Description

As a consequence of the Danish IT Strategy for Healthcare 2003-2007, it was decided to use SNOMED CT as a reference terminology for communication across the Danish healthcare services. Denmark became a member of the IHTSDO and initiated a translation of all preferred terms in SNOMED CT in to Danish, to support standardized IT development in the Danish healthcare service. The translation was completed in 2008. It is hosted and maintained by the National Health Data Agency in Denmark.

In 2014, two of Denmark’s five regions purchased the electronic patient record EPIC. The two regions together account for half of Denmark’s population and contain 19 hospitals. Implementation of Epic will be completed at all hospitals in the two regions by the end of 2017.

In the EPIC system, SNOMED CT is incorporated by being mapped to specific Epic elements in the form of, e.g. master files, records, items, category list values, flow sheet data rows, etc. and can be used within Epic grouper functionality following hierarchy and description logic in SNOMED CT to collect e.g. all diagnoses within a disease area. An important part of the implementation of Epic in the two regions is standardization of key clinical workflows across the regions.

Based on Epic Foundation content, the implementation organization and clinical experts, have compared Epic content with the two regions content management systems for clinical guidelines (VIP and D4) and developed interregional guidelines. This done by using the SNOMED CT mapped elements in Epic in relation to the regions’ guidelines. It became possible to: Get an overview of the common content of the three systems – Epic, VIP and D4; Make a prioritization of the interregional standardization work and Customization of EPIC. Semantic interoperability -even across languages has been possible because of the Danish translation.

Location: Denmark

Scope

  • Classifying content of the Epic Foundation system with SNOMED CT
  • Identification of/tag content elements in the Epic Foundation System to SNOMED CT concepts (like for clinical instructions)
  • Use tags for adjusting content between clinical practice and content of the Epic Foundation system, e.g. workflow navigation in the system Decision support, links to clinical instructions Document support, links to clinical instructions

How SNOMED CT will be used

SNOMED CT content is tagged with the following SNOMED CT concept types:
  • Diagnosis 
  • Procedure
  • Clinical
  • Process
  • Specialty
This allows easy identification of content for review by SME experts/groups.

Why SNOMED CT was selected

  • SNOMED CT – An obvious reference terminology for classification
  • A prerequisite – That a translation of the Fully Specified Names in SNOMED CT is accessible, to make sure of semantic correct classification (translation done by the Danish National Board of Health 2004-2008)
  • Overall goals of implementing EPIC in Denmark
  • One patient – One record
  • Coherent data
  • Harmonization across hospitals and across regions
  • Secure portal for patients and their families
  • Patient empowerment
  • Customer implementation – Epic methodology

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