A commitment to grow social determinants of health content within SNOMED CT Back 9 Sept 2020 Back Achieving health equity is a priority item for health systems globally. Collective international interest has heightened awareness and recognition of the pressing need for action. Health inequity is the difference in health that results from the living and working conditions people experience, particularly relevant among vulnerable populations. A serious and growing public health issue locally, nationally and globally, social determinants of health contribute to health inequity, with these factors ranging from early child development and education to working conditions, food security and income, gender, race and housing, etc. On average, no fewer than 17 social determinants have been identified as capable of impacting an individual’s health. SNOMED International is committed to supporting the reduction of health inequity through developing and managing social determinants of health content within SNOMED CT’s clinical terminology. To maximize accessibility of this content, SNOMED International plans to include all social determinants of health content within the organization’s Global Patient Set , a managed list of existing SNOMED CT unique identifiers, fully specified names, preferred terms in international English, and status flags, made openly available for global use. Social Determinants of Health and SNOMED CT’s Clinical Terminology A strategic direction for the ongoing evolution of SNOMED CT over the next 5 years is facilitating improvements in patient outcomes and meeting the needs of integrated health and social care systems in a sustainable fashion. Defined as part of our strategic plan for 2020-2025, SNOMED International has initiated a project to gather requirements from stakeholders to enhance social determinants of health content coverage within SNOMED CT, while assessing its structure and placement within the SNOMED CT hierarchy. Core to this approach is addressing existing gaps in SNOMED CT content to meet user requirements for electronic health records. What is the practical use of this expanded content? Once complete, SNOMED CT enabled systems will be equipped with the ability to record a person’s social and environmental status as factors to be considered in care planning and provision of related services. Once captured using SNOMED CT, clinicians, researchers and policy makers can benefit from leveraging encoded health records for numerous avenues of analysis and for development of evidence-based practice, clinical guidelines and policies. What has this project yielded so far? Early analysis of SNOMED CT’s 350,000+ concepts indicates good coverage of concepts related to aspects of social determinants of health arranged across various hierarchies in no particular order for the content area. Early phases of the project indicate that SNOMED CT is already representative of ~4,700 items of relevant content. This analysis is encouraging as SNOMED CT has a significant head start in building out social content to support this globally prevalent issue through SNOMED CT and the openly accessible Global Patient Set. In terms of what remains within the scope of the project slated to continue into 2022, outlining and confirming how social determinants of health content is used within the clinical record is critical to determining its structure and placement within the SNOMED CT hierarchy, and where gaps persist. Collaborating Globally: The Gravity Project The Gravity Project was initiated in November 2018 by The Social Interventions Research & Evaluation Network (SIREN) and is a direct response to calls to action around creating national standards for representing social determinant of health data in electronic health records in the United States. Taking a consensus-building community approach, the Gravity Project has convened broad stakeholder groups, including SNOMED International, to identify and harmonize social risk factor data for interoperable electronic health information exchange. The project seeks to identify coded data elements and associated value sets to represent social determinants of health data documented in EHRs across four clinical activities: screening, diagnosis, planning and interventions across three specific social risk domains: food insecurity, housing instability and quality, and transportation access. Continuing beyond 2020, the outcomes of the Gravity Project will serve to inform the continued development and placement of this content within SNOMED CT, along with other sources of analysis and contribution. Approaching Social Determinants of Health Content: Next Steps This project represents SNOMED International’s commitment to advancing this area and is our first step in determining broad representative social care content for our global audience. The organization is currently engaged in requirements gathering; and content development and hierarchy restructuring will be ongoing into 2022. Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

