West Coast Informatics works to lower barriers to entry, effective use, and understanding of healthcare terminologies

SNOMED International recently spoke to West Coast Informatics (WCI) about its mission, its products and the focus of the company's presentation at #SCTExpo23.

Q: Many healthcare organizations face challenges when trying to adopt or implement healthcare terminologies due to the complexities inherent in these standards. How does West Coast Informatics help simplify this adoption/implementation?

?A: Any real-world healthcare application is going to need to interact with a variety of different terminologies. For example, an application may need a terminology standard for conditions, another for procedures, then any number of others for medications, labs, genetic information, and so on.?

Standard terminologies are published by different organizations, exist in different formats, and are released on different schedules. To make things more complicated, they operate in different jurisdictions and may have different licensing constraints.? It doesn’t end there!

They must be able to express content at different levels of granularity and grouping of meanings in different ways.

The various terminologies express content at different levels of granularity while simultaneously organizing the data they represent in different ways. To effectively make use of a combination of these requires deep expertise in each one - a hard commodity to come by these days. WCI is working to lower barriers to entry, effective use, and understanding of these terminologies.

Our latest effort, TermHub?, is a unification of all content into a single approach that allows varying types of users to interact with whichever content they are interested in with almost no effort beyond choosing the content of interest!?Our tools provide training as-you-go by offering examples for both non-technical users and developers. This will help those who are being introduced to terminology for the first time to appreciate how the content works, what content areas a terminology covers, when each is appropriate for use in a standards context, and so on. In summary, we believe that TermHub will facilitate mass adoption of standard terminologies across the digital health industry through simplicity and ease of use by all stakeholders.

Q: Recent developments in Artificial Intelligence (AI), and specifically Large Language Models (LLM), are having a big impact in healthcare. What is WCI doing to leverage these new technologies?

A: The reporting on ChatGPT and other language models and their revolutionary impact on the world has been amazing to follow over the course of the last year. The reality, of course, is somewhere in between the true believers who think all jobs will be replaced by AI in 5 years and the naysayers who think this is all just a flash in the pan.

We are presently leveraging these technologies to supercharge our efforts in the terminology "auto-mapping" space, allowing high-quality cross-walking between terminologies with high-value confidence scoring to manage unavoidable ambiguities. While we don’t fully rely upon the automated maps, there is very significant savings in letting these tools perform a first pass while our subject matter experts review for mistakes and handle the more complex cases manually.

We believe the language capabilities of LLMs like GPT-4 offer an opportunity to break free of the purely lexical-based manipulation of content that has been at the core of how search, retrieval, indexing, natural language processing and terminology linking have worked for the better part of the past generation.?

Though in a sense, the problem space has just been pushed into a different realm.? Now, rather than writing algorithms to perform tasks, the challenge is to develop "chat GPT prompts" that facilitate the ability for these machine models to correctly interpret questions and produce results which can then be cross-checked to verify accuracy.

Q: WCI is doing a lot of different things with the future of the terminology browser. Tell us more about that.

A: The terminology browser has come a long way over the last 10 years.? Most publishers of standard terminologies (SNOMED International included) have offerings that provide targeted access to their content with a unique perspective on viewing and interacting with the data.?API access to the underlying content continues to grow with FHIR endpoints now available for SNOMED CT and LOINC content.? We believe these efforts were primarily about getting access out there to what otherwise required building of bespoke internal tools to do anything useful with this data.

As a company that has been operating in this space for many years and with a wide variety of customers, we have seen the challenges for newer organizations coming to the space who are interested in learning and exploring the implementation of SNOMED CT, ICD, LOINC, RXNORM and more.?As we see it, the two most obvious opportunities at this point in time are to bring together all of the disparate means of accessing terminology content (whether by humans through a browser or by machines through an API) into a holistic solution.?A single place to access and interact with all the terminology content needed to solve for real-world healthcare data situations.?For us, this is TermHub? - a unified way for humans to browse content - current and historical without having to worry about where their content comes from or when new versions are released.?TermHub also provides a unified way for machines to interact with all of that content, through consistent download formats and consistent API access.?By unifying the content in this way, we can also start to offer truly revolutionary features like advanced vector-based searching, tolerance for spelling mistakes and variations in the way search queries are phrased.

Our TermWiki presentation at the conference this year adds another dimension to all of this, which is presentation of content to a non-technical audience.?So many of the stakeholders in the healthcare space understand the content, but not the vagaries of things like expression languages, vector representations of meaning, or logical definitions of content.?For them, we offer a content-focused experience through well-known tooling (in this case Atlassian Confluence) that allows for natural "document-oriented" searching of terminology content and friendly ways for suggesting content changes.

Attend the West Coast Informatics presentation at SNOMED CT Expo 2023, titled Beyond the browser: Terminology as Wiki, on October 26 at 12:00 EDT/16:00 UTC.