The Alphabet Soup of Discrete Data
One of the major benefits of electronic health records has always been the storage of discrete data. This has massive implications for everything from calculating drug interactions to patient reports to interfaces. With the increased attentions of late on decision support, analytics and interoperability the focus on capturing data in an organized, discrete manner is also on the rise. Coupled with the standardization that is starting to take place within the industry as different data models start to bubble to the top, certain terms are being thrown around more and more. Though the variety of classification systems is beginning to consolidate, the large number that remain coupled with their propensity to have acronymic names can lead to confusion.To help navigate the world of discrete data below are brief descriptions of some of the more common data models.
Common Discrete Data Models
IMO – Intelligent Medical Objects (IMO) is a proprietary medical concept terminology created and maintained by the company of the same name. The company produced multiple products distinguished by their use in a number of different medical terminology categories. IMO is widely used by many HIT vendors to manage problems and conditions amongst other data types.
SNOMED/SNOMED CT – Systematized Nomenclature of Medicine (SNOMED) / Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) is a comprehensive core medical terminology collection covering a wide variety of medical lexicons and is the primary base terminology standard for most electronic health records. SNOMED CT is generally considered to be the most complete and most widely used terminology convention in the World.
MEDCIN – Another proprietary terminology system developed and maintained by Medicomp Systems Inc. Meant to serve as a general core level data model similar to IMO and SNOMED, MEDCIN was designed specifically with how it would interact with users at the point of care in mind and as such is structured to reflect the relationships between clinical events and concepts.
LOINC – The Logical Observation Identifiers Names and Codes (LOINC) is a universal code set for identifying laboratory and clinical observations. LOINC was designed to standardize the concepts used by labs, EHRs and other systems for orders and results.
CVX – A standard of vaccination identifiers created and maintained by the CDC. Meant to assist in the adoption of immunization registries and other reporting efforts.
MVX – A standard of vaccine manufacturer identifiers created and maintained by the CDC. Meant to assist in the adoption of immunization registries and other reporting efforts.
CPT – Current Procedure Terminology (CPT) is a code set created and maintained by the American Medical Association and is the first level of code classes in the larger HCPCS code system. The model consists of a very large number of numeric codes that identify evaluation and management activities, procedures and other physician services.
HCPCS – Healthcare Common Procedure Coding System (HCPCS) is the overarching medical services coding schema as identified by the Centers for Medicare and Medicaid (CMS). The system identifies three levels: Level I is the Current Procedure Terminology (CPT) code set created and maintained by the American Medical Association. Level II consists of an additional set of alpha-numeric codes to primarily identify non-physician services and supplies which by itself is sometimes referred to as HCPCS codes. Level III covers any local requirements as dictated by state Medicaid agencies and other stakeholders.
ICD-9/ICD-10 – International Classification of Diseases (ICD) is the system of diagnostics codes created and endorsed by the World Health Organization. Revisions of the system are used throughout the world to track conditions, findings and injuries for general reporting, reimbursement and data calculation purposes.