In Memoriam: Management Board Chair Lady Barbara Judge CBE Back 4 Sept 2020 Back Since the date of issue, this information is now out of date and has been archived. It has been made available for reference. London, United Kingdom – It is with sadness that we announce that our Management Board Chair, Lady Barbara Judge CBE, has passed away after a battle with pancreatic cancer. Lady Judge was an advocate for women’s rights in both her personal life and a professional career that spanned law, banking, regulation and nuclear industries. Appointed the youngest commissioner at the US Securities and Exchange Commission, the first female director at News International, the first woman to be appointed an executive director of a British merchant bank, the first woman on the Board of Overseers of the Wharton School of Management , and the first woman to chair the UK’s Institute of Directors, Lady Judge broke barriers in these sectors and encouraged other women to strive for similar achievements. We were obviously both honoured and delighted when Lady Judge agreed to join SNOMED International as Management Board Chair in April 2017, harnessing her corporate governance acumen to improve patient health outcomes through terminology-enabled digital health initiatives. As a result of her highly effective contributions in this role, she had been invited to continue as Chair until October 2023, something she gladly welcomed. Throughout her tenure at SNOMED International, she led the organization to strive for innovation and excellence in our governing practices, while serving as a mentor to all whom she worked with. Her mentorship was not, however, confined to the boardroom, Barbara had an infectious sociability and encouraged informal gatherings where people could be themselves and exchange ideas on almost any topic. Lady Judge was also committed to raising awareness of pancreatic cancer and to supporting research efforts to better understand and treat the disease. She took time in her last weeks to record a video in which she shares her experience with pancreatic cancer and exhorts others, who may not act sufficiently quickly to obtain medical attention, to do so before the cancer is too advanced. This moving video can be viewe d here . As will so many people around the globe, we shall miss her very much and, on behalf of the organization that she served so faithfully for the past four years, SNOMED International extends its sympathy to Lady Barbara’s family. Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

SNOMED International SIGs embrace clinical engagement with Clinical Reference Groups Back 13 Apr 2017 Back For more information on SNOMED International's Clinical Reference Groups, please review our clinical resources . To enable continuous development of SNOMED CT, it is critical that its clinical content is relevant and up to date. To do this, SNOMED International relies on input from clinicians and clinical groups internationally. Given the significance of this relationship, SNOMED International, in consultation with its Healthcare Professional Coordination Group, made a decision to cease using the existing Special Interest Groups (SIGs) approach for clinical engagement along with a move to a virtually supported model. All clinical engagement activities undertaken by SNOMED International’s Clinical Engagement Team will flag prospective contributing contacts to a relevant Virtual Clinical Group. Why should clinicians continue their contributions as SIGs transition to Clinical Reference Groups? Engaging via Clinical Reference Groups provides clinicians with a mechanism to ensure that the content required by clinicians is included in SNOMED CT quickly and accurately. The Clinical Reference Groups model supports collaborations with external partners (professional groups and organizations, etc.) through the use of project groups where the collaboration has a specified deliverable, before transitioning to an editorial group to provide ongoing clinical validation. The model of Clinical Reference Groups will also support specifically focused work, bringing together groups with a common interest such as developing or migrating to a SNOMED CT based registry that is needed internationally. The SIGs will formally retire April 13, 2017 with the launch of the Clinical Reference Groups. Please visit the Clinical Participation homepage to learn more, or email info@snomed.org with your questions regarding approach and participation. Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

This is our experience in standardizing nursing records within the Korean Multi-Institutional Multi-modal Intensive Care (K-MIMIC) dataset, a Korean intensive care EMR database, using SNOMED CT. By comparing AI-based clustering results with classifications by clinical nursing experts, we explored the feasibility of AI-human collaboration in structuring nursing documentation and discussed practical implications for implementation. Back View Map Gangneung-Wonju National University Standardizing Nursing Records in K-MIMIC Using SNOMED CT: Exploring the Potential for AI-Human Collaboration Read More Country / Region APAC Tags Artificial intelligence, Clinical Practice, Innovation, Mapping, Research This is our experience in standardizing nursing records within the Korean Multi-Institutional Multi-modal Intensive Care (K-MIMIC) dataset, a Korean intensive care EMR database, using SNOMED CT. By comparing AI-based clustering results with classifications by clinical nursing experts, we explored the feasibility of AI-human collaboration in structuring nursing documentation and discussed practical implications for implementation. Description This study aims to structure and standardize