chapter three

3 Demystifying clinical informatics

 

This chapter covers

  • Ensuring health data maintains its clinical meaning as it moves across disparate systems
  • Evaluating why a single universal ontology cannot capture the full breadth of specialized modern medicine
  • Asking structured clinical questions using standardized observation codes
  • Applying the "Golden Triad" of terminologies (SNOMED-CT, LOINC, and RxNorm) to represent the "Who, What, and How" of clinical care

Thus far we’ve discussed how EHRs orchestrate clinical workflows and generate health data. In this chapter we will pivot from how health data is generated in EHRs to their meaning: namely, the ontology and semantics of health data. We’ll examine how clinical concepts are represented in standardized terminologies, why no single clinical ontology can capture all of clinical reality and how systems combine SNOMED-CT, LOINC and RxNorm to preserve semantic meaning across systems.

3.1 What are clinical informatics?

3.2 Ontologies, code systems and clinical reality

3.3 The golden triad

3.3.1 SNOMED-CT: A standardized clinical terminology

3.3.2 LOINC: A code system for clinical observations

3.4 64941-8: When frightened, I feel like throwing up.

3.4.1 RxNorm: Standardizing medications within health IT

3.4.2 The work of clinical informatics: Preserving semantic meaning

3.5 Summary