Updated: Aug 26, 1998
This is the most recent structured information on this project. Complementary data can be found on previous documents
TOMELO Towards a strategic alliance between developers of medical terminology and health care record systems

Overview

Now we see an emerging need for safe and sensible communication between these applications. Next to a good insight of what is really necessary to exchange, also the language used is important. For instance, the slow progress in the application of knowledge based systems may to a great deal be attributed to the lack of semantically coupling with the patient record.

The urgent needs are reflected in the many projects around the Computerised Medical Record (GEHR, MARGOT etc.), projects for a unified medical language (UMLS, GALEN, CANON, etc.). Also CEN TC 251 is investing a considerable resource presently. Because of the sheer size of medicine all these projects are necessarily limited in their scope. There is a need for a broad view on the further development of medical language in a computational linguistic perspective. The cost of researching and developing clinical systems is too great to be borne by a single national market. Whilst much re-use of system components is feasible there are significant costs associated with the 'localisation' of systems to the needs of a particular market. Perhaps the most important of these costs is the localisation to the linguistic needs of each national market.

Medicine is a descriptive, language intensive activity, and the costs of developing, and perhaps more importantly maintaining, the linguistic resources needed to localise clinical systems are clearly high. This presents a genuine barrier to the development of systems for use in Europe. And not only systems, but more general it is of prime importance to communication documentation, education, evaluation, comparison etc. Any practical approach to the management and exploitation of linguistic resources in large scale clinical information systems must be based on common methods and internal representations for linguistic information. This information must be reusable across a wide range of systems and local variants of those systems, and the cost of maintaining that information must be separable from those of maintaining the rest of the system Significant regional differences in linguistic usage exist even within single languages, and even more so when minority languages are taken into consideration. To be truly successful, a programme of linguistic engineering in medicine must have a strategy for recognising and managing regional and well as national linguistic differences. These considerations further complicate and increase the expense of 'localisation' of products for the European market.

Purpose and objectives

ToMeLo not only provides a missing link perceived in the healthcare community as described above, but also fills in a gap in the interrelationships of ongoing projects in Health Telematics related to the Electronic Healthcare Record. Indeed, where the PROREC-project acts as horizontal dissemination and harmonisation platform for Electronic Healthcare Related projects, and the European Federation for Coding and Classification Centres provides similar services towards healthcare terminology and classification activities in the Health Telematics Sector, there is not yet a platform where both issues are covered multidisciplinary. ToMeLo therefor will:

• initiate, through a series of moderated workshops, a closer and lasting co-operation between developers of terminology and health care documentation system builders, using 4FW technology;
• determine the scope of the terminology problem for patient documentation, and to formulate recom-mendations for future actions to insure increasing levels of interoperability between systems.;
• deliver a proposal for natural problem holders for issues relating to terminology and medical records;
• deliver working example prototypes to show the principles of sensible connections;
• broaden the awareness of terminological issues in patient documentation.

Results

The second workshop was held on the 26th November 1997, in connection with the Eurorec conference in Paris. The workshop was moderated by Dr. Glyn Hayes from Meditel, and prepared by Angelo Rossi-Mori. In preparation for workshop 2 participants have received from the moderator of workshop 1 the consolidated criteria set. On the basis of those criteria they have to analysed and submitted before the workshop a set of real medical records drawn from their own organisations. Workshop 2 also marked the definitive deviation from the workplan. The original goal was to analyse exhaustively records for detailed terminology not available in standard terminologies. The focus now has completely changed to the Headers/Context area. Parties concluded that this was the first place where common work can be fruitfully done. It is believed that along these lines a semantic continuum from record architecture to patient documentation can be achieved. Results of the workshop 2 have later been fed into the CEN meeting in Berlin, where Angelo Rossi-Mori was given the task on ‘record and terminology’ of work item 1.8. The material of workshop 2 is fed into that project team. It is planned to validate the work of the project team against HcT project results in workshop 3. In conclusion it can be said that ToMeLo is highly successful in achieving it’s goal to bring together the world of terminology and record architecture.

List of deliverables

List of participants

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