free-text nursing records from the K-MIMIC dataset, which contains electronic medical records from Korean intensive care units. A total of 19,511 nursing phrases were collected. To perform clustering, we used sentence-level embeddings generated by three pretrained language models: Sentence-BERT, PubMedBERT, and S-BioBERT. Each phrase was embedded using these models, and semantically similar terms were grouped using the K-Means algorithm. We also examined the effect of translating Korean nursing phrases into English prior to embedding. The resulting AI-generated clusters were compared with classifications created independently by five experienced clinical nurses with 4, 5, 9, and two with 11 years of experience. This comparison was conducted to evaluate the clinical alignment and semantic accuracy of AI-derived clusters, assess the potential for semi-automated terminology mapping, and explore their suitability for integration with SNOMED CT. Scope SNOMED CT was chosen due to its comprehensive clinical coverage, including nursing domains, and its ability to support international interoperability and multilingual usage. Its alignment with global standards makes it well-suited for structuring Korean EMR data for both local implementation and international collaboration. How SNOMED CT will be used Nursing concepts identified through both AI clustering and expert review were mapped to SNOMED CT concept IDs. We utilized SNOMED CT's hierarchical structure and concept definitions to ensure semantic consistency and clinical relevance. The mapping process aimed to establish a foundation for structured nursing documentation and enhanced interoperability across systems. Why SNOMED CT will be used Contact More information Learn more Get SNOMED CT Information about our license and fee structure Learn more Learn more Explore the wide range of resources available to our community of practice Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

The territory-wide, patient-oriented Electronic Health System (eHealth) of Hong Kong, China was launched in March 2016. Hong Kong, China The territory-wide, patient-oriented Electronic Health System (eHealth) of Hong Kong, China was launched in March 2016. Contact Details Secretary for Health 18/F, East Wing Central Government Offices 2 Tim Mei Avenue Tamar, Hong Kong, China Website: http://www.ehealth.gov.hk Appointed Representatives General Assembly: Veronica Hung Member Forum: Austen Wong News articles The Hong Kong Clinical Terminology Table (HKCTT) was developed by integrating international terminologies commonly used in Hong Kong, China, including SNOMED CT to ensure shared health data can be accurately interpreted for supporting the interoperable eHR. The NRC has actively promulgated the use of HKCTT and it is widely adopted by eHealth healthcare providers in Hong Kong, China to record and transmit clinical information. In addition to being made available for use in eHRs, public health research and other applications, HKCTT is mapped to SNOMED CT and made available to end-users online or offline means, and through incorporation into end-user software applications. Hong Kong, China will continue to develop and maintain content that is specific to the needs of the territory-wide eHR for the better delivery of healthcare services to patients. As one of exploration trial initiatives, SNOMED CT is used in Hong Kong, China to generate clinical alert for suspected cancer cases. With the adoption of SNOMED CT, it is hoped that alert can be sent to clinicians for timely actions such that it can enhance patient safety and facilitate pathology result management. In addition, SNOMED CT is being used to support self-service data retrieval on microbiology / virology and histology data at the Hospital Authority who manages 43 public hospitals. More information about SNOMED CT in Hong Kong, China can be accessed here: http://www.ehealth.gov.hk Back Learn more Global Patient Set Built from the globally recognized SNOMED CT terminology standard at no cost to users Learn more Get SNOMED CT Information about our license and fee structure Learn more Software and tools We develop and operate applications platforms to support our products and services Learn more Document library Access overviews, guides and specifications Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

Both the Netherlands Comprehensive Cancer Organization (IKNL) and Dutch Institute for Clinical Auditing (DICA) collect patient data concerning esophageal and gastric cancer, albeit with different primary purposes‚ÄîIKNL for statistics and research and DICA for auditing and research. To enhance the efficiency of data collection, IKNL and DICA have initiated a joint effort to harmonize their registries. This poster presents the methodology used to align these registries with electronic health records (EHRs) and describes how SNOMED CT contributes to the standardization of their datasets, enabling consistent and streamlined clinical data reporting. Back View Map IKNL (1 of 2) Efficient and unified cancer data collection: The role of SNOMED CT in linking registries and electronic health records Read More Country / Region EMEA Tags Collaboration, Data analytics, Data quality, Mapping, Research Both the Netherlands Comprehensive Cancer Organization (IKNL) and Dutch Institute for Clinical Auditing (DICA) collect patient data concerning