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Req-715: Standard Terminologies and Terminology Models
Release Package: 2013 Format


Release Package:

2013 Format

Requirement ID:

Req-715

Title:

Standard Terminologies and Terminology Models

Description:

STATEMENT: Employ standard terminologies to ensure data correctness and to enable semantic interoperability (both within an enterprise and externally).
Support a formal standard terminology model.

DESCRIPTION: Semantic interoperability requires standard terminologies combined with a formal standard information model. An example of an information model is the HL7 Reference Information model.
Examples of terminologies that an EHR-S may support include: LOINC, SNOMED, ICD-9, ICD-10, and CPT-4.
A terminology provides semantic and computable identity to its concepts.
Terminologies are use-case dependent and may or may not be realm dependent. For example, terminologies for public health interoperability may differ from those for healthcare quality, administrative reporting, research, etc.
Formal standard terminology models enable common semantic representations by describing relationships that exist between concepts within a terminology or in different terminologies, such as exemplified in the model descriptions contained in the HL7 Common Terminology Services specification.
The clinical use of standard terminologies is greatly enhanced with the ability to perform hierarchical inference searches across coded concepts. Hierarchical Inference enables searches to be conducted across sets of coded concepts stored in an EHR-S.
Relationships between concepts in the terminology are used in the search to recognize child concepts of a common parent. For example, there may be a parent concept, "penicillin containing preparations" which has numerous child concepts, each of which represents a preparation containing a specific form of penicillin (Penicillin V, Penicillin G, etc.). Therefore, a search may be conducted to find all patients taking any form of penicillin preparation.
Clinical and other terminologies may be provided through a terminology service internal or external to an EHR-S. An example of a terminology service is described in the HL7 Common Terminology Services specification.

Related Requirements:

Relationship Release Package Requirement ID Requirement Title Requirement Type SHALL / SHOULD / MAY Compare Requirements
Req-715 Is Related To 2013 Format Req-249 Health Record Output Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-253 Manage Allergy, Intolerance and Adverse Reaction List Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-254 Manage Assessments Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-257 Manage Immunization Administration Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-259 Manage Medication List Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-263 Manage Problem List Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-266 Present Ad Hoc Views of the Health Record Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-268 Manage Patient History Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-271 Support for Research Protocols Relative to Individual Patient Care Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-277 Registry Notification Function Not Applicable Compare
Req-715 Is Related To 2013 Format Req-278 Standard Report Generation Function Not Applicable Compare
Req-715 Is Child Of 2013 Format Req-296 Standard Terminologies and Terminology Services Header Not Applicable Compare
Req-715 Is Related To 2013 Format Req-740 Manage Medication Orders Function Not Applicable Compare
Req-715 Is Parent Of 2013 Format Req-1010 Validate clinical terms against a standard terminology Normative Statements MAY Compare
Req-715 Is Parent Of 2013 Format Req-1011 Standard child health terminology for system communication Normative Statements SHALL Compare
Req-715 Is Parent Of 2013 Format Req-1012 Standard terminology for diagnoses Normative Statements SHOULD Compare
Req-715 Is Parent Of 2013 Format Req-1013 Standard terminology for medications and treatments Normative Statements SHOULD Compare
Req-715 Is Parent Of 2013 Format Req-1014 Standard terminology for signs, systems, and development Normative Statements SHOULD Compare
Req-715 Is Parent Of 2013 Format Req-1015 Standard terminology for laboratory testing Normative Statements SHOULD Compare

Provenance:

HL7 EHR FM R1

Achievability:

Requirement Type:

Function

Shall/Should/May:

Critical/Core:

No

Status:

Released

Links:

Not Provided

See Also:

Not Provided

Comments:

Not Provided

Additional Information:

Not Provided

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Last Updated 04/13/2016
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