGE project related to detailed clinical models.

Decision Support Systems, Clinical↗
PubMed2004

Development and representation of a fall-injury risk assessment instrument in a clinical information system.

The potential for informatics solutions to address inpatient safety issues is significant; however, several challenges are associated with the development of patient safety related informatics applications. These challenges include: 1) the identification and/or development of valid and reliable instruments; 2) adequate representation of key safety concepts, constructs, and associated concepts in the clinical information system; and 3) identification of data sources for instrument pre-population. As part of a larger project aimed at identifying and addressing the information needs of clinicians while using a clinical information system, an electronic fall and injury risk assessment instrument is in development to address a hospital-based fall and injury prevention initiative. The concepts contained in the instrument are well represented by Clinical LOINC and the UMLS. Associated concepts have been identified in the existing clinical information system data dictionary for pre-population of the instrument.

Accidental Falls↗
PubMedDate not supplied

A look at LOINC.

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Education, Continuing↗