If you are new to the world of healthcare terminologies, you will learn quickly that there are many of them, each with its individual terminology model (content structure and organization), area(s) of focus, release schedule and format, language, and other characteristics. As an example, some of the terminologies the 3M Healthcare Data Dictionary (HDD) team work with include SNOMED CT, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, LOINC, and RxNorm, as well as many country-specific terminologies such as ICD-10-CA and CCI (for Canada) and ICD-10-AM and ACHI (for Australia). There are also languages other than English, such as Spanish (for SNOMED CT and ICD-10-CM). These vocabularies require continued maintenance and updates to make sure the latest release is there for our customers. 

As a newcomer, make sure you obtain training on each terminology you will be working with. Over the past few years, we’ve published many tips of the month on various standards that you may find helpful. Pay attention to the following:

• Understand the different way each terminology structures its content.
• Learn how to navigate the hierarchies and make use of the information provided by the hierarchies and groupings; for example, in some terminologies, you cannot simply interpret the meaning of a concept by its description but must “concatenate” the description of its parent to get the full intention of the concept.
• Know what the rules and guidelines are for implementing the terminology.
• Track the release schedule (see the tip of the month: Keeping Up with the Standards).

Once you understand a terminology and how it is used, another area of training may be to learn how to map customer data to this standard. The following are the questions you may want to ask:

• Is there a specific mapping tool you should be trained on? Unless there is exact string match already constrained to the specific domain, you’ll be called upon to make a clinical judgement. For instance, should you map “abscess” to “abscess (disorder)” or “abscess (morphologic abnormality)”? Terminology mapping tools should be designed to help you be more efficient and consistent in your decision making.
• What is the mapping use case for the customer and how does that affect the kind of mapping required? For example, will the mapping be one-to-one, many-to-one or one-to-many? Will the match be “clinically equivalent” or “closest match”? Do you need to record the map specificity e.g., “clinically equivalent”, “broader than”, “narrower than”? – it’s usually a good idea.
• What kind of analysis of customer data needs to be done before mapping can start?
• Do we have customer collaboration to resolve ambiguous terms and custom data requirements?

In addition to understanding the standard terminologies, you need to understand your organization’s applications that will make use of terminologies. For example, the 3M HDD team members must also understand the HDD. The HDD contains unique concepts associated with standard and customer-specific/legacy codes and descriptions. This creates a simplified way to utilize standards while mapping customer data. Processes for creating new concepts, updating past concepts, storing multiple concurrent versions of standard terminologies, creating map sets and value sets for customer needs is essential to properly utilizing data within the HDD. Similarly, understanding these processes in your environment will enable you to support your applications’ needs.

There is a vast need for organized computable terms that allows systems to exchange data with an unambiguous, shared meaning – this is the purpose of medical terminologies. The result is a “standardized language” that helps clinicians communicate more efficiently, makes documentation easier, supports care delivery and research to improve the health of patients and populations. Terminologies are a foundational requirement of this vision; welcome to the world of terminologies!