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First published March 31, 2005 as JAMIA PrePrint; doi:10.1197/jamia.M1786
Journal of the American Medical Informatics Association 2005;12(4):410-417
© 2005 American Medical Informatics Association

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Submitted on December 23, 2004
Accepted on March 11, 2005

Toward Semantic Interoperability in Home Health Care: Formally Representing OASIS Items for Integration into a Concept-oriented Terminology

Jeungok Choi RN, MPH, PhD1*, Melinda L. Jenkins FNP, PhD2, James J. Cimino MD3, Thomas M. White MD, MS, MA4, and Suzanne Bakken RN, DNSc1

Affiliation of the authors: 1 School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY; 2 School of Nursing, Columbia University, New York, NY; 3 Department of Biomedical Informatics, Columbia University, New York, NY; 4 New York State Office of Mental Health, New York, NY

* To whom correspondence should be addressed.

Objective (1) to formally represent OASIS-B1 concepts using the Logical Observation Identifiers, Names, and Codes (LOINC) semantic structure, (2) to demonstrate integration of OASIS-B1 concepts into a concept-oriented terminology, the Medical Entities Dictionary (MED), (3) to examine potential hierarchic structures within LOINC among OASIS-B1 and other nursing terms, and (4) to illustrate a web-based implementation for OASIS-B1 data entry using Dialogix, a software tool with a set of functions that supports complex data entry.

Design and Measurements 209 OASIS-B1 items were dissected into the six elements of the LOINC semantic structure and then integrated into the MED hierarchy. Each OASIS-B1 term was matched to LOINC-coded nursing terms, Home Health Care Classification, the Omaha System, and the Sign and Symptom Check-List for Persons with HIV, and the extent of the match was judged based on a scale of 0 (no match) to 4 (exact match). OASIS-B1 terms were implemented as a web-based survey using Dialogix.

Results Two hundred and four out of 209 terms were successfully dissected into the elements of the LOINC semantics structure and integrated into the MED with minor revisions of MED semantics. One hundred fifty one OASIS-B1 terms were mapped to one or more of the LOINC-coded nursing terms.

Conclusions The LOINC semantic structure offers a standard way to add home health care data to a comprehensive patient record to facilitate data sharing for monitoring outcomes across sites and to further terminology management, decision support, and accurate information retrieval for evidence-based practice. The cross-mapping results support the possibility of a hierarchic structure of the OASIS-B1 concepts within nursing terminologies in the LOINC database. Index terms: OASIS-B1, LOINC semantic structure, MED, Dialogix .




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