A detailed examination of the clinical terms and concepts required for communication by electronic messages in diabetes care

The wider electronic exchange of clinical information between heterogeneous information systems in the delivery of diabetes care demands a common stru cture in the form of a message standard. A European Standard electronic dia betes message is being developed in conjunction with CEN TC251, This paper describes the methodologies that the 1998 DO IT Workshop has used to identi fy potential areas of difficulty in the design and implementation of the pr eliminary message model. To facilitate implementation and to avoid ambiguit y in electronic messaging it is particularly important that there is standa rdisation of the definitions of the clinical terms specifically used in dia betes care across systems. Comprehensive lists of such terms to describe al l areas of diabetes care do not exist and there is a lack of harmonisation of definitions in many areas. Thus, to better understand the user requireme nts of diabetes messaging several approaches were adopted. A review of the clinical terms and concepts contained in pre-existing datasets was undertak en,with detailed study of a number of specific areas of diabetes care, anal ysing the conceptual structure of all the clinical terms that they comprise d. Consideration of several worst case clinical scenarios for messages to c ommunicate was also made to identify deficiencies in the message structure, This activity confirmed the importance of creating a Standard for a supers et or thesaurus of diabetes specific terms, with appropriate definitions, t o harmonise data communication in different IT systems to facilitate messag ing. A substantial number of new terms were identified in the workshop and these will form an important first step to accomplishing a first draft supe rset once fully analysed. It was also apparent that certain specific areas within diabetes care, but most particularly in nursing, dietetics and podia try, need urgent work to further develop the concepts and terms. This needs to be facilitated for an appropriate group of such professionals, To achie ve such a Standard, continued co-operation with CEN/ISSS was recognised to be very important. (C) 2000, Editrice Kurtis.