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SNOMED CT
Denise Downs
Knowledge Management & Education Lead
Data Standards, Technology Office
Department of Health Informatics Directorate
Why a terminology?
Common vocabulary across the UK required for data communication
SNOMED CT is the NHS mandated terminology for clinical and data
interoperability
Applications such as Summary Care Record, Choose and Book,
ePrescribing use SCT for recording clinical data (DM&D part of
SCT release)
New messaging requirements such as microbiology requests and
results will use SCT
With a common terminology other ‘services’ such as NICE, NHS
Evidence, Map of Medicine ... all looking to tag using SCT
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Why SNOMED CT?
(SCT)
• Current coding systems not scalable, maintainable, or accurately
used – and content dated
o eg. 587 terms in ICD in relation to accident caused by a pedal
cycle
o Only something like 3000 terms used in any one year
•V12.24 Pedal cyclist injured in collision with two- or three-wheeled
motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting,
sleeping, eating or engaging in other vital activities
•V31.22 Occupant of three-wheeled motor vehicle injured in collision with
pedal cycle, person on outside of vehicle, nontraffic accident, while
working for income
•W65.40 Drowning and submersion while in bath-tub, street and highway,
while engaged in sports activity
•X35.44 Victim of volcanic eruption, street and highway, while resting,
sleeping, eating or engaging in other vital activities
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Why SNOMED CT?
(cont)
• International
o 12 countries collaboratively developing and growing
o Includes USA, Canada, Australia
o Also non English speaking, and being translated
• Rich terminology not just list of codes
o Provides for more sophisticated searching, reporting,
investigation
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Optometry and SNOMED CT
There is a large amount of content relevant to Optometry in SCT –
needs verifying by Optometry domain experts
Descriptions may need enriching to support optometry – remember
SCT is international, concept is unique but can have additional
descriptions
May need some new concepts adding – there is a request
mechanism
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SCT Submission request process
There is a request process for new concepts to be added to SCT
You need to register on the site
It is helpful for these to be well formed requests
https://www.uktcregistration.nss.cfh.nhs.uk/requests/myRequests.jsf
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Subsets
SCT contains over 500,000 terms – not all relevant to Optometry
Subsets ‘hold’ concepts within SCT that are relevant to a particular
specialism – ie most regular used vocabulary – can be used
within software to support pick lists etc on forms
Subsets usually developed by a group; sometimes brought together
through a Royal College or Association; to provide an area
domain subset used by all suppliers within that domain
Development of Subsets – ideally via ‘rules’ – as SCT is not static
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Some considerations:
Patient Identification - and how to make referrals into the NHS,
checking medications of own patients if required
What is required ‘outside’ immediate practice as well as within
eg. Accepting referrals, government required statistics, care
pathways (diabetes), reporting ....
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Next Steps ...
Identify use cases .... what to record, why, what messages needed
to go out of system and what will be received
Undertake analysis - requirement for structured data, messages
indicates record in SCT, data for re-use is prime candidate for
SCT coding - and hence need for SCT usually ‘drops out’ of
analysis – free text in systems usually for data not to be re-used
Agree commonality for shared data elements in data model, consult
other work such as LRA
Subsets – do as collaboration and share, identify owner and need to
keep subset current as new concepts added (why rules help)
Take account of existing research and work – both locally and
internationally that can inform eg diabetic retinopathy
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