The main objective was to normalize the allergies that has been registered in our EHR until then in free text and create an instant search widget that use SNOMED CT as a background taking into account the local terms of the organization and the outmost frequent terms until then.
Location: Tetuán, Madrid, Spain
Under leadership of TicSalut Foundation (Department of Health, Autonomous Government of Catalonia, Spain) has been developed the Clinical Dictionary Project to standardize vocabulary within the health system in the public network of Catalonia whose base is SNOMED CT. The subset of allergies has been implemented in our institution.
Location: Barcelona, Spain
To know why a patient has been prescribed a specific medication is important for the patient as well as for the health care staff. The National Board of Health and Welfare in Sweden has developed a new, national knowledge base for reasons for prescription.
This knowledge base will facilitate the documentation of the reasons for prescription in day to day health care. The term “reason for prescription” signifies the rationale for the prescription as specified by the prescriber, e.g. the disease or symptom to be cured or relieved by a specific drug treatment. The knowledge base contains about 1500 reasons for prescription, which are mapped to SNOMED CT.
Location: Socialstyrelsen, Rålambsvägen, Stockholm, Sweden
The National Board of Health and Welfare has developed national guidelines for methods for disease prevention with the focus on lifestyle habits such as tobacco consumption, drinking habits, physical activity and dietary habits. The Board has also developed a tool for recording and following up lifestyle habits using SNOMED CT and other coding systems.
Location: Kungsholmen, Stockholm, Sweden
Including SNOMED CT in our GP Practice Management Software for recording and searching.
Location: Mallow, Ireland
The College of Occupational Therapists, the UK professional body for occupational therapists, has developed a number of occupational therapy subset standards in collaboration with its members which should be used for all service user care records, whether they are stored digitally or on paper. All the subsets are specified using SNOMED CT, and are aimed at supporting Occupational Therapy practice in the UK, within systems supporting clinical practice.
Location: London, United Kingdom
Cloud based electronic patient record system now entering tenth year of operation having been an early adopter of SNOMED CT.
Location: Isle of Man
Every health care provider has to record medical alert information about their patients. The National Board of Health and Welfare has described how the information should be documented in a structured way and developed a coding system for medical alert information such as allergies, contagious diseases and critical conditions using SNOMED CT and other coding systems.
Location: Västerbroplan, Stockholm, Sweden
An all-Wales web-based platform with SNOMED CT supporting the recording of diagnostic and problem lists with treatment, medication and procedural information. Currently over 20,000 patients recorded and 147,891 clinical encounters since 2009.
Location: Cardiff CF14 4XW, United Kingdom
Standard list of diagnoses and interventions for optometrist. To be used for documentary and quality analysis.
SNOMED CT is used to code drugs and pathology findings in the Catalan region in Hospital Clínic of Barcelona.
Location: Carrer de Villarroel, 170, Barcelona, Spain
Use of SNOMED as a Controlled Vocabulary for the Submission of Medicinal Product Information
Location: Wessobrunn, Germany
Planned use for capture of medical information (diseases, procedures, complaints, etc.) in our EHR and further reuse of these data for communication with other hospitals, fulfilling national registration obligations, alerts and health statistics.
Location: Haine-Saint-Paul, Belgium
SNOMED CT is being used to define evaluation criteria for concept-based rule logic and understand potential use cases for the derivation of actionable clinical insights through alerts/reminders, cohort identification, and clinical documentation improvement.
The ability to understand clinical context for patients and populations rests on our understanding of clinical terminology in a variety of health information systems. SNOMED CT is foundational to our terminology infrastructure that enables both real-time concept detection from free text as well as real-time computation against clinical data sources in a way that adds value to an existing body of knowledge.
The following are use cases for this approach:
To implement a single EHR system across the different hospital sites, to provide the primary source of information on the patient.
Location: St. Bartholomew’s Hospital, West Smithfield, London, United Kingdom
We have implemented the Project during which:
SNOMED CT terminology will be used for the capture of medical information (diseases, procedures, complaints,..) in our EHR in structured fields as well as in free text (through a parsing application).
Further reuse of these SNOMED CT “smart” medical data will then be implemented along the following axes:
At first, SNOMED-CT terminology will be used for the capture of surgical procedures in our operating room management software. In a near future, we plan to generalize the use SNOMED-CT to capture medical information (in structured fields or using NLP technology on unstructured text) in our EHR.