esophageal and gastric cancer, albeit with different primary purposes‚ÄîIKNL for statistics and research and DICA for auditing and research. To enhance the efficiency of data collection, IKNL and DICA have initiated a joint effort to harmonize their registries. This poster presents the methodology used to align these registries with electronic health records (EHRs) and describes how SNOMED CT contributes to the standardization of their datasets, enabling consistent and streamlined clinical data reporting. Description This research focuses on the harmonization of the overlapping items between two national registries‚Äîmanaged by the Netherlands Comprehensive Cancer Organization (IKNL) and the Dutch Institute for Clinical Auditing (DICA)‚ that collect data on patients with esophageal and gastric cancer. The aim is to align these datasets while simultaneously standardize clinical terminology (among others SNOMED CT) and prepare (future) integration with electronic health record (EHR) systems. This will enhance data interoperability, minimize redundancy, and enable more effective use of clinical information for research, auditing, and reporting purposes. Ultimately this will also contribute to a reduction of the registration burden and an improvement of data quality. Scope The Dutch government decided that SNOMED-CT should be implemented as a standard in electronic health records (EHR). Our goal is to prepare for (future) integration with electronic health record (EHR) systems and therefore it was investigated how SNOMED CT can contribute to standardization of the harmonized data set. How SNOMED CT will be used SNOMED CT is used in the new proposals for the harmonized data set. Why SNOMED CT will be used Contact More information Learn more Get SNOMED CT Information about our license and fee structure Learn more Learn more Explore the wide range of resources available to our community of practice Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

IHE International Back IHE International Standards Partner In April 2019, IHE International and SNOMED International formally announced a license agreement encouraging data consistency and interoperability across international boundaries, with benefits for clinical care, research and operational efficiency. Additional information Through this agreement, the organizations have agreed on the production of a SNOMED CT IHE Set which includes a jointly decided upon set of SNOMED CT concepts and identifiers within IHE profiles. By placing the SNOMED CT codes referenced in IHE profiles under a free international license, the current agreement reduces incentives for national groups to specify variant code sets based on other terminologies. The SNOMED CT value sets specified in IHE profiles are selected to ensure data consistency and interoperability in support of a variety of clinical use cases. IHE profiles are developed in eleven active clinical and operational domains. SNOMED CT value sets referenced in these profiles are typically used to bind coded values to content in structured documents, discrete data elements and metadata. Approximately 30 IHE profiles reference SNOMED CT value sets as of the date of this agreement. Over the course of the 5 year agreement, the SNOMED CT IHE Set will be updated officially annually, taking into account updates to the IHE profiles which are performed annually in each IHE domain. Thirty-seven profiles within 6 domains currently fall within the scope of the agreement. Phast-Services, based in Paris, France, will serve as experts on behalf of IHE to maintain the SNOMED CT IHE Set. The IHE freeset is available as part of SNOMED International's Global Patient Set. The GPS is a managed collection of existing reference sets, available to any user at no cost. The GPS offers clinical content across dentistry, renal, family & general practice and nursing areas, and includes IHE , DICOM and HL7 International Patient Summary (IPS) domains and activities. Press Release: April 2019: SNOMED International and IHE International forge inaugural agreement jointly supporting optimal patient care Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

Karlien Hollanders James Read Memorial Lecture Panelist Karlien Hollanders 'How ONC is advancing nationwide interoperability' October 26, 2023 (09:00-10:00 EDT/ 13:00-14:00 UTC) (Sponsored by West Coast Informatics ) Micky Tripathi is the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, where he leads the formulation of the federal health IT strategy and coordinates federal health IT policies, standards, programs, and investments. Learn about how ONC is leveraging work across policy, standards and technology to further advance nationwide interoperability. Micky will give the latest updates about how ONC’s Trusted Exchange Framework and Common Agreement (TEFCA), U.S. Core Data for Interoperability (USCDI), and information sharing policies are helping to deliver safe, effective, patient-centered care across the nation. Dr. Tripathi has over 20 years of experience across the health IT landscape. He most recently served as Chief Alliance Officer for Arcadia, a health care data and software company focused on population health management and value-based care, the project manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR, and a board member of HL7, the Sequoia Project, the CommonWell Health Alliance, and