Updated version of SNOMED CT released

12 Aug 2008

The International Health Terminology Standards Development Organisation has announced that a new version of SNOMED CT is now available.

The international release, which is the second this year, has a series of refinements aimed at enabling clinicians to continue working with IT systems with minimal disruption to their daily routines.

Revisions to the international version of SNOMED CT are released twice a year. Each release includes the core of the terminology - concepts, descriptions and relationships - together with works to support the implementation and use of SNOMED CT.

These include subsets, cross maps to existing classifications and coding schemes and an extensive set of guidelines.

The updates are driven by users of the terminology and prior to release, the SNOMED CT content undergoes a quality assurance process. A preliminary version is then pre-released to members for broader review before the final files are generated and distributed.

Enhancements in the new international version include improvements to the definitions of concepts in the specimen hierarchy, allowing automated processes to appropriately place concepts within the hierarchy.

Standard naming conventions and consistent definitions have also been implemented for many new imaging procedure concepts, to allow for easier data retrieval.

The development organisation (IHTSDO) says that adopting standardised naming conventions for imaging procedures will assist SNOMED CT users in retrieving content, while the availability of synonyms for concepts in SNOMED CT will allow clinicians to continue using their preferred terms.

In the pharmaceutical sector, dose forms have been added to many concept definitions, allowing computer-readable definitions. The aim is to improve a clinician’s ability to identify specific drug products that have multiple dose forms and enable decision support systems to more readily differentiate between these forms for treatment, contraindications and adverse effects.

Over 2,000 new organisms monitored by organisations such as the US centre for disease control and prevention have also been added, as well as a new references table, which allows the inclusion of historical information about retired descriptions.

This means that a concept with now inappropriate descriptions can now remain active and only the description is inactivated and referenced to another active concept.

“Consistent, on-time delivery of SNOMED CT releases is critical to IHTSDO Member nations and other users who rely on the terminology in their electronic health record applications,” said Jennifer Zelmer, CEO of the IHTSDO.

She added: “Ultimately, the quality of patient care will be improved by the use of a standardized terminology and electronic health records.”

Link

IHTSDO

Joe Fernandez

Reader's Comments

Why is this newsworthy?

12 Aug 08 18:08

The Read Codes (arguably still the de facto standard in the NHS) used to be released 4 x per year without anyone batting an eyelid.

It's hard to see why is this item considered newsworthy.

So what?

14 Aug 08 21:08

And the impact of this new release is...?

On live systems in use today, and on systems in process of implementation, and on LSP standard issue systems waiting in the wings?

Up-to-date clinical terms, consistently applied, should be a "given" in modern healthcare systems (IT and non-IT). How pervasive is the use, today, of Snomed CT? Vs Read Codes?

SNOMED CT ALLERGENS UK SUBSET

15 Aug 08 13:08

What would be very useful would be a SNOMED CT UK subset file of Allergens (Drugs, chemicals, foods etc.) which could be used to record a patient's allergies and adverse reactions in ALL NHS clinical systems. Is this file available now and if so where can it be downloaded from. Could someone at CfH lead on this please? Thank You.

Re; Allergens subset

18 Aug 08 07:08

And if the subset were to be available, what proportion of current NHS clinical systems would be able to do anything with it?

re: SNOMED CT ALLERGENS UK SUBSET

18 Aug 08 13:08

Since no one had yet answered this poster's (rhetorical) question... there are NHS/UK/NPfIT SNOMED subsets maintained for

1. Allergies and Adverse Reaction Groups 2. Food allergens 3. Non-food substance allergens

probably not coming soon to a system near you ;-)

Any UK individual or organisation can register to download these from the excellent UK Terminology Centre TRUD site

https://www.uktcregistration.nss.cfh.nhs.uk/trud/

Caution: the subsets on TRUD are published in data format unsuitable for casual review.

You can currently view human readable lists of subsets here... http://www.jdet.com/

Posted by someone not from the NHS ;-)

Re:Re: Allergens subset

18 Aug 08 14:08

Back in the late 1980s and early 1990s, many professional groups had developed stand-alone code sets and many of these - including comprehensive lists of allergens - were incorporated into the Read Codes Version 3 during the Clinical Terms Project.

Almost 10 years after the NHS changed direction and started working with SNOMED are we seriously saying that - in real terms - what's currently on offer is downloadable subset files and that widespread integration of SNOMED into clinical systems will not be "coming soon"?

So we've made no progress in almost 20 years? The PAC were pretty quick to criticise the lack of progress in implementing Read 3 in the mid-1990s: perhaps they should take a look at SNOMED?

Re:Re:Re: Allergens subset

18 Aug 08 17:08

>>So we've made no progress in almost 20 years?<<

I wouldn't say that... the Read code IP rights were passed to the College of American Pathologists - who after five years in turn passed them to the IHTSDO.

http://www.e-health-insider.com/news/2407/college_bows_out_of_snomed_development

Meanwhile the UK is still maintaining Read 4-byte, Version 2 and CTV3 plus the UK SNOMED extensions.

Terminology development has been driven forward largely by the belief that a useable electronic medical record and the 'solution' to system interoperability are best delivered by a bigger terminology. The combination of burgeoning size, instability and questionable content coherence have increased the terminology maintenance and implementation burdens for what seems as yet little payback.

Someone will doubtless refer to n billion NHS CfH spine messages passed containing SNOMED codes. However always question whether message content was auto-mapped from another terminology on a one way trip to the great bit bucket in the sky - or whether downstream machine processing actually occurs.

Meanwhile some heretics have insisted all along that an information model precedes a terminology. There are encouraging signs that this message is no longer being ignored. You still however face villification for suggesting that a use case precedes an information model. Maybe give it another 20 years....

Can this really be true?

19 Aug 08 08:08

If I understand the preceding comments correcty:

1. The main tangible progress has been the transfer of ownership through a series of entitites that are increasing remote from the UK NHS.

2. Meanwhile, the NHS is still maintaining several Read Code versions (which are being used) whilst participating in the aspirational SNOMED venture (which has been running for nearly 10 years and which is not likely to see significant penetration in NHS systems for the foreseeable future).

3. We are still awaiting proof-of-concept around the use case(s) and information models for large terminologies.

Oh dear!