Kaiser Permanente Donates Terminology Technology

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Kaiser Permanente spent about 16 years and millions of dollars developing its Convergent Medical Terminology for its own use. But now the healthcare provider is donating the CMT to the global health community -- a dictionary of 75,000 medical terms and concepts for interoperable use among electronic health records.

The open availability of vendors, healthcare providers and others to integrate KP’s CMT in its clinical information systems, including e-health records, can make it easier for clinicians to communicate with each other, as well as with patients.

KP decided to donate its CMT to the International Healthcare Terminology Standards Development Organization (IHTSDO) for distribution in the U.S. by IHTSDO members and the National Library of Medicine, to help other U.S. healthcare providers meaningfully use health IT, KP officials said.

“Every vendor needs to find a way to take standards medical terminology and translate it” so that terms and concepts used in the electronic medical records of patients are understood by clinicians and patients, said Dr. David Blumenthal, national coordinator of health IT during a U.S. Health and Human Services Dept. press conference in Washington D.C. where KP announced the CMT donation.

The donation of CMT by KP for use by others will allow vendors and providers to implement common medical terminology content into new and existing e-health records faster and more easily than developing their own translation solutions, Blumenthal said.

KP’s CMT donation also includes a set of tools to help create and manage terminology, and processes to control the quality of terminology that is developed or added in the future. CMT also includes mappings to other classifications and standard vocabularies, such as the Systematized Nomenclature of Medicine Clinical Terms, or SNOMED CT. Also, CMT can link to standard codes, such as ICD-9 and ICD-10, used in medical claims documents.

CMT is used by about 15,000 clinicians at KP hospitals and other care facilities in the U.S. as it “sits inside” KP HealthConnect, which is KP’s EHR system, said KP senior VP and CIO Phil Fasano in an interview with InformationWeek.

KP HealthConnect, based on software from Epic, is the nation’s largest private deployment of an EHR system in the U.S. Only the VA has a larger EHR system in use in the U.S.

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CMT was created with collaboration among more than 1,000 KP clinicians -- including doctors, nurses and pharmacists -- as well as technologists over the last 16 years, said Fasano, who estimated that KP spent “many millions of dollars” to develop the technology.

CMT is used in the underlying architecture of KP’s health IT systems to support data flow between health care providers. It provides mapping to standardize the use of terminology and ensure systems, some already in use in most U.S. medical offices, can talk to each other effectively.

The utilization of CMT will support a common set of medical concept descriptions so that one doctor’s diagnosis can be reconciled with another’s, as well as understood by patients.

For instance, while a doctor might indicate in a patient’s record that the individual experienced a MI, or myocardial infarction, CMT would translate that for the patient as “heart attack,” said Susan Matcha, a KP physician.

Also, CMT helps to clarify terminology for patients so that’s it’s more "patient friendly," she said. For example, if a doctor diagnoses a patient as “morbidly obese,” CMT would translate that for the patient as “obese, with BMI greater than 40,” she said.

“We want doctors to have information but don’t want the medical terms to be misunderstood or scary,” she said. “This provides translation between languages.”

CMT is “the Rosetta stone” for EHR usage among clinicians, as well as clinician relationships with patients, said Fasano.

CMT also includes the key taxonomies required for Stage one of the HITECH Act’s Meaningful Use programs, such as problem list sets in SNOMED CT. This helps clinicians map to the standards set by the Office of the National Coordinator of Health IT and the Center for Medicare and Medicaid Services.

The National Library of Medicine expects to have CMT available for use by end of October. KP will also continue to add to the CMT, and others are invited to do so as well. KP will also donate $1 million annually over the next three years for ongoing support of CMT, KP officials said.