Viewing Kaiser Permanente via the logistician lens. KP has learned to exploit that terminology in ways that are clinician-acceptable and that provide powerful options for data analysis and reporting. Over the past several years, there has been substantial progress made in the domain coverage and standardization of medical terminology. Our experience with CMT has lead us to conclude that a successful terminology solution requires that: (1) usability considerations are an organizational priority (2) "interface" terminology is differentiated from "reference" terminology (3) it be easy for clinicians to find the concepts they need (4) the immediate value of coded data be apparent to clinician user (5) there be a well defined approach to terminology extensions. Context sets provide subsets of CMT for use in specific contexts. Cross map sets provide bi-directional translations between CMT and ancillary applications and administrative billing codes. These are integrated into a single poly-hierarchically structured knowledge base. The core of CMT is comprised of SNOMED CT, laboratory LOINC, and First DataBank drug terminology. CMT serves as the definitive source of concept definitions for the organization, provides a consistent structure and access method to all codes used by the organization, and is KP's language of interoperability, with cross-mappings to regional ancillary systems and administrative billing codes. Initially developed to serve the needs of a regional electronic health record, CMT has evolved into a core KP asset, serving as the common terminology across all applications. This paper describes Kaiser Permanente's ( KP) enterprise-wide medical terminology solution, referred to as our Convergent Medical Terminology (CMT). Kaiser Permanente's Convergent Medical Terminology.ĭolin, Robert H Mattison, John E Cohn, Simon Campbell, Keith E Wiesenthal, Andrew M Hochhalter, Brad LaBerge, Diane Barsoum, Rita Shalaby, James Abilla, Alan Clements, Robert J Correia, Carol M Esteva, Diane Fedack, John M Goldberg, Bruce J Gopalarao, Sridhar Hafeza, Eza Hendler, Peter Hernandez, Enrique Kamangar, Ron Kahn, Rafique A Kurtovich, Georgina Lazzareschi, Gerry Lee, Moon H Lee, Tracy Levy, David Lukoff, Jonathan Y Lundberg, Cyndie Madden, Michael P Ngo, Trongtu L Nguyen, Ben T Patel, Nikhilkumar P Resneck, Jim Ross, David E Schwarz, Kathleen M Selhorst, Charles C Snyder, Aaron Umarji, Mohamed I Vilner, Max Zer-Chen, Roy Zingo, Chris Kaiser Permanente Northwest's Center for Health Research was created to study health maintenance organizations by scientists were recruited from a variety of fields to study a range of health and medical care issues. Outcome indicators to date suggest that the initiative has been successful final outcome monitoring will be completed in December 2003. Conclusions: Endorsement of this Hand Hygiene Program initiative by KP leadership has led to implementation of the initiative at all medical centers throughout the KP organization. As of May 2003, use of artificial nails had been reduced by 97% nationwide. To date, outcome monitoring has shown a 26% increase in compliance with hand hygiene as well as a decrease in the number of bloodstream infections and methycillin-resistant Staphylococcus aureus (MRSA) infections. Results: From 2001 through September 2003, the National KP Hand Hygiene Work Group coordinated implementation of the Hand Hygiene initiative throughout the KP organization. Design: The infection control initiative was designed to include employee and physician education as well as to implement standard hand hygiene products (eg, alcohol degermers), eliminate use of artificial nails, and monitor outcomes. Supplied with this information, the National Infection Control Peer Group convened a KP Hand Hygiene Work Group, which, in August 2001, launched a National Hand Hygiene Program initiative titled “Infection Control: It’s In Our Hands†to increase compliance with hand hygiene throughout the Kaiser Permanente ( KP) organization. Recently, the advent of waterless, alcohol-based skin degermer and elimination of artificial nails have been recognized as other important interventions for preventing infection. Objective: Hand hygiene has historically been identified as an important intervention for preventing infection acquired in health care settings. Kaiser Permanente National Hand Hygiene Programīarnes, Sue Barron, Dana Becker, Linda Canola, Teresa Salemi, Charles The Division of Research within KP-MCP conducts, publishes, and disseminates high-quality epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. Kaiser Permanente Medical Care Programs ( KP-MCP)
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