the CARIN Alliance. Dr. Tripathi served as the President and Chief Executive Officer of the Massachusetts eHealth Collaborative (MAeHC), a non-profit health IT advisory and clinical data analytics company. He was also the founding President and CEO of the Indiana Health Information Exchange, a statewide HIE partnered with the Regenstrief Institute, an Executive Advisor to investment firm LRVHealth, and a Fellow at the Berkman-Klein Center for Internet and Society at Harvard University. He holds a PhD in political science from the Massachusetts Institute of Technology, a Master of Public Policy from Harvard University, and an AB in political science from Vassar College. Prior to receiving his PhD, he was a Presidential Management Fellow and a senior operations research analyst in the Office of the Secretary of Defense in Washington, DC, for which he received the Secretary of Defense Meritorious Civilian Service Medal. Back Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

BLOG: SNOMED International seeks community feedback on proposed description character limit increase Back 6 Aug 2024 Back Since the date of issue, this information is now out of date and has been archived. It has been made available for reference. When SNOMED International prepares to make changes to various aspects of SNOMED CT, most of which are driven by Member and user request, we often ask our community for their feedback on the potential impact to them. We are now launching a community consultation to solicit feedback on a proposal to increase the size limits of SNOMED CT concept descriptions to 4096 from the current limit of 255 characters. While this change does not represent a modification of the existing specification, it could be disruptive to implementers who have coded fixed length limits into their systems. In this Q&A, SNOMED International Technical Specialist Peter Groves Williams explains the proposed change, its potential benefits, the feedback process and timelines, and the issues that may need to be considered in such an update. Q: What are we asking the community to provide feedback on and why? A: We are considering increasing the maximum length of Fully Specified Name (FSN) and Synonym descriptions from the current limit of 255 to its maximum of 4096 characters, representing the largest number of characters allowed by the specification. We want to understand how this will affect implementers as it may have an impact on software vendors who have created data storage structures that are not dynamically sized. It is important for SNOMED International to understand how this change will affect them, and how we can support them. Q: Why are we considering this change? A: This increase is primarily to accommodate medicinal product FSNs, as their formation is procedurally dictated by the concept model. Terming guidance leads to the current limit being exceeded where there is a large number of ingredients, which is particularly common in multivalent vaccines. Increasing the limit to 4096 characters will ensure that SNOMED CT has the flexibility to accommodate future terming requirements. Q: When does the consultation period start and end? A: The consultation is open now and runs until December 31, 2024. Q: Are there any potential downsides or risks to this change? A: That is the purpose of the consultation – to understand how the proposed change might impact specific implementers so we can help ensure an easy transition in a feasible time frame. Q: What does this mean to me? A: SNOMED CT users should check with their software provider to ensure that relevant storage systems are capable of handling longer descriptions; that they either do not feature a 255 character limit, or that this limit can be increased prior to loading in a release of SNOMED CT which features longer descriptions. The actual timing of that release will be determined in response to feedback received from this consultation exercise. Q: How can I learn more and provide feedback? A: Visit this page for all the details and background and for the link to the feedback document. Questions? Email us at info@snomed.org . Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

BLOG: SNOMED CT focuses on traditional medicine at Expo 2024 pre-conference workshop Back 10 Sept 2024 Back On October 23, 2024, as part of SNOMED CT Expo 2024 pre-conference sessions, SNOMED International is hosting a half-day workshop on traditional medicine . In this blog, Liara Tutina, SNOMED International’s Customer Relations Executive Asia and Pacific & Global Education Lead, and Yongsheng Gao, Senior Terminologist, discuss the purpose of learning goals for the session, the growing need for traditional medicine content in SNOMED CT and the benefits of its inclusion, as well as the challenges posed by integrating various global traditions into the terminology. And while the inclusion of this type of content into SNOMED CT reflects SNOMED International’s commitment to our Members and to enabling better patient care delivery around the world, it also tells the story of the collaborative process driving SNOMED CT’s ongoing content development and refinement. Q: What is traditional medicine? How does SNOMED International define it? A: SNOMED International uses the same definition as that used by the World Health Organization : It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. A