Congratulations Betsy Humphreys!

Apelon congratulates Betsy Humphreys on her appointment as Acting Director of the National Library of Medicine. Betsy has been a leader in interoperability and in advancing the science and the adoption of controlled vocabulary throughout my informatics career. When Apelon (in the person of our predecessor Lexical Technology) got involved in the initial efforts leading to the Unified Medical Language System (UMLS), Betsy was a firm hand on the wheel, keeping the project grounded in practical reality rather than allowing some of the more “novel” ideas to drive the project back into the bowels of a university. Today, working not only inside NLM but also on the national and international stage, she continues to advocate for an information ecosystem that makes sense for patients and providers.

Read More

DTS 4 Production Release, Now Available

Apelon is very pleased to announce general availability of Version 4.0 of the Distributed Terminology System (DTS). For over fifteen years, DTS has been the industry’s leading vocabulary server supporting the creation, maintenance and deployment of healthcare terminologies. Recently made available as an open source project, DTS is a comprehensive solution for the deployment of standardized terminologies, with local enhancements, into distributed application environments. DTS creates a platform for robust data standardization and interoperability for EHRs, HIEs, and decision support systems by establishing a single common resource for an organization’s terminology assets. Being open source, DTS also provides significant cost, integration and adoption advantages compared to proprietary solutions.

DTS Version 4 is a major new release that enhances both functional capabilities and ease-of-use. Key features include:

  • A New Enterprise Architecture – The DTS server has been completely rewritten to use Enterprise JavaBeans 3 (EJB) and Service Oriented Architecture (SOA). This architecture simplifies many operational aspects of DTS and provides enhanced security and transaction options. Comprehensive web service, Java, and .NET APIs are available and most popular backend RDBMS systems are supported.
  • Versioning – Version 4 extends the DTS Object Model to support the complete history (versioning) of Namespaces and Subsets: e.g., what did SNOMED CT look like in 2009? Search and browse functions can specify the desired version/date and concept comparison and full historical views are supported. Locally-developed Namespaces and Subsets can be “published”, creating a new, finalized version for distribution while enabling development to continue on the “working” version.
  • New Metadata – User-definable metadata can now be added to Namespaces, Versions, and Authorities. Metadata additions are available for both Subscription and Local DTS Objects.
  • Enhanced Subsets/Value Sets -Subset Expressions are significantly more expressive supporting multiple namespaces and/or subsets, specification of Namespace and Subset versions, and support for association-based hierarchies for Thesaurus Namespaces.
  • Role-based access control.
  • New Browser Implementation – Version 4 introduces a new DTS Browser, based on the JavaServer Faces 2 architecture and RichFaces 4 framework. This new framework will support enhanced web browsing and migration of editing functions to a web platform.
  • Editor Module Architecture – The DTS Editor provides extensive support of Version 4 features. The Search, Browse and Detail panels, for example, all support one-click selection and viewing of version snapshots of DTS objects. The Version 4 DTS Editor extends its popular Plug-in Framework to a new Module Framework making all Editor functionality available through independent Modules; the Editor layout can be completely customized for specific user requirements. Role-based access control has been added and the Editor has been enhanced for internationalization; prompts and messages have been relocated to a Locale-dependent Resources file permitting translation of the GUI into many non-English languages.

For existing DTS users, the DTS API is fully backwards compatible, and a Migration Utility is available for transferring local content from DTS Version 3.5.2. See theDTS 4 Installation Guide for further information.

DTS Version 4.0 is ready for your evaluation, testing and deployment at We look forward to your feedback

Read More

DTS 4.0 Alpha 3 Release, Now Available

We’re very pleased to announce availability of the DTS 4.0 Alpha 3 release. The Alpha 3 release is the final Alpha release of DTS Version 4. The next release will be a full functionality Beta release available this summer. New features in Alpha 3 include enhanced DTS Subsets, Namespace Root specification, and Namespace and Subset Publishing.

Version 4 adds significant new functionality to DTS Subsets. Like Namespaces, Subsets now can have Properties and are versioned. Subset Versions themselves can have Properties and the Subset Expression is associated with a Version. Subset Expressions are also much richer, supporting multiple Namespace and Subset filters in addition to the familiar Concept, Concept Name and Attribute Filters. Namespace and Subset filters can also be nested under other filters. Descendant and Children options in the Concept Filter are now available for Thesaurus Namespaces (using the “Parent Of” association).

For a full list of the new features and additional information on DTS 4.0 or to download the Alpha 3 release, visit

Read More

DTS 4.0 Beta 1 Release, Now Available

We are all very excited about the release of a full-functionality build of DTS Version 4. The feedback from our early adopters has been very positive, validating the extensive effort to create a next-generation vision for DTS. While development on Version 4 will continue, to correct outstanding bugs and complete documentation, we do not expect any major functional changes.

