Why SNOMED CT? Features, Examples of Use & Benefits

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© Crown Copyright 2011

© Crown Copyright 2011

Why SNOMED CT?

Features, Examples of Use & Benefits

Denise Downs, September 2011

http://www.networks.nhs.uk/nhs
-
networks/snomed
-
ct/about
-
us


© Crown Copyright 2011

Welcome

Useful links:


UKTC website
-

http://www.nhscfh.nhs.uk/uktc




Email
for Data Standards help
desk


datastandards@nhs.net




NHS
Networks


network name: SNOMED CT
http://www.networks.nhs.uk/


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WHY SNOMED CT?

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Electronic Patient Records

Quality Healthcare requires effective
communications

Effective communications need a
common language and a common
structure for humans AND for computers

SNOMED CT allows clinical data to be
recorded in a human recognisable and a
computer recognisable way

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The Current Situation

Electronic
records

ICD
-
10

OPCS
-
4

Read2

CTV3

SNOMED CT


Paper records

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Future Vision

Electronic
records

ICD
-
10

OPCS
-
4

SNOMED CT


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Interoperable


With an agreed structure, data can be passed from one
system to another but only if we use structured records and a
structured terminology

GP makes
referral
to Trust

Discharge
summary
sent to
GP

Choose
and
Book

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Coding systems don’t last

forever

LS1 4YH

020 .....

Read2 is getting full

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SNOMED CT

Can be used by all healthcare domains.

Is a collaborative effort from a number of countries.

SNOMED
CT

Primary
Care

Australia

Secondary
Care

Denmark

Community
Care

Canada

Mental
Health

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SNOMED CT


The chosen terminology for the NHS England

SNOMED
CT

GP’s

Community

Acute

Mental
Health

A&E

Laboratories

Use of
Synonyms
helps cater
for different
expressions
with the same
meaning

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Terminology / Classification


are used to populate a computerised patient
record (EPR) and describe concepts related
to
individuals

and can support the clinical
decision making process

Terminologies


categorise concepts usually relating to
populations

or
groups
of patients and
support business planning and epidemiology
purposes

Classifications

Classifications are intended for population statistics
and analysis.


They are not designed to be used by
clinicians in their recording of data in a patient
record; maps between SNOMED CT and the
classifications are provided as part of the national
product set to support clinical coders in their role

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Any Questions

Please put yourself on mute when not talking. Many Thanks

© Crown Copyright 2011

SNOMED CT

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First things first

College of
American
Pathology


SNOMED RT

NHS


Read
codes
Clinical
Terms V3

SNOMED
CT

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SNOMED RT
CTV3
BOTH
NEW
Source of Concepts in

SNOMED CT 1999

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SNOMED CT


What is it?


SNOMED CT is a clinical terminology



Systematized Nomenclature of Medicine (Clinical Terms)

© Crown Copyright 2011

SNOMED CT


What is it?


SNOMED CT is a clinical terminology



Systematized
Nomenclature

of Medicine (Clinical Terms)



Collection of names and words

© Crown Copyright 2011

SNOMED CT


What is it?


SNOMED CT is a clinical terminology



Systematized Nomenclature of
Medicine (Clinical Terms)



Collection of names and words


Relevant to the field of medicine

© Crown Copyright 2011

SNOMED CT


What is it?


SNOMED CT is a clinical terminology



Systematized

Nomenclature of Medicine (Clinical Terms)



Collection of names and words


Relevant to the field of medicine


Organised in a structured and logically consistent manner

© Crown Copyright 2011

SNOMED CT


What is it?


SNOMED CT is a clinical terminology



Systematized Nomenclature of Medicine (Clinical Terms)



Collection of names and words


Relevant to the field of medicine


Organised in a structured and logically consistent manner


More ‘like’
a thesaurus
than just
a coding scheme

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SNOMED CT Content


Disease and deformity


scar


Symptoms


difficulty breathing


Social


walking aid use


Examination findings


tachycardia

Clinical
Findings


Forces


pressure change


Events


road traffic accident


Organisms


felis

silvestris

(cat)