few examples are acupuncture and homeopathy, both of which are widely available in Western countries as well. Q: What is the goal for this initiative and what is driving the push for inclusion of traditional medicine content in SNOMED CT? A: The objectives of the traditional medicine project are to support clinical practice and secondary use of data for research, policy making, patient safety, and clinical guidelines. To a certain extent, the project has been driven by Member requests, but the big-picture benefits are that it will enable practitioners and traditional medicine users around the world to use SNOMED CT to record conditions and access related services. Researchers and policy makers will benefit significantly from encoded health records for development of evidence-based practice and clinical guidelines and policies, and it will help close the gap in SNOMED CT content. It will enable clinical recording of traditional medicine in SNOMED CT and mappings to classification systems such as ICD-11. Interest and research in complementary and alternative medicine have increased considerably worldwide, and a number of ISO standards for traditional medicine have been developed in the last decade or so by ISO TC 249 and TC 215 /JWG1, WG10. Q: What traditional medicine content existed in SNOMED CT prior to the formation of the traditional medicine pilot project? Where are we now and what is our goal in terms of the type and amount of traditional medicine content? A: At the beginning, SNOMED CT had a limited amount of content – a number of terms for acupuncture, herbal medicine agents/herbal medicines, a few concepts in other areas and a handful of related findings and procedure codes. Today, there are about 900 concepts for traditional medicine excluding clinical findings and diseases that are also applicable to traditional medicine. In particular, we have covered key pattern diagnoses with a new concept model in clinical finding, and introduced a new top-level category for the theoretical entity of traditional medicine. You can find them under the Traditional Medicine Community Content tab of the SNOMED CT Community Content browser . Q: To what extent can the inclusion of traditional medicine in SNOMED CT contribute to a better understanding of the efficacy of such treatments? A: Encoding traditional medicine content in SNOMED CT is a major step toward supporting comprehensive health data analytics, expanding the scope of health research and enhancing best practice guidelines for clinical care. Q: What regions use some form of traditional medicine? A: Traditional medicine has been widely used for millennia in many Asian and African countries as well as throughout Latin America, the Caribbean, the Middle East and Eurasia. They are also available in Europe and America as complementary and alternative medicines. Q: How is the traditional medicine content in SNOMED CT being used – and by whom? A: It is still in the early stages of content development for traditional medicine. One example of how this content is being used by our Members is from the Republic of Korea. At SNOMED CT Expo 2023, Ah Jung Byun and Hyeoun-AE Park presented on research to map Korean traditional medicine terms to SNOMED CT . Although the Korean health system introduced an electronic medical record (EMR) system in 2018, traditional medicine was not part of that development. Practitioners of traditional medicine in Korea took steps starting in 2021 to close that gap by developing a big data platform for traditional medicine and clinical practice guidelines on up to 30 diseases or conditions, and realized the need for standard terminology to describe those clinical ideas. Another example is that India has translated SNOMED content, e.g. clinical findings/diseases, related to traditional medicine, and started the development of traditional medicine specific content in their SNOMED CT extension. Q: What is the scope of the traditional medicine project? A: The initial stage for the development of traditional medicine terminology in SNOMED CT only covers top-level structures and some requests from Member countries. The project will build the infrastructural foundation for the future development of this type of content. Q: Describe the collaborative process that has been used to include traditional medicine content in the Community Content area. A: When the project kicked off, we already had received a request from Malaysia to incorporate 200 traditional medicine terms into SNOMED CT. Currently, the requests from Malaysia have been reviewed and existing concepts have been identified. The new concepts have been added to SNOMED CT. We have established key editorial decisions with the expert group: Patterns as a new subhierarchy of clinical findings A new top-level hierarchy for the theoretical entity of traditional medicine The Chinese language represents the original meaning of concepts. Other languages can be added to extensions. New concept models for modeling patterns by principles, organ frameworks, ect. Organ systems are represented as theoretical entities, in contrast to pure anatomical representations. The existing concepts in SNOMED CT have been utilized for disorders in traditional medicine, unless the specific disorders are different and needed as new additions. The content has been published in the community content area and we are