Introduction

0.1 General

Healthcare organizations and software vendors are increasingly using maps to convert data from one code system to another. In the past, data in health information systems were largely used for organizations’ administrative planning and decision making. Data captured in electronic health record (EHR) systems for patient care have a significant impact on patient safety. The use of these data as source of data for other purposes and for information exchange in clinical care through the use of information technology is an emerging problem. Where those data are translated through maps from one code system to another, the safety and quality issues associated with data use can be significant. The increasing use of maps is costly.

The objective of this work is to provide a method to quantify the quality and requirements for map sets to:

a) establish standard quality conformance requirements for a map for a purpose;
b) assess the quality of a map for a purpose;
c) guide decision makers in map project requirements and processes;
d) establish pathways to improvement.

Maps are widely used but the quality of these maps cannot be accurately and consistently assessed and compared against their intended use. It is not currently possible for decision makers to assess whether a map will be worth the cost of building and whether the scope and map processes will deliver a map which is able to meet the intended business case.

This document is based on ISO/TR 12300. Some terminological resources are so different in their content and purpose that it is not possible to produce a useful map. Therefore, it is possible that the decision maker needs to consider whether to map at all or to move to a new terminological resource.

Quality measures consider a wide range of requirements and processes relevant to the creation and maintenance of data maps and their use (including manual and tool-based mapping), as well as for the map sets delivered as a result of using that process.

0.2 Stakeholders and audience

This document is focused on the needs of:

a) implementers and software vendors developing and implementing maps sets;
b) health information and data managers developing and using maps sets;
c) data users such as researchers, government, decision makers;
d) developers of map sets in mapping teams, including terminologists, coders, clinical users, epidemiologists and statisticians, project managers.

Additionally, the target audience for this document can include

— procurement officers who establish requirements of map product capacity and quality, or
— decision makers to determine and assess resources needed in projects and services associated with map creation, maintenance, or use.

0.3 Challenges of mapping

Today, maps are being used for a much broader range of use cases and the challenges of their use include the following.

a) Map purpose — it is possible that a map built for one purpose does not suit use for other purposes. It is important to establish the purpose and use of a map at the beginning of a project to ensure the best result when building a map from a source code to a target code. When the purpose changes, the resultant map content is likely to need to be different.
b) Map accuracy — there are three broad aspects to accuracy. The first is map development and maintenance. The second is how closely the results of applying the map deliver an outcome consistent in meaning to that of original source data. The third is the ability to use the outcome of the map for the purpose intended.
c) Map effectiveness — Information retrieval is a critical functionality of maps.

The actual consequence of assigned map links imposed between terms of different code schemes impacts the effectiveness of information retrieval searches. Map purpose and accuracy can impact both the potential safety and appropriateness of the use of that map in healthcare. If the original meaning is changed through use of a map, this can impact clinical safety. There is also the consideration of whether the map is applied consistently to defined data elements in the health record. The data element in which the original source data is recorded can add meaning to the code allocated (e.g. family history of condition versus clinical diagnosis of the individual).

Another significant issue is the cost of creation and maintenance of a map and the ongoing risk and difficulties of maintaining currency of the map.

BS ISO 21564:2025

Health informatics. Terminology resource map quality measures and requirements (MapQual)

Current

Published:

31 May 2025