UMLS uses three knowledge sources to make it easier for users to link separate information systems:
1. The metathesaurus provides a uniform collection of more than one hundred biomedical/health-related vocabularies, coding systems, and classifications and links the different names used in the various vocabularies and classifications, such as SNOMED CT, LOINC, and RXNorm to a common concept. The UMLS Metathesaurus contains the complete set of SNOMED CT.
2. The specialist lexicon contains syntactic information for many terms. (For example, it lists the parts of speech, various forms of a word, and spelling variations of the terms within UMLS.)
3. The semantic network provides a system for categorizing objects and identifying the relationships among various concepts.
The UMLS knowledge sources overcome retrieval problems that occur when different terminology and separate databases are used. They are currently being used in a variety of applications, including patient data creation, natural language processing, and information retrieval. The NLM maintains fact sheets describing the progress of this project on its Web site (http://www.nlm.nih.gov/pubs/factsheets/umls.html).
Development of the Nosologist Role
Nosology is the branch of medical science that deals with classification systems. A nosologist is a person who works with using and developing classification systems. The AHIMA Coding Futures Task Force envisions that the role of the coder will change dramatically over the next decade. At present, the coder's primary responsibility is the assignment of codes. In the future, the coder will become responsible for the development, maintenance, and management of classification systems and vocabularies.
In today's healthcare environment, HIM professionals, especially those with career paths in clinical coding, are enjoying a wealth of opportunity in the job market. There is a critical need for qualified coding professionals to classify, manage, and maintain clinical information for analysis and transactions. As a result of increased regulation in healthcare, heightened compliance risks, and progressively more complex reimbursement tied to code assignments, coding professionals have a greater array of choices within the profession than ever before.
Along with increased demand for coding professionals is a clear broadening of roles within the HIM profession. Today's work force demands knowledge and job skills that go beyond the basic conventions of standard diagnosis and procedure code assignment from health records. Clinical terminologies are expanding into a broader use of data sets beyond the traditional ICD-9-CM and HCPCS/CPT code sets to include SNOMED-CT, LOINC, specialized terminologies for pharmaceuticals and nursing care, and a host of others to serve an environment hungry for data that is easily digested by computer software and reliable, consistent, and accurate.
Many levels of HIM expertise are needed, and a variety of skills are important for career success. Most employers are seeking a minimum of a bachelor's degree in a healthcare discipline as well as "high-end" knowledge that facilitates integration of data management with a specific business case, software application, or clinical workflow support process. Current employment trends favor master's degree preparation in HIM, health informatics, computer information management, or related fields of study. A solid clinical knowledge base is required for many positions related to clinical terminology use involving clinical coding systems and data analysis.
To complete the picture, there are a number of healthcare professionals managing health information today. HIM roles involve physicians, nurses, technicians, and other allied health professionals in some job settings. Career pathways in HIM frequently merge with an educational foundation or experience in these disciplines. These pathways are helpful for illustrating how selected jobs evolve over time and how entry-level positions lay the foundation for new opportunities with greater responsibility, variety, and compensation potential (AHIMA Practice Council for Clinical Terminology and Classification 2007).