developing a subontology for traditional medicine that will be published soon. Q: Are there any unique challenges to including traditional medicine content in SNOMED CT (e.g., capturing “notions” such as energy)? If so, what are they and how are we approaching it? A: A 2019 research paper (Progresses and challenges in the traditional medicine information system: A systematic review ) identified many of these challenges: “Sometimes, one medicinal plant happens to be named differently using the general, Latin, local or commercial names. In contrast, some other of different species take similar names. This becomes more complicated given the prevalence of the terminology specific to different world languages (Mukherjee et al., 2015). Currently, there is no universal terminology and a unified coordinated regulatory attitude (Wiesner, 2014). To standardize the structured clinical data, an integration of the systematic terminologies is required (Liu et al., 2012). Accordingly, in line with the information standardization projects such as International Classification of Traditional Medicine (ICTM), a new project for the compilation of an international standard terminology has been incorporated into the recent ICD-11 revision (WHO, 2007; Gao and Watanabe, 2011; Katayama et al., 2012).” The key challenge is to represent concepts, theories, and logics that are unique to traditional medicine. They do not fit into the current top categories of SNOMED CT. We have developed a new top category for theoretical entities in traditional medicine. The new concepts, such as Yin (阴), Yang（阳）, Qi（气）have been added. However, there are many different traditional medicines. It is a challenge to represent them when there are potential overlaps, similarities, or even conflicts. For example, Qi in traditional Chinese medicine can be loosely interpreted as a concept for energy. In Ayurvedic medicine, ojas is defined as ‘vigor’. It is the vital energy, or core essence, that nourishes all tissues and is responsible for the optimal functioning of our body, mind, and spirit. However, Qi also includes breathing air. We cannot map or treat Qi and Ojas as the same concept. More work and discussions are needed to overcome the challenge. There are also changes in specific subject areas of traditional medicine. The representation of medications can be named differently using the general, Latin, local, or commercial names. In particular, some species could have similar or the same names. Furthermore, the classification of plants based on morphological features alone could be time-consuming and error prone. The advancement in genetic studies could provide reliable classifications, but it raises the challenge of connecting them to the daily clinical use of plants in traditional medicine. Q: Why did we decide to hold a half-day workshop before Expo this year? Who is leading it? A: Both of us, along with input from representatives from Korea, India, Malaysia and other countries, will be leading the session. The workshop will provide an opportunity for international collaboration, experience exchange and discussion on various aspects of the traditional terminology model and content development. Q: Who should attend and what can people expect to learn at that session? A: This session will be useful for anyone, whether your background is clinical or technical, who is interested in learning more about our traditional medicine project and the next steps for supporting a standardized terminology for this type of parallel healthcare system. LEARN MORE To learn more about SNOMED CT and traditional medicine, visit the SNOMED CT Traditional Medicine Pilot Project Confluence page , and view the following presentations on YouTube: Development of SNOMED CT India Ayush Extension Common ontology model for multiple systems of traditional medicine using SNOMED CT Mapping traditional Korean medicine terms to SNOMED CT SNOMED CT Expo 2024 traditional medicine sessions: Traditional medicine workshop, October 23 from 09:00-12:30 KST How to improve SNOMED CT ontology t represent concepts used in Korean traditional medicine: October 24, from 13:30-14:00 KST Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

American Joint Committee on Cancer Back American Joint Committee on Cancer Clinical Partner In July 2022, the American College of Surgeons (ACS) and SNOMED International entered into a licensing agreement to include agreed upon American Joint Committee on Cancer (AJCC) references in SNOMED CT. The AJCC is administered by the Chicago-based American College of Surgeons. Additional information The focus of the agreement enables SNOMED International to include updated AJCC staging concepts critical to understanding cancer and treating patients, while eliminating outdated AJCC content no longer relevant to clinical care within SNOMED CT. Press release: July 2022: Cancer staging content from the American Joint Committee on Cancer will appear in SNOMED CT under new licensing agreement Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe

