Verify Interpretation aspects


Identify Overlapping independent variables
address Inconsistencies
Language of color
Getting values set right
Correlation between the values
Reasonable separation of concerns re these fields
Are these colors or observations?/
How does this need to be said
Interpretation of Abnormal skin color and abnormal foot color


Susan Matney
March 14, 2017, 6:51 PM

Below is an email thread with the discussion. My proposed solution is to create a separate, disjoined concept other than the “Skin Color Normal” value from the skin color value set which is a situation with explicit context of Skin Color Normal for Subject.


That’s what the style guide states re interpretation, that I pertains to lab. I’m looking specifically at SkinColorEval and there is an Interpretation (not impression) qualifier attached to it. The values are “Abnormal Skin Color” and “Normal Skin Color”. From your answer, this pertains to that specific subject so I think we would create a separate, disjoined concept than the “Skin Color Normal” value in the skin color value set.

Thanks for your quick answer. I appreciate it. Susan

From: Cyndalynn Tilley
Sent: Tuesday, March 14, 2017 10:28 AM
To: Susan Matney <>
Cc: van Berkum, Monique <>; Keith E. Campbell <>
Subject: RE: "Interpretation" CEM

Hi Susan,
In CEM, we have ‘Interpretation’ models, but they are usually pertain to labs.

We do have ‘ExamEval’ models or ‘Impression’ models, which are the same as an Interpretation model, but used for clinical observations. We use the Normal/Abnormal value set for the values.

Here is a description from the SkinExaminationEval:

SkinExaminationEval model is an impression model. An impression model holds a "question" in the key and holds a coded value (CD) of "normal", "abnormal' or "unremarkable" in data

In the SkinExaminationEval model, the question is "what is the impression of subject's Skin Examination?" and the coded answer can be "Normal", "Abnormal", or "Unremarkable".

"SkinExaminationEval" by definition means to evaluate the subject's skin for abnormalities.

I hope I understood the question.



Cyndalynn Tilley MS, BSN, RN

Data Semantics and Clinical Modeling

Data and AnalyticsServices (DaAS)

Intermountain Healthcare

3930 Parkway Blvd

Salt Lake City, UT 84120

Office: 801.442.5134 | Cell: 801.906.1155

From: Susan Matney
Sent: Tuesday, March 14, 2017 9:30 AM
To: Cyndalynn Tilley <>
Cc: van Berkum, Monique <>; Keith E. Campbell <>
Subject: "Interpretation" CEM

Hi Cyndalynn,

I am meeting with the VA nurses and SNOMED CT modelers who are working on encoding skin assessment. They asked how the CEM “interpretation” model is used. In the SkinColorEval CEM model there is a code in the value set for “natural color” which I would map to 297952003 |Skin normal color (finding)|. The interpretation value set has a value “normal skin color” which to me is also 297952003 |Skin normal color (finding)|.

Keith Campbell feels that the interpretation should be disjoined codes since one is the judgment. Does the interpretation mean “normal” or “abnormal for patient”?

I looked in the CEM style guide and there is not much guidance on how the interpretation CEM is used clinically so I’m hoping you can answer these questions. Thanks…Susan


Susan Matney


Janet Morris



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