Causes of
Disease


Laboratory


Therapy / regimes


Investigation


Operation

Procedures

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SNOMED CT Content


Normal


knee joint


Abnormal


ganglion cyst


Lesions


bony callus

Anatomy


Vital signs


blood pressure


Body product properties


normal saliva


Values
-

present

Observations


Drugs and appliances


paracetamol



Substances


latex


Devices


bedpan

Products

© Crown Copyright 2011

Clinical ‘utterances’ are a Concept in the
terminology

mild

moderate

severe

acute

Blood
pressure

exertional

angina

ischaemic

cough

bacterial

viral

finger

toe

phlegm

infection

inflammation

Lung

Sitting
Blood
pressure

von Recklinghausen's bone
disease


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A Concept


Codes and descriptions

Relationships

Is a

Attributes

Qualifiers
& values

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A Concept in SNOMED CT


Heart disease (disorder)
56265001

Relationships

Is a

cardiac
finding

Is a

disorder
of
mediastinum

Is a

disorder
of
cardiovascular
system

Finding site
heart
structure

Severity

Episodicity

Courses

Preferred Term
:
Heart Disease

Synonym
:
Cardiopathy

Synonym
: Disorder of Heart

Synonym
:
Morbus

Cordis

Synonym
: Cardiac Disorder

Synonym:
Cardiac Diseases

Synonym:
Heart Diseases

© Crown Copyright 2011

Bacterial
pneumonia

Infective pneumonia

Pneumonia

Lung disorder

Respiratory

system disease

Disease

Bacterial

Infectious

disease

Infectious
lung disease

Bacterial
LRTI

Lung consolidation

Pneumonitis

LRTI

Bacterial
resp

infection

LRT

Inflammation

Organ

Inflammation

Lower

Resp

Tract

disease

Thoracic Disease

Respiratory

system

inflammation

RTI

Infectious

disease

SNOMED CT

October 2011

© Crown Copyright 2011

The same concept in CTV3


X2003 Disorder of Heart

Relationships

Is a

Cardiovascular
disorder

Finding site
cardiac
structure

Severity

Episodicity

Preferred
: Disorder of Heart

Synonym
: Heart Disease

Synonym
: Cardiac Disorder

© Crown Copyright 2011

A Concept in SNOMED CT


Heart disease (disorder)
56265001

Relationships

Is a

cardiac
finding

Is a

disorder
of
mediastinum

Is a

disorder
of
cardiovascular
system

Finding site
heart
structure

Severity

Episodicity

Courses

Preferred Term
:
Heart Disease

Synonym
:
Cardiopathy

Synonym
: Disorder of Heart

Synonym
:
Morbus

Cordis

Synonym
: Cardiac Disorder

Synonym:
Cardiac Diseases

Synonym:
Heart Diseases

© Crown Copyright 2011

X100H Bacterial
pneumonia

Infective pneumonia

Pneumonia

Lung disorder

Respiratory

system disease

Disease

Bacterial

Infectious

disease

Infectious
lung disease

Bacterial
LRTI

Lung consolidation

Pneumonitis

LRTI

Bacterial
RTI

LRT

Inflammation

Organ

Inflammation

Lower

Resp

Tract

disease

Thoracic Disease

Respiratory

system

inflammation

RTI

Infectious

disease

CTV3

October 2011

© Crown Copyright 2011

Browser Demo


Examples of concepts in a browser

© Crown Copyright 2011

Any Questions

Please put yourself on mute when not talking. Many Thanks

© Crown Copyright 2011

Subsets

What is a SUBSET?


SNOMED CT is extensive


it is supporting a common
vocabulary for all healthcare specialisms, and all healthcare
professionals, as well as keeping up to date with current
practice


A subset is ‘smaller set of SNOMED CT ‘ that meets a
particular requirement


A SNOMED CT subset can be a group of concepts, descriptions
and/or relationships chosen for relevance under certain
conditions or in certain contexts



© Crown Copyright 2011

Subsets

WHY SUBSETS?


it is often desirable to constrain the SNOMED
CT concepts available to a subset, say to help
faster data entry


so for example, all possible
performed procedures in a radiology
department.


© Crown Copyright 2011

Subsets

HOW APPLICATIONS USE SUBSETS



Supports easier navigation


Can be used to limit to specific SNOMED CT
codes


Can act like a ‘favourites’ for the end user


Can be used nationally or locally

synchronised national releases


Access to subsets may be role based

© Crown Copyright 2011

Current Subsets Examples

Allergens

Non
-
human
concepts

Laterality

Radiology
procedures

© Crown Copyright 2011

EXAMPLES OF USE AND BENEFITS

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The World Changes…


Changing demographics, increasing requirements


Wider range of drugs


Greater understanding of medical conditions

Systems need to
support


People use the internet to research


Peoples expectations with regard to knowledge
and care have changed

Changing
behaviour


Care Pathways


NHS Evidence


Map of Medicine

On
-
line
Knowledge Bases
widely available

© Crown Copyright 2011

Summary Care Record


Patient summary record


Contains allergies, adverse reactions, medications
(current repeat, discontinued repeat, acute).
Additional information with patients consent such as
current diagnoses
eg

diabetes, asthma



This SCR clinical data is stored using
SNOMED CT


Provides consistent recording and semantic
interoperability across a mixed coding domain


© Crown Copyright 2011

Patient makes choice of provider with
information support

GP and patient decide that referral
is appropriate, and creates
appointment request

GP produces referral letter as template or dictation

Consultant reviews and
accepts referral

Appt. booked by the patient via internet or phone,
or in the practice

Choose and Book

© Crown Copyright 2011


Cerner


Millennium



iSoft
-

Lorenzo



CSE Healthcare Systems
-

RiO

© Crown Copyright 2011

Across Professions

Across different
specialisms
: orthopaedics,
cardiology, renal, microbiology, histopathology ...

Across primary, secondary, community, social care,
mental health

Synonyms


same concept said in different ways to
support cross discipline working

© Crown Copyright 2011

Communication

‘Connect All’

Seamless transfer
-

coded information to be
electronically communicated
-

without
mapping

Translated into different languages: Spanish,
French, Swedish, Danish ... Work starting in
Lithuanian, Polish

© Crown Copyright 2011

International

Suppliers in different countries using the same terminology

Potential for improved functionality of systems as supporting just one
terminology

Collaborative effort: more cost effective

Links with other international standards


eg
. World Health Organisation

© Crown Copyright 2011

How can I look at SNOMED CT?


There are various free to use browsers
available on the market. Details of those
recommended by the NHS can be found at:


http://www.connectingforhealth.nhs.uk/syste
msandservices/data/uktc/snomed/browser


© Crown Copyright 2011

Learn more about SNOMED CT


Visit: Training & Resources on UKTC website

eLearning

future webinars

Case studies

Documentation

SNOMED CT NHS network

© Crown Copyright 2011

Any Questions

Please put yourself on mute when not talking. Many Thanks

© Crown Copyright 2011

Please take time to complete the Evaluation to
help us improve current provision and identify
additional webinars.



UKTC website
-

http
://www.nhscfh.nhs.uk/uktc



Email for Data Standards help
desk


datastandards@nhs.net



NHS
Networks


SNOMED CT



http://www.networks.nhs.uk/