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Articles
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EU - Germany
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Ontology-Based Integration of Medical Coding Systems and Electronic Patient Records
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Ceusters W (ab), Smith B (bcd), De Moor G (a)
(a) RAMIT (Research in Advanced Medical Informatics), University of Ghent, Belgium
(b) ECOR (European Centre for Ontological Research), Saarland University, Germany
(c) IFOMIS (Institute for Formal Ontology and Medical Information Science), Saarland University, Germany
(d) Department of Philosophy, University at Buffalo, NY, USA
"...
European and international efforts towards standardization of
biomedical terminology and electronic healthcare records were
focused over the last 15 years primarily on syntax.
...
We can safely say that the syntactical issues are now resolved
and also that the problems relating to biomedical terminology
...
are well understood - at least in the community of specialized
researchers. Now, however, it is time to solve these problems by
using the theories and tools that have been developed so far,
and that have been tested under laboratory conditions
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This means using the right sort of ontology, i.e. an ontology
that is able explicitly and unambiguously to relate coding
systems, biomedical terminologies and electronic health care
records (including their architecture) to the real world
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To do this properly will require a huge effort, since the
relevant existing standards need to be reviewed by experts who
are familiar with the appropriate sort of ontological thinking
(and this will require some effort in training and education).
Even before that stage is reached, however, there is the
problem of making all constituent parties - including patients
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(or at least the organizations that stand up for them),
healthcare providers, system developers and decision makers
- aware of how deep-seated the existing problems are.
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The message of realist ontology is that, while there are
various different views of the world, this world itself is one
and unique. It is our belief that it is only through that
world that the various different views can be compared and
made compatible. To allow clinical data registered in
electronic patient records by means of coding (and/or
classification) systems to be used for further automated
processing, it should be crystal clear whether entities in the
coding system refer to diseases or rather to statements made
about diseases, or to procedures and observations, rather
than statements about procedures or observations. As such,
coding systems used in or for electronic healthcare records
should be given a precise and formal semantics that is
coherent with the semantics of the record as well as with
the real world parts that are described by them
..."
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