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Flexible Clinical Terminology

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Multilingualism for medical data

Since medical and clinical services have moved into the electronic arena, the vast amounts of terminologies and classifications produced, in order to support medical decision making, information exchange and resource management, have far exceeded practical, manageable proportions. GALEN aims to produce a classification and terminology system that standardizes such classifications across a multi-lingual platform.

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Health care, across Europe, has a major barrier in that there is no common, easily defined, single terminology for electronic data. More specifically, this problem is compounded when seeking a multi-lingual platform as terminologies for treatments, procedures and definition of ailments differ considerably from country to country. The lack of coherence in healthcare across Europe prevents a European-wide market in electronic based medical records, decision support, information sharing and resource management which further undermines efforts to construct an across-the-board effectiveness in healthcare management. Health insurance policies, for example, is one area alone which could benefit from a clear, homogenous and systematised classification. GALEN and the OpenGalen system however, are not just another classification programme. There are currently many more such systems than there are practical uses for. GALEN is primarily a technology that seeks to represent terminology in a new way. This has led to the development of the Galen Common Reference Model (GCRM), which in short, represents all, and common, medical concepts in a fashion that is both understandable to the clinician and capable of being manipulated by computer systems-regardless of the platform that they are currently programmed with. This makes GALEN a behind-the-scenes utility, compatible with most platforms currently in use. GALEN is based on GRAIL, the Galen Representation And Integration Language. What GRAIL provides, is far more detailed in scope than other such cross representation facilities currently used, such as the American designed Unified Medical Language system (UML), the Metathesaurus. Whilst the Metathesaurus converses between different coding systems, this is only one of the many functions that GALEN renders. Unlike the Metathesaurus, GALEN is an extendable system, providing in addition, the meaning to cross-referenced codes. Additionally, the Metathesaurus and other such UML's do not provide a classification of organisms into groups based on similarities of structure or origin. GALEN contains thousands of such categories in complex hierarchies, making such categories through the use of GRAIL, which is the formal system used to represent such medical concepts in a form suitable for computers to use. All in all, the GALEN programme involves the Classification Workbench which includes the necessary tools for classification or specialised terminologies, mapping these to or from existing classifications, as well as allowing the reorganisation of this data along alternative axes. It includes the integration environment for harmonising the work done in classification centres, and the multilingual language generation so that results can be viewed in a variety of languages. Furthermore, new languages can be added in a matter of weeks. Currently, GALEN is being used to develop new classifications currently underway in French, Dutch, Swedish, Greek, Belgian and in the UK for the Prodigy prescribing support system. The GALEN and OpenGalen systems are available for demonstration, and more information can be found at:

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