A detailed examination of the clinical terms and concepts required for communication by electronic messages in diabetes care.
The wider electronic exchange of clinical information between heterogeneous information systems in the delivery of diabetes care demands a common structure in the form of a message standard. A European Standard electronic diabetes message is being developed in conjunction with CEN TC251. This paper describes the methodologies that the 1998 DO IT Workshop has used to identify potential areas of difficulty in the design and implementation of the preliminary message model. To facilitate implementation and to avoid ambiguity in electronic messaging it is particularly important that there is standardisation of the definitions of the clinical terms specifically used in diabetes care across systems. Comprehensive lists of such terms to describe all areas of diabetes care do not exist and there is a lack of harmonisation of definitions in many areas. Thus, to better understand the user requirements of diabetes messaging several approaches were adopted. A review of the clinical terms and concepts contained in pre-existing datasets was undertaken with detailed study of a number of specific areas of diabetes care, analysing the conceptual structure of all the clinical terms that they comprised. Consideration of several worst case clinical scenarios for messages to communicate was also made to identify deficiencies in the message structure. This activity confirmed the importance of creating a Standard for a superset or thesaurus of diabetes specific terms, with appropriate definitions, to harmonise data communication in different IT systems to facilitate messaging. A substantial number of new terms were identified in the workshop and these will form an important first step to accomplishing a first draft superset once fully analysed. It was also apparent that certain specific areas within diabetes care, but most particularly in nursing, dietetics and podiatry, need urgent work to further develop the concepts and terms. This needs to be facilitated for an appropriate group of such professionals. To achieve such a Standard, continued co-operation with CEN/ISSS was recognised to be very important.
Vaughan
N J
NJ
Royal Sussex County Hospital, Brighton, UK. nvaughan@mistral.co.uk
Cashman
S J
SJ
Cavan
D A
DA
Gallego
M R
MR
Kohner
E
E
Benedetti
M M
MM
Sandø
S H
SH
Sönksen
P H
PH
Storms
G E
GE
Vermeij
D
D
D003146:Communications Media; D003195:Computer Communication Networks / Q000592:standards*; D003695:Delivery of Health Care; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000451:nursing; D003930:Diabetic Retinopathy; D004282:Documentation; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D009732:Nursing Care / Q000592:standards*; D012015:Reference Standards; D009626:Terminology as Topic
D007004:Hypoglycemic Agents; D007328:Insulin