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常见医学术语走向成熟,第一部分:标准语言提升医疗质量。

Common medical terminology comes of age, Part One: Standard language improves healthcare quality.

作者信息

Rose J S, Fisch B J, Hogan W R, Levy B, Marshal P, Thomas D R, Kirkley D

机构信息

Health Language, Inc., Aurora, Colorado, USA.

出版信息

J Healthc Inf Manag. 2001 Fall;15(3):307-18.

Abstract

It has become abundantly clear that standards of recording clinical terms in human-readable, computer-processable format are indispensable. Controlled medical terminology is the missing link in health information standards (in fact, medical terminology can be viewed as the mother of all standards); its absence interferes with the business of healthcare and impedes the core processes of healing and maintaining health. Medicine has lacked the controlled common medical vocabulary that would enable universal sharing of data at the point of care and ensure reliable information for determining health intervention effectiveness. Simple clinical and code content alone has proven insufficient for healthcare enterprises to successfully manage the terminology problem; the "lexical runtime engine," formerly called a vocabulary server (VOSER), which manages the vocabulary ontology and serves up the relevant vocabulary to users of applications in the clinical environment, has recently become a reality.

摘要

已经非常清楚的是,以人类可读、计算机可处理的格式记录临床术语的标准是必不可少的。受控医学术语是健康信息标准中缺失的环节(实际上,医学术语可被视为所有标准之母);它的缺失干扰了医疗保健业务,并阻碍了治疗和维持健康的核心过程。医学一直缺乏能够在护理点实现数据通用共享并确保用于确定健康干预效果的可靠信息的受控通用医学词汇。事实证明,仅简单的临床和代码内容不足以让医疗保健企业成功解决术语问题;“词汇运行时引擎”,以前称为词汇服务器(VOSER),它管理词汇本体并向临床环境中的应用程序用户提供相关词汇,最近已成为现实。

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