This articles answers the often asked questions What Is The Omaha System and What Does It Offer You?

Do you:

  • Have little time to set everything else aside to research standardized terminologies and EHRs?
  • Need to be shown the criteria a standardized terminology should meet in order to fulfil your requirements?
  • Want the tools to find the terminology that meets that criteria?

Then you might have already heard of the Omaha System.

What makes the Omaha System a good standardized terminology?

One example of a standardized terminology that not only achieves these benchmarks, but exceeds them, is the Omaha System.

The Omaha System is a standard terminology that provides interoperability and communication across the continuum of community health, for:

  • Clinicians
  • Administrators
  • Educators
  • Researchers

The Omaha System originated as a product used by nurses in public health and home health settings.

While it has expanded to use by multiple types of health practitioners, administrators, educators, and researchers alike, it was designed to address your public health needs.

Why is the Omaha System so highly regarded?

The Omaha System was one of the first clinical nomenclatures to be developed, and is so highly regarded because it is:

  • Research based
  • Created specifically to describe community health care
  • Designed to be used in electronic documentation systems

The Omaha System is also highly regarded as it has been extensively tested for reliability and validity.

The Omaha System can be divided into 3 components

So, what is the Omaha System?

The Omaha System is composed of three essential components to describe care.

1. Problem Classification Scheme

In a nutshell, the Problem Classification Scheme organizes 42 problems / needs / foci of care across four domains:

  • Environmental
  • Psychosocial
  • Physiological
  • Health‐Related Behaviors

Clinicians use the Problem Classification Scheme as a guide for assessment of client needs.

The need can be at multiple levels including:

  • Individual
  • Family
  • Community

Problem label examples include:

  • Income
  • Communication with community resources
  • Caretaking /parenting
  • Growth and development
  • Hearing
  • Skin
  • Respiration
  • Pregnancy
  • Communicable / infectious disease
  • Substance use
  • Medication regimen

Problem‐specific lists of signs / symptoms and additional problem modifiers allow for accurate and highly descriptive client assessments.

2. The Intervention Scheme

The Intervention Scheme is the clinician’s toolbox and allows you to describe the care you provide for your clients to address problems, whether that is on an individual or family basis or in the community as a whole.

The scheme is composed of 75 ‘targets’ of care that can be used for any problem and under any of four intervention categories:

  • Surveillance
  • Treatments and Procedures
  • Teaching, Guidance and Counselling
  • Case Management

Target examples include:

  • Anatomy / physiology
  • Caretaking / parenting skills
  • Dietary management
  • Dressing change / wound care
  • Infection precautions
  • Legal system
  • Substance use cessation
  • Transportation  

3. Problem Rating Scale for Outcomes

Last, but just as important, is the Problem Rating Scale for Outcomes

Clinicians use the scale to rate the Knowledge, Behavior, and Status of the client related to each problem opened for care.

Ratings are done at admission, discharge, and at defined intervals in between (as dictated by agency practices) to evaluate client progress and outcomes.

Each measure of Knowledge, Behavior, or Status is based on a 5 point Likert scale and is easily performed by users with a high rate of inter‐rater reliability.

What does the Omaha System offer you?

The Omaha System is an interdisciplinary language that can be used to describe the services provided across your agency.

It is a leader among similar taxonomies in meeting the demanding criteria necessary for the meaningful and use of data into electronic health records.

You want a standardized terminology that accomplishes everything this article has discussed.

You can read more about the Omaha System, and a valuable overview of the system, publications, FAQ’s, case studies, references, links, upcoming events, and the Omaha System Listserv.

And check out the ‘Helpful Links and Resources’ section of the website for even more information about standardized terminologies and Omaha System users.

What has the Omaha System achieved?

The following is a list of criteria that the Omaha System has achieved, feel free to use it as a measuring rod as you continue in your research of standardized terminologies:

✔ Passed the Healthcare Information Technology Standards Panel (HITSP Tier 2 selection criteria for Use Cases in 2007)

✔ Approved by the US Department of Health and Human Services interoperability standards as terminology for EHRs

✔ Recognized by the American Nurses Association (ANA) as an approved standardized terminology since 1992

✔ Consistent with the reference terminology model for the International Organization for Standardization (ISO).

✔ Registered by Health Level Seven (HL7®).

✔ Member of the Alliance for Nursing Informatics (ANI ) since 2009 (its users remain on the cutting edge of community health informatics).

 ✔ Integrated into the following:


Now you know more about the Omaha System, what information it can provide, why it is so highly regarded and what it has achieved, you’ll want to make sure that your EHR is built on the Omaha System.

Nightingale Notes is.

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