Terminology as a Service HL7 AU

Transcription

1 Terminology as a Service HL7 AU Michael Lawley, PhD Research Group Leader, Health Informatics 26 May 2017 THE AUSTRALIAN E-HEALTH RESEARCH CENTRE HEALTH & BIOSECURITY

2 terminology is the foundation of semantic interoperability

3 Terminology More than just codes and associated display text synonyms properties hierarchy subsumption, versioning / change over time

4 HL7 s FHIR terminology subsystem Code System codes, properties of codes, available filters Value Set rules for what codes are in the value set Concept Map source code, target code, relationship Operations $expand, $lookup, $validate-code, $translate, $closure, $subsumes,... $batch _elements parameter All Metadata identity, version, publisher, description Health Informatics Michael Lawley

5 Common use cases 1. Data entry quickly find the right code to record in a specific context 2. Validation Is the code I ve been given valid for this context 3. Display / understanding tell me about this code (from this code system) 4. Mapping find me a code in that set that is related to the code I have from this set 5. ValueSet authoring describe the set of valid codes for a purpose 6. ConceptMap authoring describe the context-specific relationships between one set of codes and another 7. Determine server capabilities

6 National Clinical Terminology Service

7 NCTS Distribution & Access Services National server with a federated set of servers designed to aid implementation of terminologies in Australia Central national server currently limited to simple design time use (read-only) Local servers runtime use ; data entry, analytics, content development content syndication Supported by connectathons and community building

8 Australia s National Clinical Terminology Service

9 NCTS Syndication Model Terminology Service FHIR API Syndication API list, get Terminology Service FHIR API Syndication API Terminology Service FHIR API Syndication API Terminology Service FHIR API Syndication API

10 Why syndicated servers? Local autonomy Localisation: Value sets (including alternative descriptions for concepts) Mappings Local and additional terminologies/code sets Scalability, performance and availability Centralised management of content Operate disconnected, synchronise when connected

11 Ontoserver - basis of the NTS - free use in Australia

12 Ontoserver Turnkey, high performance, HL7 FHIR Terminology Service Fast search with state-of-art ranking algorithms Manages complexity of RF2 (SNOMED CT) distributions & multiple version support Integrated classifier for local SNOMED CT extensions Snorocket or ELK via OWL-API

13 Core: HL7 s FHIR terminology subsystem Code System codes, properties of codes, available filters Value Set rules for what codes are in / not in the value set Concept Map source code, target code, relationship Common metadata identity, version, publisher, description, Operations expand, validate-code, translate, [closure, subsumes,...]

14 Notable features SNOMED CT support All SNOMED CT Implicit ValueSets supported Hierarchy-based membership Available Reference Sets Reference Set-based membership All of SNOMED CT Code searching matching defaults to term prefix, any order order of search results is significant, based on a state-of-the-art custom scoring function

15 Advanced features Multi-version support SNOMED Expression Constraint Language support Deep support for FHIR: CodeSystem properties & filters ValueSet filters ConceptMap automap Content Syndication with ATOM Concrete domains not yet supported

16 Technical Architecture Deploys as a pair of Docker containers Ontoserver & Database docker-compose file to configure Syndicate with NCTS for SNOMED CT- AU Run production, staging, dev, and scratch instances Run locally or in the cloud e.g. Ontoserver Docker DB

17 Docs - online

18 Current Status Latest release Based on FHIR (DSTU2_1) Development version SNAPSHOT Based on FHIR several customers in production (including NCTS) many customers in evaluation & pre-production

19 Deployment models Simple single production instance normally with throw-away staging and indexing instances Support for authentication (OAuth2, Basic Auth) Role-Based Access Control including anonymous read-only mode Caching with standard HTTP-based methods (nginx, apache, etc) Logging support for dashboards with ELK or similar Small footprint 2 CPUs, 4-8GB RAM for low usage scenarios

20 In practice Autocomplete widgets using ValueSet/$expand + filter RACS Morbidity Audit and Logbook Tool (MALT) Several production EHRs ConceptMap/$translate SnoMAP, Non-admitted patients SNOMED CT -> ICD10-AM map MALT Reporting Delegating FHIR Servers RedCAP integration Backend tooling browsing, authoring Shrimp, Snapper,

21 How to get your free Terminology Server Get a free Docker Hub account Register with NCTS - Agree to free licence with ADHA request for licence and include docker hub account - help@digitalhealth.gov.au Follow instructions at Set up your Docker Engine run with docker-compose

22 Thank you Australian e-health Research Centre Michael Lawley, PhD Group Leader, Health Informatics t e michael.lawley@csiro.au w aehrc.com THE AUSTRALIAN E-HEALTH RESEARCH CENTRE HEALTH & BIOSECURITY

23 Shrimp - for browsing

24 Snapper - for mapping currently in beta

25 ValueSet Explorer - compare performance and behaviour