A Focus on Implementing Nursing Vocabularies

''Implementation of Nursing Vocabularies in Computer based Systems'' was the theme of an invita-tional conference held before the 1997 AMIA Spring Congress. The conference served as a summit to bring together vocabulary developers, industrial partners, sites implementing systems that include nursing vocabularies , researchers, policy-makers, and government representatives to discuss issues surrounding the difficulties of implementing languages that represent nursing concepts in computer-based systems.* To expedite discussion, conference faculty provided an overview of the challenges and strategies for implementing nursing vocabularies in their own settings. Categories of challenges were varied but included familiar themes of user resistance, data structure, cost, discipline-specific terminology, redundancy , and representation of the patient as a whole. A recurring challenge was the necessity to determine the level of granularity needed for data collection and coding of languages. Issues of simplicity versus spec-ificity were commonly raised. Through open discussion, assembly participants identified strategic actions related to the challenges. Although 30 actions addressing the challenges of implementing vocabularies were identified initially by the assembly, three actions received highest priority. The first priority is to develop a model that depicts a nursing view of information and to link the resulting information model with health care vocabularies. The second priority is to disseminate information about vocabularies, emphasizing their use in practice. The third priority is to coordinate language activities so that redundant work is avoided, research efforts are cumulative, and resources are used efficiently. These priorities will be the focus of AMIA's Nursing Infor-matics Work Group projects relative to nursing vocabularies over the next two years. Recognizing a need to share conference outcomes with the informatics community, the Nursing Infor-matics Work Group disseminated information about the conference through a followup workshop, ''Im-plementation of Nursing Vocabularies in Computer-based Systems,'' and a tutorial, ''Implementing Standardized Coding and Classification: A Nursing Summit,'' will be held at the 1997 AMIA Fall Congress for the larger AMIA membership and those interested in the topic. The Nursing Informatics Work Group hopes that drawing attention to the implementation of vocabularies that represent nursing will spur vocabulary developers, software industry leaders, researchers , and implementors to work together to meet existing challenges.—CAROLE A. GASSERT The views expressed in this editorial are solely those of the author and not necessarily those of the Department of Health and Human Services.