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Units of Measure. Cecil Lynch, MD, MS Mary Cooper CTMS Lab Interface SIG 1/31/2006. Discussion Topics. Lab Interface SIG Recommendations: Units of Measure should encompass all areas of clinical medicine and not be limited to Lab, Pharmacy, Adverse Events, etc.

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units of measure

Units of Measure

Cecil Lynch, MD, MS

Mary Cooper

CTMS Lab Interface SIG

1/31/2006

discussion topics
Discussion Topics
  • Lab Interface SIG Recommendations:
    • Units of Measure should encompass all areas of clinical medicine and not be limited to Lab, Pharmacy, Adverse Events, etc.
    • Units of Measure will be represented by the Unified Code for Units of Measure (UCUM).
    • After presentation to CTMS there will be a 2 week comment period for CTMS members to respond.
use case analysis
Use Case Analysis
  • Purpose of collecting UoM data:
    • Assessment
    • Analysis
    • Identification
    • Interoperability
  • Use/Applications:
      • Laboratory (Test result values and reference ranges)
      • Pharmacy (Agent Dose)
      • Radiology (Diagnostic Imaging)
      • Adverse Event Reporting
      • Non-Clinical Measurements (ex. Time)
high level usage relevant standards
High Level Usage/Relevant Standards
  • Applicable External Standards which reference Units of Measure
    • ANSI X12
    • HL7 v2
    • HL7 v3 RIM
    • ISO
    • IUPAC
    • DICOM
  • The majority of current external standards use an atomic classification system based on the Unified Code for Units of Measure (UCUM).
  • Other standards & applications represent units of measure as a bulk list.
description of ucum
Description of UCUM

Unified Code for Units of Measure (UCUM)

http://aurora.regenstrief.org/UCUM/ucum.html

UCUM is heavily based on ANSI X3.50-1986, ISO 2955-1983,

and HL7 extensions “ISO+”.

Basic set of terminal symbols unit atoms

Includes a code of multiplier prefixes and business rules

for algebraic expression.

Tables

kind of quantity

(Mass, Length, etc.)

applicable use

(SI Units, Units Used Predominantly in Clinical Medicine)

other reasons for ucum
Other Reasons for UCUM

Notice: Consolidated Health Informatics (CHI) Initiative; Health Care and Vocabulary Standards for Use in Federal Health Information Technology

Systems

Federal Register: December 23, 2005 (Volume 70, Number 246) Page 76287-76288

Units of Measure. Standard: HL7 Version 2.X+. (UCUM)

it s the law
It’s The Law
  • IV. Impact Statement

… The Federal government will require all future health information technology system acquisitions to be based on CHI standards when applicable, whether system development occurs within the Agency or through the use of contractor services.

proposed data element
Proposed Data Element
  • One Units of Measure CDE
  • Data Element Concept (reused)
  • Value Domain referenced to UCUM
recommendations units of measure ucum codes
RecommendationsUnits of Measure UCUM Codes

Data Element Concept

Units of Measure

Public ID 2013051v3 (reused from CCR)

Data Element

Units of Measure UCUM Codes

Public ID 2423412

Value Domain

UCUM Codes

Public ID 2423409

http://aurora.regenstrief.org/UCUM/ucum.html

recommendation details units of measure ucum code
Recommendation DetailsUnits of Measure UCUM Code

Units of Measure

Definition: Standard used to

express the size or magnitude

of something.

Units of Measure UCUM Codes

Definition:

The code that represents the determinate

amount or quantity used as the standard

of measurement for the size, magnitude

or capacity of something.

UCUM Codes

Definition:

A code system of symbols and rules

that represents the size, magnitude

or capacity of a determinate amount

or quantity used as the standard of

measurement for international science,

engineering, and business.

hl7 v3 and ucum
HL7 v3 and UCUM
  • Coded Simple Value (CS) specializes CV
  • Definition:      Coded data in its simplest form, where only the code is not predetermined. The code system and code system version are fixed by the context in which the CS value occurs. CS is used for coded attributes that have a single HL7-defined value set.
  • CS can only be used in either of the following cases:
  • for a coded attribute which has a single HL7-defined code system, and where code additions to that value set require formal HL7 action (such as harmonization.) Such coded attributes must have type CS.
  • for a property in this specification that is assigned to a single code system defined either in this specification or defined outside HL7 by a body that has authority over the concept and the maintenance of that code system. (This is the case of UCUM)
  • For CS values, the designation of the domain qualifier will always be CNE (coded, non-extensible) and the context will determine which HL7 values to use.
ucum in application use
UCUM in Application Use
  • The patient’s height is 72 inches.
  • UCUM expression for inches is [in_i] 
  • Not user friendly
  • Very computable
  • HL7 allows translation to a more friendly presentation
hl7 v3 messaging of ucum
HL7 V3 Messaging of UCUM
  • Physical Quantity (PQ) specializes QTY
  • Definition:      A dimensioned quantity expressing the result of measuring.
  • value REAL The magnitude of the quantity measured in terms of the unit.
  • unit CS The unit of measure specified in the Unified Code for Units of Measure (UCUM) [http://aurora.rg.iupui.edu/UCUM].
  • translation SET<PQR> An alternative representation of the same physical quantity expressed in a different unit, of a different unit code system and possibly with a different value.
hl7 example
HL7 Example

<Observation classCode="COND">

<code codeSystem="2.16.840.1.113883.6.5.96" code="248333004" displayName="standing height" />

<value xsi:type="PQ" value="72" units="[in_i]"> <translation xsi:type="PQR">

<codeSystem="2.16.840.1.113883.6.5.96" code="258677007" displayName="in - inch" originalText="inches"/>

</translation>

</value>

</Observation>

discussion summary
Discussion Summary
  • Decisions:
  • Action Items:

Comment period of 2 weeks.

  • Outstanding Issues:
  • Next steps and meeting dates

Review comments with Lab SIG.

Present proposal to VCDE workspace.