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Introduction to SNOMED CT presented by Jo Oakes, [email protected] Agenda • • • • • Introduction Where are we now and where are we going? What does SNOMED CT look like? SNOMED CT in more detail Benefits and further resources Introduction ‘Go-compare’ Key Messages • We are seeing the biggest change in healthcare that we’ve seen in years – Care model is going to change – Electronic records are driving improvements in care • Shared care – Wherever the patient goes, the person treating them should have access to key information Key Messages • Analysis of patient data throughout healthcare will be used to improve patient care • IT needed to support the growing knowledge that helps personalised patient care, e.g. NICE guidelines, stratified medicine • This will take time Where are we now and where are we going? Where are we now – Primary care? Where are we now – Secondary care? Where are we now? • Primary care and secondary care are not as well joined up as they could be Primary Care Secondary Care Strategy • Aim for the NHS: Patient centred – patients can view own records • Actions: – Interoperability – move data around electronically – Record once, use many times • All require a common standardised vocabulary 11 Framework for Action • The National Information Board (NIB) document “Personalised Health and Care 2020: A Framework for Action”: – endorses the move to adopt a single clinical terminology – SNOMED CT – to support direct management of care – will actively collaborate to ensure that all primary care systems adopt SNOMED CT during the financial year of 2017 – 2018 12 Framework for Action • The National Information Board (NIB): – States the entire health system should adopt SNOMED CT by April 2020 – During this time, we must also work with local authorities to understand and address the implications of this for social care. 13 Transfer of Care Initiative Any Questions Please put yourself on mute when not talking. Many Thanks What does SNOMED CT look like? SNOMED CT in Action • The following sections contain screen shots from applications that use SNOMED CT • We are grateful for their kind permission to use these as without them it is sometimes difficult to envisage what SNOMED CT looks like in use Moorfields Eye Hospital – Open Eyes software SNOMED CT in Action Click on the drop down list to see a list of common diagnoses which are all SNOMED CT terms SNOMED CT in Action Diagnosis can be selected from a list of common diagnoses which are all SNOMED CT terms SNOMED CT in Action Alternatively type in what you are looking for and a list of SNOMED CT terms containing the text will appear SNOMED CT in Action The same can be done for procedures, select from a list of commonly used procedures which are all SNOMED CT terms SNOMED CT in Action You can also type in the procedure you are looking for and the list that appears will all be SNOMED CT terms NHS e-Referral Service Making an Appointment • GPs can use e-Referral to make appointments for their patients who can then make their decision based on choices such as ease of travel or nearest location SNOMED CT in Action The Clinical Term is selected from a list of SNOMED CT terms SNOMED CT in Action Type in the term to be searched for SNOMED CT in Action A list of terms appears SNOMED CT in Action The selected term is shown below with its parents and children SNOMED CT in Action Select the required term SNOMED CT in Action The selected term then appears in the Clinical Term box CSC Lorenzo Type in what you are looking for and then click on the search button Select the required term Select certainty from the drop down list Find the term you require Select severity from the drop down list Select severity from the drop down list Type in the body site and click to search for it Select body site from the list displayed Select laterality from the drop down list Select laterality from the drop down list Click on add to add the body site Click on Finish to complete save Start to type the procedure you are looking for Click on the search button to display the procedures Click to use the advanced search Children of the term are displayed allowing you to select a more detailed term Select the term to display even more detailed terms Further terms are displayed Select the required term Click on Finish to add it to the record The other fields can be completed in the same way as for diagnosis Click on Finish to complete save SNOMED CT in Applications • SNOMED CT has been implemented in many applications and as has been shown in the previous slides should not make