Federal Health IT Ontology Project (HITOP) Group

1. Federal Health IT Ontology Project (HITOP) Group The Vision Toward Testing Ontology Tools in High Priority Health IT Applications October 5, 2005

2. Overview Vision Toward Testing Ontology Software with High Priority Health IT Applications ONCHIT Focus: • NHIN • Standards & Interoperability • RHIOs • Adoption of EHRs HITOP Group • Purpose • Supporting Actions • Four Major Goals • Strategy for Health IT Project Collaboration

3. ONCHIT Major Focus • Nationwide Health Information Network (NHIN): Work towards a nationwide interoperability that allows secure and seamless health information exchange. Work on harmonizing standards for interoperability and health information exchange.

4. ONCHIT Major Focus, cont. • Standards and Interoperability Achieving the vision of a national health information infrastructure first requires interoperability to link previously disparate health care information systems. People often confuse interoperability with standards, even though they are different. Standards are much narrower and specify technical details. Interoperability, on the other hand, is a much broader concept that involves both a technical and business context. In the effort to establish this national health information infrastructure, precise interoperability standards for practice must be specified.

5. ONCHIT Major Focus, cont • Regional Health Information Organizations (RHIOs) Regional Health Information Organizations or RHIOs support state and other regional projects that help harmonize the privacy and business rules for health information exchange. There are over 100 regional projects under way that are funded by the Federal government. Several other projects are being supported by private industry efforts or are substantiated by State Governors and/or state legislation.

6. ONCHIT Major Focus, cont • Adoption of EHRs Drive Adoption of Electronic Health Records or EHRs requires reducing the loss and risk physicians face when investing in EHRs. This risk be reduced by ensuring EHR products comply with minimal standards for functionality, security and interoperability; and helping provide implementation support to doctors so they can re-engineer their business processes with IT.

7. HITOP Group Purpose • HITOP will survey existing best practices and actions in the semantic interoperability and ontology communities of practice, identify leading–edge innovations in the use of ontology software tools for health IT applications, and advance interoperability and standards supporting the NHIN.

8. Ontology Actions Supporting Health IT Project Development • The Ontology and Taxonomy Coordinating Work Group (ONTCWG) will provide a mechanism for voluntary coordination of all activities within the Federal government and other interested parties, in developing Knowledge Classification and Representation systems such as ontology, taxonomies, thesauri and graphical knowledge representations.

9. Ontology Actions Supporting Health IT Project Development, cont. • The National Center for Ontological Research will hold its inaugural event at the University of Buffalo, Oct. 27, 2005 – presenting a important opportunity to form a roadmap toward testing ontology tools in high-priority health IT applications.

10. Ontology Actions Supporting Health IT Project Development, cont. • AHRQ is funding $4 million with the FDA and $ 1.15 million with the NLM to move critical drug safety information from the drug manufacturers to FDA, using an HL7 standard format and content, for FDA approval. Once approved,, the information will be posted publicly on the DailyMEd web site. This project will continually improve the standardization of drug vocabulary and lead to improved patient safety and quality of care.

11. Ontology Actions Supporting Health IT Project Development, cont. • AHRQ is funding NLM with $2.4 million to undertake mapping of ICD-9 diagnostic codes and CPT-4 procedure codes to SNOMED, to undertake a compilation of HL7 standards’ terminologies and incorporate them into NLM’s Metathesaurus.

12. Ontology Actions Supporting Health IT Project Development, cont. • AHRQ is funding CMS with $300,000 to build and maintain a meta-data registry of terms in the CHI standards that have been adopted by HHS, VA and DoD. • AHRQ is funding NIST with $300,000 to build and populate a web-based Landscape that shows who is doing what in health data standards in the U.S.

13. Ontology Actions Supporting Health IT Project Development, cont. • NIST points out, that for a long-term robust solutions, ontology tools will need to be able to classify standards and describe how standards are related to each other. • Understanding semantics will be essential to a long-term solution for interoperability. • NIST has proposals for a major interoperability test bed for health care ontology, sharing ontology tools, aligning different technologies, comparing ontology tools for overlap and dovetails.

14. Ontology Actions Supporting Health IT Project Development, cont. • FHA interoperability Working Group is identifying sets of data standards to promote interoperability. • Further work needs to be done to address mapping and CHI regarding implementation and relationships between standards. • Therefore, mapping of government furnished information is important.

15. Four Major Goals for the HITOP Group • Develop a Statement of Mission for HITOP • Communicate collective knowledge supporting usage of ontology tools in health IT applications. • Coordinate a meeting, to broadcast to the broader audience, plans to develop test projects for the use of ontology tools in health IT applications. • Develop a roadmap on the state-of-the-art use of ontology tools to achieve semantic interoperability for high priority health IT applications involving clinical decision support systems (DSS) and electronic health records (EHRs).

16. Four Step Strategy for Identifying High Priority Health IT Projects for Collaboration with Ontology Software Tools • Present a description of the goals for using ontology tools in HIT applications to the National Center for Ontological Research (NCOR), Oct. 27th - HITOP Roadmap • Pick-up from the major eGov CHI vocabulary work. • Connect CHI SMEs with NCOR SMEs • Coordinate public-private partnerships for recommending, planning and developing projects – testing the use of ontology software tools in high priority health IT applications.