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Can SOLOR (SnOmed LOinc, Rxnorm) Project Create Terminology Foundation for Interoperability?

July 22, 2016
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Healthcare Services Platform Consortium eyes delivery of sharable clinical decision-support capabilities

Last year I wrote about a presentation I saw by Intermountain Healthcare Chief Medical Informatics Officer Stan Huff, M.D., about why 22-hospital Intermountain and other provider organizations came together to form the nonprofit Healthcare Services Platform Consortium (HSPC).

Basically, Huff said, these providers hope to create an open, standards-based, services oriented architecture platform that supports a new marketplace for interoperable healthcare applications. The hope is that this approach would allow for the sharing of knowledge, not just data. The group envisions developers creating applications that don’t need to know about the physical structures of databases in EHRs. So the same application built using the SMART approach developed at Boston Children’s Hospital can run in Epic, Cerner, Allscripts or Greenway as long as those systems support standards-based services.

Huff spoke about the need for shareable clinical decision support modules. He said that Utah-based Intermountain provides advanced clinical decision support covering 150 items, ranging from ventilator weaning to sepsis and pneumonia, all of them very valuable. “What we realize, though, is that while we have 150 of those, the opportunity is for 5,000,” he said. “We have focused on ones involving high-volume activities or where the patient is at great risk. But we are not doing anything for hyperthyroidism or other clinical syndromes. But with the budget we have and other constraints, we’ll never get from 150 to 5,000. We might get to 300. We realized we needed to change the paradigm,” he said.

Now HSPC, which also included the Veterans Health Administration and LSU Health Care Services Division, a Baton Rouge-based academic healthcare organization, has announced that its members, are undertaking an initiative to simplify the implementation of healthcare information systems in order to provide highly specific decision support over highly refined, standards-based, encoded data.

HSPC members are supporting existing efforts to integrate SNOMED CT and Laboratory LOINC as specified by the IHTSDO/Regenstrief cooperative agreement ( and to expand that effort to include Clinical LOINC and selected components of RxNorm so that an integrated, description-logic-based system is available that covers the essential domains necessary for healthcare.

HSPC said this SOLOR (SnOmed LOinc, Rxnorm) project would provide the terminology foundation for related CIMI (Clinical Information Modeling Initiative) efforts, and HL7 FHIR profile development.

“We hope SOLOR can serve as a foundation to deliver sharable clinical decision-support capabilities both within the VA and ultimately throughout the nation’s healthcare system,” said Jonathan Nebeker, M.S., M.D., deputy chief medical informatics officer for strategy and functional design, Veterans Health Administration, in a prepared statement. Nebeker is clinical lead for the VistA Evolution Program, which is developing the VA’s next-generation EHR.

“Integrating the hard-won standards of existing data organizations in healthcare is a critical step on the journey to healthcare interoperability,” said Huff, chairman of the HSPC board, in a statement. “We are standing on the shoulders of many unsung heroes who have been working in the trenches for decades to make health information systems talk to each other for the benefit of patients everywhere.”

The American College of Surgeons is sponsoring and hosting HSPC’s next meeting in Washington, D.C., on July 25-27, 2016, which will address the data-standard integration initiative as well as many other topics.