Abstract: A medical terminology management and translation system that is cloud-based, on-demand, and allows semantic translations of medical terminologies and corresponding healthcare controlled medical vocabularies. A multiple-layer domain structure is provided for the database that designates whether data is to be added or changed, locates where the data exists in the database, and presents the new or substituted data. A semantic data structure and process calculates the probability that an entry matches the particular terminology in a database library and uses the most likely correct answer. Concepts are also employed for particular terminology, handling terms with two or more meanings, and the terminology is mapped according to the concept.