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SNOMED CT-A technologist's Perspective

Explains about SNOMED presence, origin, scope, and benefits.For more information visit: http://www.transformhealth-it.org/<br>

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SNOMED CT-A technologist's Perspective

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  1. SNOMED CTA Technologist’s Perspective Gaur Sunder Principal Technical Officer & Incharge, National Release Center VC&BA, C-DAC, Pune

  2. SNOMED CT Origin • A controlled coded clinical terminology for use in Electronic Health Records • Developed in the USA and the UK by • College of American Pathologists in USA • National Health Service in the UK • Design based on • Identified user requirements • Practical experience • Scientific principles established in peer reviewed publications • First released in 2002 • All rights and administration transferred for the public good to IHTSDO in 2007 • Earlier Systematized Nomenclature for Medicine (SNOMED) – Clinical Terms (CT), now simply SNOMET Clinical Terms

  3. IHTSDO • IHTSDO: International Health Terminology Standards Development Organization • Maintains and delivers SNOMED CT • Licensed to registered Affiliates • IHTSDO does not charge for use in Member countries • Low-cost licenses for institutions in other countries • Free in lowest income countries • Fee waivers for approved research and “Public Good” uses • An International not-for-profit standard development organization • Owned by Nations as Members • Governed by General Assembly of its Members

  4. Worldwide Presence • Currently 27 countries are Members of IHTSDO • The clinical terminology is used in more than 50 countries • India became a member in April 2014 • Represented by e-Governance Division, Ministry of Health & Family Welfare, Government of India • Interim National Release Center (NRC) created at C-DAC, Pune in September 2014

  5. Design Benefits of SNOMED CT • Comprehensive clinical scope • Reduces need to support multiple code systems • Common framework for consistent retrieval and processing • Logical definitions • Allow clinically relevant meaning-based retrieval • Optional post-coordination • Combining codes to add detail and specificity • Increases scope without ‘combinatorial explosion’ of codes • Updates and versioning • Regular updates to International Release (six-monthly) • Support for incremental updates • Full historical view of all previous versions of SNOMED CT

  6. SNOMED CT – Comprehensive Scope • It is the richest vocabulary available to describe clinical findings, diseases, procedures etc. • Contains more than 365,000 concepts, almost 1 million descriptions and nearly one and a half million relationships. • SNOMED CT aims at transmitting all concepts that have been expressed throughout history in the healthcare domain, unambiguously • SNOMED CT concepts are divided into 19 hierarchies

  7. SNOMED CT Design • Every coded concept is linked to related concepts • Multi-axial subtype hierarchy (‘is a’ relationships) • Logical definitions (attribute relationships)

  8. SNOMED CT Basic Components • Concepts • A “concept” is a clinical idea identified by a unique numeric identifier (ConceptID) that never changes • Concepts are represented by a unique human-readable Fully Specified Name (FSN) • Descriptions • Concept descriptions are human readable terms or names assigned to a SNOMED CT concept • Descriptions are of two types • Fully Specified Name (FSN) • Synonym • Descriptions can be Preferred or Acceptable according to the language dialect used • Relationships • Relationships link concepts in SNOMED CT

  9. SNOMED CT Expressions • Precoordinated Expression • Representation of a clinical meaning using a single concept identifier is referred to as a precoordinated expression • Postcoordinated Expression • Representation of a clinical meaning using a combination of two or more concept identifiers is referred to as postcoordination

  10. SNOMED CT Additional Components • Subsets & Reference Sets • A SNOMED CT subset is a set of  Concepts, Descriptions, or Relationships from the international edition that is appropriate to deployment to support particular requirements of implementation • Extensions • The International Edition contains the core content of SNOMED CT. • Extensions can be added to the International Edition to meet specific national or local needs • Cross Maps • Mapping of concepts to other international standards and classifications such as ICD or LOINC

  11. Technical Views • A SNOMED CT Affiliate License is required to obtain the release files • SNOMED CT International Release Files are released biannually (in Jan and July) • Three release file types exists: • Snapshot: containing the current version of every component • Full: containing the complete history of every component • Delta: containing only the additions and changes since the previous release • The snapshot type is recommended to use in applications • All release files are UTF-8 encoded tab-delimited text files • Data in these files need to be imported in relevant tables in database

  12. Integration Approaches • SNOMED CT can be integrated as:

  13. Usage in Software - Search

  14. Usage in Software – Data Entry

  15. Use in Practice • Clinical ideas are complex and interrelated • A form of representation that captures this inherent complexity is essential • SNOMED CT • Provides comprehensive coverage of a broad clinical scope • Is designed based on practical experience & scientific principles • Adds value with a concept model that locates clinical ideas relative to one another in a way that supports computable semantics enabling meaning-based retrieval • Clinicians need to remember the codes as only the descriptions are relevant • Well-engineered EHR systems using SNOMED CT • Provide user interfaces that simplify capture of clinical ideas • Share information taking advantage of the global terminology • Harness the logical design of the terminology to deliver effective meaning-based retrieval

  16. EHR Benefits of SNOMED CT • Enhancing the care of individual patients: • Display of appropriate information • Guideline and decision support integration • Communicating and sharing relevant information • Enhancing the care of populations of patients: • Epidemiology monitoring and reporting • Research into the causes and management of diseases • Supporting cost-effective delivery of care: • Guidelines to minimize the risk of costly errors • Reducing duplication of investigation and interventions • Auditing the delivery of clinical services • Planning service delivery based on emerging health trends

  17. India Updates • 74 Affiliate Licensees issued in first year • 06 Workshops / trainings Conducted • More trainings focused on clinical use and implementations planned • Check official website of India NRC at https://www.snomedctnrc.in

  18. Thank You nrc-help@cdac.in info@snomedctnrc.in

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