Solor Terminology

Historically, medical terminologies have been designed to meet a range of specific goals – mainly to support administration and billing. Consequently, application of clinical terminologies to encode electronic clinical data is not yet mature. Administration-oriented terminologies cannot capture clinical data at a sufficient level of detail to support clinical care requirements. Although ‘Meaningful Use’ standard terminologies are used by electronic health record (EHR) systems, these terminologies are often used in an inconsistent way across implementations of the same underlying systems (i.e., mapping), and the minimal integration of systems such as SNOMED CT, RxNorm, and LOINC is an area requiring considerable attention if we want to support safe and effective information exchange, decision support, and analysis needed to achieve zero harm and high-reliability in patient care.

Seamless integration of disparate terminology standards is non-trivial because each distinct terminology has different semantic models, different formalisms and tools for their representation, separate release cycles, and different versioning mechanisms. To combat challenges of integrating health data from multiple terminological sources, healthcare systems today create mappings and localizations to represent clinical data in Health IT systems as a primitive means to achieve data representation and data interoperability.

Solor is an open-source ecosystem for management, harmonization, and extension of medical terminologies – sponsored by the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) and Logica Health. Solor allows users to import, transform, view, extend, and export content from disparate medical terminologies, all in one common model. Users can navigate and search Solor content, view details of the data elements, and select specific concepts to view more information. Solor has two fundamental building blocks: concepts and semantics. A concept is defined as an idea or a general notion and is represented by a universally unique identifier (UUID). A semantic is attached to a concept to provide contextual meaning and semantic data to the concept’s content. Solor’s open source repository/tooling is available and is sponsored by Logica Health and VHA’s Knowledge Based System: https://github.com/logicahealth/komet

The creation of Solor extensions should follow best practices for domain specific concept modeling (as outlined in the SNOMED CT Editorial Guide, for instance). Currently Solor can export terminological data and extensions in the SNOMED CT Release Format 2 (RF2) – which is widely used in almost every health IT system that utilizes SNOMED CT content.

There is also an initiative within HL7’s Vocabulary Working Group to create an agnostic data representation format that follows Solor’s specific improvements/vision around versioning and underlying concept model (logical and physical). This project begins the work to describe a flexible self-describing standard logical model for format and distribution of terminology knowledge bases. Next steps include (1) Creation of the logical model and analysis to map the requirements to existing standards, including FHIR; and (2) If necessary, definition of a syntax for sharing the terminology artifacts (may be new or an extension to existing standards, including FHIR). The project scope statement is available at: https://confluence.hl7.org/x/IGn9Aw

 In order to utilize Solor’s ecosystem and terminology you must have:

 o   Terminologist – who understands and can work with the US core meaningful use standards (e.g., SNOMED CT, LOINC, RxNorm)

o   Clinical Informaticist – who understands the clinical area that is being automated through business processes (aka BPM+)