You already know the major features of Version 4: J2E architecture, web service APIs, version management, metadata and new Subset/Value Set capabilities. These capabilities get most of attention. But what excites Dr. DiTS, are the new features of the DTS Editor. Since these don’t get the publicity of “the big guys”, we are pleased to share Dr. DiTS’sTop Ten Things to Try in DTS 4. Next time you’re in the Editor give these a try.

  1. Don’t like clicking on Connect all the time? Check the “Auto-connect …” box in the Connect Parameters dialog and DTS will automatically connect to your database when it starts.
  2. Would you like the Tree panel display to use another display name, or sort differently? Right click in the panel and select the Tree Config option. Display SNOMED using the Preferred Term, or ICD-9-CM using its Code in Source.
  3. Want to see where a Concept fits into a hierarchy? Drop the Concept into the Tree panel’s main window (not the Focus box).
  4. Need to review a large number of Search matches? Page through the matches using the arrows at the bottom of the panel. And check out the result Tool Tips to see where the match occurred (especially helpful on Synonym and Attribute searches).
  5. Wondering what Concepts use a Term? Drag the Term into the Detail panel (maybe from a Concept Synonym) and view the Inverse Synonyms.
  6. Don’t want to have to right click to edit Attributes in the Detail panel? Double click on the Attribute to open the Attribute’s editor.
  7. Need to add a new Root Concept to your Thesaurus Namespace? Drag the Namespace into the Detail panel (or open the Namespace Editor panel), right click on the Working Version and select Add Root.
  8. Want to get a hardcopy of a Concept’s contents? Right click on Concept’s name in the Detail panel and select Print Details.
  9. Need to create a sophisticated Value Set? Use the Subset Editor to create an Expression that includes two different Namespace Filters. Or two Subset Filters. Or even one that excludes one Subset from another Subset.
  10. Want to change the string associated with Copy on a Concept Name? Open the Set Clipboard Formats panel from the Options menu and add the Concept’s Namespace name to the format.
  11. Have to see how SNOMED Concepts have changed over time? Drag a Concept into the Concept History panel to see attribute changes across all versions or into the Concept Compare panel for a detailed comparison between two versions.
  12. Tired of the same old DTS Editor layout? Edit dtslayout.xml in bineditor to remove some panels or build an alternate 2×2 panel structure.
  13. Learning a new language? Create a French DTS Editor by translating in the lib directory. Or see how DTS looks right-to-left by creating a Hebrew translation. Check out the sample screen shot below and see theInternationalizing the DTS Editor document for more info.

Okay, so Dr. DiTS couldn’t keep it to just ten.

That’s it for this month. Time to get back to DTS 4! 

Read More

Health Level 7 Letter to the US Senate

Yesterday, Health Level 7 sent a letter (read the entire letter by clicking here) to the US Senate HELP Committee, which is thinking about interoperable electronic health records. 

The letter offers four high-level recommendations, as follows:

  • Focusing on business cases and return on investment (ROI) objectives first;
  • Requiring pilot and demonstration projects before national mandates of standards and implementation guidance;
  • Ensuring national health information technology standards development organizations (SDOs) are engaged in the development of health IT standards guidance, along with other stakeholders from patient, provider and industry groups; and
  • Establishing a minimum floor for standards and implementation guidance.
In our consulting engagements, we are often asked to help our clients navigate the standards development process. It usually starts with an incredulous question: how do we possibly get from the high-level statements above to a much longer and more difficult set of implementable criteria in a FHIR resource or an IHE profile where the correct SNOMED CT terms appear in the correct value sets with the correct cardinalities attached to the correct set of documentation choices? It seems like such a big gap to bridge, and we have products to build now.


There’s no single answer, but we advise our clients to base their standards implementation efforts on a set of criteria pretty similar to what HL7 is recommending to the Senate. Go slow, choose carefully, but make a choice and go. The combination of government actions to set a policy direction, standards development to create the necessary artifacts, and market forces for reimbursement and quality, all work together to create better and better resources for high-quality documentation based on standards.


Standards implementation success isn’t necessarily linear, nor always quick. Without good guidance and a clear strategy, it’s still possible for a vendor to bet on the wrong standards, or implement a standard only to discover that they’ve negatively affected user satisfaction. Nonetheless, the long-term trend is for electronic health data to be more shareable, more standards-based. The train is still moving relatively slowly, but as it speeds up it will be much harder for data-silo’ed vendors to jump on.
Read More