things complicated • Clinicians should just see terms they are familiar with using and not even realise they are SNOMED CT terms Any Questions Please put yourself on mute when not talking. Many Thanks SNOMED CT in more detail SNOMED CT Content Clinical Findings Causes of Disease Procedures • • • • Disease and deformity – scar Symptoms – difficulty breathing Social – finding of walking aid use Examination findings – tachycardia • Forces – pressure change • Events – road traffic accident • Organisms – herpes simplex virus • • • • Laboratory Therapy Clinical Investigation Surgical procedure SNOMED CT Content Anatomy Observations Products • Normal – knee joint • Abnormal – ganglion cyst • Lesions – bony callus • Vital signs – blood pressure • Body product observable – colour of urine • Values - present • Drugs – paracetamol • Substances – latex • Devices – bedpan A Concept in SNOMED CT Fully specified name: heart disease (disorder) Preferred term: heart disease Synonym: cardiac disorder Synonym: cardiopathy Synonym: morbus cordis Synonym: disorder of heart A concept in SNOMED CT 56265001 Fully specified name: heart disease (disorder) Preferred term: heart disease Synonym: cardiac disorder Synonym: cardiopathy Synonym: morbus cordis Synonym: disorder of heart Browser Demo • SNOMED CT browser demo A concept in SNOMED CT Concept Attributes fully specified name preferred term synonyms Relationships A concept in SNOMED CT 56265001 Fully specified name: heart disease (disorder) Preferred term: heart disease Synonym: cardiac disorder Synonym: cardiopathy Synonym: morbus cordis Synonym: disorder of heart Finding site: heart structure Is a – cardiac finding Is a – disorder of mediastinum Is a – disorder of cardiovascular system Disease Infectious disease Disorder by body site Infection by site Disorder of trunk Disorder of thorax Bacterial infectious disease Respiratory tract infection Bacterial infection by site Disorder of lung Lower respiratory tract infection Lung consolidation Pneumonia Bacterial respiratory infection Infectious disease of lung Infective pneumonia Bacterial lower respiratory infection Bacterial pneumonia Success with SNOMED CT Things are normally in the singular, e.g. eye not eyes When searching don’t always use full words, e.g. diab would return both diabetic and diabetes Don’t enter words like “and”, “to” and “the” Success with SNOMED CT Use techniques similar to how you currently search the internet and medical publications Search for significant words and don’t worry about the order, e.g. implant lumbar cath would return implantation of lumbar epidural catheter Try common abbreviations, e.g. PID for prolapsed intervertebral disc 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 or relationships chosen for relevance under certain conditions or in certain contexts Why Subsets? • In an ophthalmic theatre department SNOMED CT Procedures Ophthalmic procedures 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 Current Subsets Examples Allergens Diagnoses Laterality Radiology procedures Any Questions Please put yourself on mute when not talking. Many Thanks Benefits and further resources Across Professions • Across different specialisms: orthopaedics, cardiology, renal, microbiology, histopathology ... Cardiology Across Professions • Synonyms – same concept said in different ways to support cross discipline working Patient – black eye Nurse – bruise of eye Clinician – contusion of eye Across Professions • Across primary, secondary, community, social care, mental health Primary Care Mental Health Patient Data Community Secondary Care Communication – “Connect all” • Seamless transfer - coded information to be electronically communicated - without mapping Primary Care Mental Health SNOME CT Data Community Secondary Care Communication – “Connect all” • Translated into different languages: Spanish, French, Swedish, Danish ... Work starting in Lithuanian, Polish morphine allergy morfin allergi 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 How can I look at SNOMED CT? • There are various free to use browsers available on the market. Details of those that support the UK Edition of SNOMED CT can be found in the UKTC: • Free to use browsers Learn more about SNOMED CT Visit: Training and Resources on UKTC website eLearning Webinars SNOMED CT NHS network Documentation Case studies Any Questions Please put yourself on mute when not talking. Many Thanks UKTC Website SNOMED CT Training and Resources www.digital.nhs.uk @nhsdigital For Information Standards Service Desk call 0300 303 4777 or email [email protected] [email protected] 0300 303 5678