Find the Right Term for Your Goals: How to Choose Healthcare Terminology Standards

October 20, 2021

Article Summary

With an overwhelming number of healthcare terminology standards, how do industry professionals determine which ones they need to know? Terminology users can start by matching their purpose with the correct standard. Because different healthcare terminology standards fulfill distinct purposes, matching purpose to standard generally leads users to the right term for their goals. 

Terminology users can match their purpose with the correct standard by first identifying the standard’s purpose. Purposes encompass billing, clinical, laboratory, and pharmacy terminology standards:

1. Healthcare billing terminology.
2. Clinical terminology.
3. Clinical and laboratory terminology.
4. Pharmacy terminology.

healthcare terminology standard

Healthcare has a lot of terminology standards. The sheer number of acronyms alone is often overwhelming, leaving industry professionals to wonder which ones they need to know.

The relevancy and importance of healthcare terminology depend on the user’s goals. Different healthcare terminology standards fulfill distinct purposes, and each generally does a good job meeting its purpose. In other words, when users match their purpose with the correct standard, they generally find the right term.

Healthcare Terminology Standards: Matching Purpose and Standard

Matching a purpose with the correct standard starts with identifying the standard’s purpose. Basically, there are billing, clinical, laboratory, and pharmacy terminology standards:

Healthcare Billing Terminology: ICD, DRGs, and CPT Codes

Healthcare organizations use billing terminology standards to support aspects of medical billing. International Classifications of Diseases (ICD) is a diagnosis code set. As of 2021, the United States uses the version ICD-10, with ICD-11 coming in the future. Diagnosis-related groups (DRGs) are common in the inpatient setting to bill for a patient’s hospital stay. Current Procedural Terminology (CPT) generally covers procedure billing.

Clinical Terminology

Interoperability initiatives increasingly reference clinical terminology standards. Many different standards exist and tend to have a specific clinical or workflow emphasis. The following are examples of the most common clinical terminology standards:

  • Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) primarily encodes the clinical data in a patient record. It is available for use in the U.S. via licensing by the National Library of Medicine (NLM) and managed globally under SNOMED International. With SNOMED’s clinical focus, it’s a useful standard for encoding clinical data sent between systems or organizations.
  • Health Level 7 (HL7) is a healthcare standards organization that produces a variety of interoperability standards, including Fast Healthcare. The organization produces and maintains messaging and terminology standards. HL7’s terminology contains a mix of code sets that aren’t covered by other standard terminologies. Many of these code sets are necessary for HL7 V2 messaging or Fast Healthcare Interoperability Resources (FHIR). For example, they have code sets for admission type and administrative gender among many other domains of interest.

Clinical and Laboratory Terminology: LOINC®

The Regenstrief Institute developed and maintains the Logical Observation Identifiers Names and Codes (LOINC®). This terminology initially encoded lab observations but has since expanded to represent clinical observations. LOINC is an open-source standard, which the industry widely considers the definitive lab standard. It is also the main standard for clinical observations referenced by measures.

Pharmacy Terminology

Many commercially available solutions represent the pharmacy terminology space, including First Databank, MultumMicromedex, and Medi-Span. The interoperability standard recommended for pharmacy terminology is the open-source RxNorm, available through the NLM. RxNorm has some mappings to the proprietary standards to facilitate interoperability.

Healthcare Terminology Standards Simplified

There are other terminology standards available for niche use cases, but the above listing covers the most prominent options. Terminology users will want to clarify their objectives and do their research (i.e., match purpose and standard) before embarking on any terminology project. When users simplify the terminology process by matching purpose with standard, they’re more likely to arrive at the appropriate term.

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

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