Ontoserver: a syndicated terminology server

Abstract

BackgroundEven though several high-quality clinical terminologies, such as SNOMED CT and LOINC, are readily available, uptake in clinical systems has been slow and many continue to capture information in plain text or using custom terminologies. This paper discusses some of the challenges behind this slow uptake and describes a clinical terminology server implementation that aims to overcome these obstacles and contribute to the widespread adoption of standardised clinical terminologies.ResultsOntoserver is a clinical terminology server based on the Fast Health Interoperability Resources (FHIR) standard. Some of its key features include: out-of-the-box support for SNOMED CT, LOINC and OWL ontologies, such as the Human Phenotype Ontology (HPO); a fast, prefix-based search algorithm to ensure users can easily find content and are not discouraged from entering coded data; a syndication mechanism to facilitate keeping terminologies up to date; and a full implementation of SNOMED CT’s Expression Constraint Language (ECL), which enables sophisticated data analytics.ConclusionsOntoserver has been designed to overcome some of the challenges that have hindered adoption of standardised clinical terminologies and is used in several organisations throughout Australia. Increasing adoption is an important goal because it will help improve the quality of clinical data, which can lead to better clinical decision support and ultimately to better patient outcomes.

A Neuro-ontology for the neurological examination

“…As a result, in NEO, we have subsumed absent ankle reflex, absent knee reflex, absent biceps reflex, and absent triceps reflex under Fig. 3 Dysmetria (an imprecision in performing pointing movements with the limbs) is subsumed by incoordination and reflex finding in SNOMED CT. Read hierarchy from right to left (Diagram from Shrimp Ontoserver [42].©Australian e-Health Research Centre) Fig. 4 In SNOMED CT, asterixis (a flapping tremor of the arms) is subsumed by coarse tremor and finding of upper limb.…”

“…Read hierarchy from right to left. (Diagram from Shrimp Ontoserver [42].©Australian e-Health Research Centre) absent reflex. SNOMED CT subsumes absent ankle reflex and brisk ankle reflex under ankle reflex finding and subsumes absent biceps reflex and brisk biceps reflex under biceps reflex finding.…”

“…Read hierarchy from right to left. (Diagram from Shrimp Ontoserver [42].©Australian e-Health Research Centre) Fig. 6 In SNOMED CT concept hierarchy, apraxia is subsumed by finding of praxis and musculoskeletal finding and finding of incoordination.…”

“…Read hierarchy from right to left. (Diagram from Shrimp Ontoserver [42].©Australian e-Health Research Centre) weakness| C0577655 and ignore the degree of weakness. The sensory examination is notoriously difficult to describe in text, and in the era of the paper medical record, neurologists often used drawings to document the sensory examination.…”

Research of Medical Data Exchange Standards

“…2. Отсутствует формальная онтология, объединяющая обмены концепций между различными сообщениями и интерфейсами [6].…”