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First published March 28, 2003 as JAMIA PrePrint; doi:10.1197/jamia.M1203
Journal of the American Medical Informatics Association 2003;10(4):382-388
© 2003 American Medical Informatics Association

A more recent version of this article appeared on July 1, 2003
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Submitted on August 15, 2002
Accepted on January 29, 2003

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

Jee-In Hwang RN, PhD1*, James J. Cimino MD2, and Suzanne Bakken RN, DNSc3

Affiliation of the authors: 1 Department of Medical Informatics, Columbia University, New York, NY; 2 Professor, Department of Medical Informatics, Columbia University, New York, NY; 3 Professor, School of Nursing and Department of Medical Informatics, Columbia University, New York, NY

* To whom correspondence should be addressed.

Objective The purposes of the study were: 1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED); and 2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED.

Design and Measurements We dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, we selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, we developed them in order to define the nursing diagnostic concepts.

Results The ISO model was sufficient for dissecting the source terminologies into atomic terms. We identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, we pre-coordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments.

Conclusion Nursing care represents a large proportion of health care activities, thus it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. Our study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.




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J. Choi, M. L. Jenkins, J. J. Cimino, T. M. White, and S. Bakken
Toward Semantic Interoperability in Home Health Care: Formally Representing OASIS Items for Integration into a Concept-oriented Terminology
J. Am. Med. Inform. Assoc., July 1, 2005; 12(4): 410 - 417.
[Abstract] [Full Text] [PDF]


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