Testing Three Problem List Terminologies in a simulated data entry environment.

Three Problem List Terminologies (PLT) were tested using a web-based application simulating a clinical data entry environment to evaluate coverage and coding efficiency. The three PLTs were: the CORE Problem List Subset of SNOMED CT, a clinical subset extracted from the full SNOMED CT and the PLT currently used at the Mayo Clinic. Candidate problem statements were randomly extracted from free text problem list entries contained in two electronic medical record systems. Physician reviewers searched for concepts in one of the three PLTs that most closely matched a problem statement. Altogether 45 reviewers reviewed 15 problems each. The coverage of the much smaller CORE Subset was comparable to Clinical SNOMED for combined exact or partial matches. The CORE Subset required the shortest time to find a concept. This may be related to the smaller size of the pick lists for the CORE Subset.

Integrating genetic information resources with an EHR.

As the knowledge about the genetic factors associated with clinical conditions increases, access to information that can help practicing clinicians better understand these factors becomes essential for optimal care and communication with patients. We describe the implementation of 'infobuttons' from the problem list module of an electronic health record (EHR) to on-line genetic resources.