Detailed Clinical Models and Terminology Artifacts
Over the course of this project, we have been responsible for three major tasks: 1) supporting new concept additions to the VA SNOMED Extension; 2) developing metrics and an interactive dashboard; and 3) creating Lightweight Expression of Granular Objects (LEGOs), which are Detailed Clinical Models (DCMs) that are reused across content areas. A DCM may model concepts such as a question and answer pair in a patient survey, which are broken down into components. SMEs then analyze and conceptualize the possible range of the answers so that they can be used to enable Clinical Decision Support (CDS) frameworks.
Under the DCM task, our team provided approximately 1,000 LEGOs per month and created LEGO clinical assertion models for the described clinical content areas. For each LEGO created and for each unique post-coordinated Observable expression within the modeled 10,000 LEGO models, our team added the Observable expression as a concept to the VA Extension. Our team also performed independent modeling validation to include inter-rater and intra-rater metrics to identify how often different types of errors occur. During the period of work, our team proposed a metric assessment plan to measure metrics of consistency and correctness of modeling, performed on modeled LEGO content, using fully specified name, preferred name, descriptions, and post coordinated observable expressions.
Currently, this project is comprised of two work streams: Terminology Artifact building and analysis and CIS/ARK terminology matching. Terminology Artifacts are built to capture clinical observations or procedures used in Knowledge Artifacts (KNART) in a standardized format based on national and international terminology standards (e.g. SNOMED CT). Our team creates Terminology Artifacts to be reused across content areas, which fulfills the first two major tasks.
We also provide two Medium Complexity Consultations. One consultation will be used to develop a white paper, which will serve as a strategy document for KBS. In it, we will present strategies that can help KBS in this new environment of Cerner COTS implementation.