A Terminology Service Compliant to CTS2 to Manage Semantics within the Regional HIE

Objectives: The correct semantics management represents a fundamental requirement to create health information exchange (HIE) systems able to support clinical data sharing. A research is now underway to set up an infrastructure to aggregate data coming from health information systems, and it will be experimented to support regional HIE in Veneto Region, Italy. Methods: In the first period, the focus was on the semantics management of Clinical Document Architecture Release 2 (CDA R2) laboratory reports in which observations must be encoded using LOINC® vocabulary. The existing components considered were the Laboratory Information Systems (LISs) of the local departments of the region (23 units) and the regional HIE. To manage the semantics of the data, the design and the implementation of a terminology service, the Health Terminology Service (HTS), compliant to the Common Terminology Service Release 2 (CTS2) standard was considered. Results: The HTS, formed by a set of web services, as CTS2 indicates, is the core of the proposed infrastructure. It is connected with an application that allows creating, deleting, updating and managing the versioning of the maps between the laboratory observations and the LOINC® entities. Conclusions: The adoption of CTS2 specification allows the HTS to support different use cases, which are essential to supports the clinical data sharing of the HIE content. During the development, the authors faced some problems that causes a delay in the implementation of the solution. The authors are still working to connect the HTS with the existing systems and to improve the solution.