Take Ms Magazine, Master of Science, Microsoft, just to name a few. Now step into an EMR.
I have seen the abbreviation MS used in the medical record so many ways. Here are just a few:
• Morphine Sulfate
• Magnesium Sulfate
• Ms. (as a term of address like Mr. and Mrs.)
• Mississippi
• Millisecond
• Mental Status
• Mandibular Series (X-ray order)
• Mitral Stenosis
• Musculoskeletal
• Medical Student
• Multiple Sclerosis
• Motor Strength
To a computer, the same 2 letters can mean vastly different concepts, including medications, demographics, diagnoses, procedures, and measurements. Furthermore, the 4000 mg of morphine sulfate used to treat preterm labor, would be a fatal overdose of morphine sulfate in a routine post-op patient (where 10 mg is often a sufficient dose to treat severe pain).
We’ve certainly come a long way in diminishing the use of unsafe abbreviations (thanks in large part to JCHO regulations), but the fact remains that clinicians continue to mix standard and vernacular terms in their daily lives. Even if we could successfully map disparate terms, what happens when a new instance of “MS” is used—Menkes Syndrome, motile sperm, mass spectrometry?
The point I am raising is not about abbreviations, it is about how we use terminology and symbols to represent reality in vastly different ways.
It is fascinating to realize how the human brain can actively discern truth through the use of context. By understanding the association of terms or abbreviations to specific metadata, a semantic neighborhood can be constructed that allows machines to begin delineation of context as well.
For instance “MS” in the context of an echocardiogram report clearly represents “mitral stenosis,” and “MS” in a nerve conduction study might represent “milliseconds.”
It is vital that we begin to address the huge challenge of semantics in healthcare.
There are over 540,000 words in the English language (5 times more than during Shakespeare’s time), and technical information is doubling every two years.
Meanwhile, the desire to share data is rapidly becoming a mandate in healthcare. The term “meaningful use” is becoming a buzzword. Let’s just make sure that in this avalanche of data, that we find “meaning in full use.”