University of Nebraska Medical Center pathology cancer reports have been recorded and stored as Portable Document Format (PDF) in the Electronic Health Records (EHR). Therefore, the data held within these reports is not readily available for use in research or patient care decision making. To rectify it, we developed an approach to extract and SNOMED CT encode large amounts of historical cancer pathology data and insert these data into a Clinical Data Warehouse (CDW) to support clinical research endeavors and population health efforts. A five-step process was applied to five cancer types: ampulla of Vater, pancreas, esophagus, lung, and prostate.1) PDF pathology reports were generated from a pathology information system; 2) The system's user interface for synoptic reporting was evaluated, all possible text strings were identified, and bindings of controlled text strings and SNOMED CT was created; 3) A python-based program was used to convert the PDF reports to plain text and extract synoptic text strings; 4) Free-text data were bound with SNOMED CT; 5) SNOMED CT encoded cancer data were integrated into the CDW. This project demonstrated a tractable method to extract and transform PDF-based pathology cancer data from EHR to SNOMED CT encoded data to support of research and public health. Automated data conversion from text/PDF to SNOMED CT is possible when structured text is used to create initial reports. Free-text or non-standard, unstructured text were manual, case-by-case reviewed. Following this, multiple years of historical pathology cancer data was encoded and made available for multiple future uses. Back View Map University of Nebraska Medical Center Extraction and Transformation of Pathology Cancer Report Data into a SNOMED CT Encoded Data Repository Read More Country / Region Americas Tags Data quality, Implementation, Mapping, Research University of Nebraska Medical Center pathology cancer reports have been recorded and stored as Portable Document Format (PDF) in the Electronic Health Records (EHR). Therefore, the data held within these reports is not readily available for use in research or patient care decision making. To rectify it, we developed an approach to extract and SNOMED CT encode large amounts of historical cancer pathology data and insert these data into a Clinical Data Warehouse (CDW) to support clinical research endeavors and population health efforts. A five-step process was applied to five cancer types: ampulla of Vater, pancreas, esophagus, lung, and prostate.1) PDF pathology reports were generated from a pathology information system; 2) The system's user interface for synoptic reporting was evaluated, all possible text strings were identified, and bindings of controlled text strings and SNOMED CT was created; 3) A python-based program was used to convert the PDF reports to plain text and extract synoptic text strings; 4) Free-text data were bound with SNOMED CT; 5) SNOMED CT encoded cancer data were integrated into the CDW. This project demonstrated a tractable method to extract and transform PDF-based pathology cancer data from EHR to SNOMED CT encoded data to support of research and public health. Automated data conversion from text/PDF to SNOMED CT is possible when structured text is used to create initial reports. Free-text or non-standard, unstructured text were manual, case-by-case reviewed. Following this, multiple years of historical pathology cancer data was encoded and made available for multiple future uses. Description It is still common for pathology reports to be stored and distributed as Portable Document Format (PDF). While this format helps user easily read the information, it causes a barrier to computation, secondary use, or electronic data exchange. That is an important issue because pathology reports contain crucial information for patient care and treatment planning. To address this, we initiated an ongoing project composed of three parts: (1) data extraction, (2) data encoding using SNOMED CT, and (3) integration into the Clinical Data Warehouse (CDW). This abstract will present findings from the process based on five cancer types: ampulla of Vater, pancreas, esophagus, lung, and prostate. Scope SNOMED CT was selected as it is currently the sole international medical terminology standard capable of representing pathology cancer data as found in pathology reports. In addition, SNOMED CT is a terminology supported for use in national and international research oriented Clinical Data Warehouses (CDW) including OMOP and PCORI. By performing this study, a practical, tractable process to extract uncoded pathology data from the electronic health record and convert to encoded, structured data for use in CDW has been demonstrated for widespread use. How SNOMED CT will be used In the encoding process SNOMED CT was used to bind (map) the extracted data from Portable Document Format (PDF). Specifically, terminology binding between the extracted data and SNOMED CT was conducted in two parts: (1) batch binding based on a predefined master file based on the synoptic report format, and (2) manual binding for free-text elements. The project follows the pathology cancer date methods proposed by the Cancer Synoptic Reporting Working Group (CSRWG) of SNOMED International and described in the Cancer Synoptic Reporting Implementation Guide. Why SNOMED CT will be used Contact More information Learn more Get SNOMED CT Information about our license and fee structure Learn more Learn more Explore the wide range of resources available to our community of practice Subscribe to SNOMED International news Stay up to date on SNOMED news, features, developments and newsletters by subscribing to our news service. Subscribe