In order to support an HIE-wide prior CT alerting system, designed to alert clinicians at the point of order entry whether relevant prior CTs exist across multiple organizations, we created a novel ontology called “Simple ANatomic Ontology for Proximity or Similarity” (SANOPS). In addition to sending alerts when a patient has an exact “same” prior CT at another site based on matching LOINC codes, SANOPS supports prior CT alerts based on “similar” (a prior “Head CT without contrast” when a current “Head CT with contrast” is ordered) or “proximate” (a prior “Head CT with contrast” when a current “Neck CT with contrast” is ordered) CT exams. SANOPS divides the human body into 17 major anatomic regions (See Figure). Each CT exam code can be assigned to one or more anatomic regions, based on the type of CT and its anatomical location. For example, a CT Abdomen/Pelvis CT and CT Lumbar spine would each be assigned two anatomic regions for abdomen and pelvis (regions 4 and 5). If a clinician was ordering a lumbar spine CT and the patient had a prior abdomen/pelvis CT, since both are in the same SANOPS anatomic regions, SANOPS would support an alert for a similar prior exam.

We are currently working with LOINC to adapt some of the principals of SANOPS to their anatomic ontology such that they can support alerts of this type. A link to a translation table showing SANOPS regions and their corresponding regions in other ontologies is provided below.

SANOPS other ontologies translation table

SANOPS Figure. 17 major anatomic regions defined by our SANOPS ontology. The major anatomic regions and their respective codes are: 1-Head, 2-Neck, 3-Chest, 4-Abdomen, 5-Pelvis, 6a-Proximal Left Upper Extremity(LUE), 6b-Mid LUE, 6c-Distal LUE, 7a- Proximal Right Upper Extremity (RUE), 7b- Mid RUE, 7c- Distal RUE, 8a- Proximal Left Lower Extremity (LLE), 8b- Mid LLE, 8c- Distal LLE, 9a- Proximal Right Lower Extremity (RLE), 9b- Mid RLE, 9c- Distal RLE