The idea is to be able to use these codified data for:
Since October 2015 we have deployed a home-made EMR entirely based on SNOMED CT in our academic institution. A French speaking extension has been created with the help of our NRC and is improving day by day. We use mostly precoordinated expressions, but postcoordination is already available in specific templates. Free text is allowed only when a structured item has been recorded to improve its granularity.
Artifacts covered are: reason for admission, risk factors (allergies, implants, nutritional, addictions, social factors…), systematic review of systems, physical examination (usual and some more specific: neurology and vascular), past history (personal and family) of diseases and procedures, active problems, procedures performed, staging and scales. Admission and discharge reports can be generated and sent electronically to referring physician.
At the present time (March 2017), about 70% of the inpatient activity is covered by the system and more than 2 millions concepts have been recorded.
Location: Hoptial Ersasme - Cliniques Universitaires de Bxl, Boulevard Baudouin, Bruxelles, Belgique
Chart Synergy EHR is a cloud based mobile/web health records system that facilitates cost-effective collection, storage, transmission, and analysis of clinical data. It enables health care providers to better manage their patient records, streamline their business processes, gain insights from data collected, and make more informed decisions.
Our system can help reduce errors, improve patient safety, and support better patient outcomes. Our system does not just store and transmit information; it also ‘computes’ the data. This means that Chart Synergy EHR can manipulate the information in ways that make a difference for the patient and the care provider.
Chart Synergy EHR helps bring all the fragments of information about a patient together by integrating and organizing patient health information and facilitating its instant distribution among all authorized providers involved in a patient’s care. Chart Synergy can improve health care quality by making access and provision of healthcare more convenient for patients and healthcare providers respectively.
Location: Enugu North, Enugu, Nigeria
Rotherham NHS Foundation Trust decided to move to an electronic patient record system, replacing their PAS (patient administration system) system in the process. They worked closely with their chosen supplier to adapt the existing supplier product to utilise SNOMED CT throughout for both procedure and diagnosis recording.
There are now two case studies for Rotherham, the original and a retrospective after 5 years post implementation.
More details on this can be found at:
Location: Rotherham, United Kingdom
To allow a secure way to prescribe in Primary Care (General Practice / Community), transmit to a Dispenser (e.g. community pharmacist) and send a reimbursement message to the Reimbursement Agency (NHSBSA).
Location: England, United Kingdom
Leeds Teaching Hospitals decided to embrace SNOMED CT in their Emergency Department as a way to reduce duplication of data entry and ensure recording in a consistent way, thus facilitating analysis as well as supporting completion of the national Commissioning Data Set (CDS) returns.
Location: Leeds, United Kingdom
The major target of AKTIN is to enable health care – and epidemiologic research with the use of a special emergency room documentation protocol that is published by the German Interdisciplinary Association for Intensive Care – and Emergency Medicine (DIVI).
Location: Mönchengladbach, Germany
University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) is an early adopter for the use of Lorenzo. Its senior doctors and management team have a deep and long standing belief in the importance of an Electronic Patient Record (EPR) using a structured terminology, as a key factor in both delivering better patient care and achieving much higher levels of operational efficiency.
The case study at https://hscic.kahootz.com/connect.ti/t_c_home/view?objectID=17121072 aims to provide an overview of their achievements.
Location: United Kingdom
The objective is to develop and interoperable infrastructure for the screening, monitoring and training of frailty in the elderly.
PERSSILAA is a unique project that aims to develop and validate a new service model for older people, to screen for and prevent frailty. This multimodal service model, focusing on nutrition, physical and cognitive function, is supported by an interoperable ICT service infrastructure, utilizing intelligent decision support systems and gamification.
Location: Casa de Campo, Madrid, Spain
Climate-HIV is a specialised HIV Electronic Patient Record (EPR) software solution which provides the whole multi-disciplinary clinical team with fast access to patient data. It also helps educate the patient, halves the administration needed to write GP letters and referral notes, whilst recording all the patient information in one place. Climate-HIV includes compliance with both ICD 10 and SNOMED CT codification standards for improved reporting on diagnoses, clinical findings, conditions and procedures.
Location: Barton-under-Needwood, United Kingdom
The “Anti-Infection Tool”, is a national IT support tool for consistent documentation, storage and feedback of information on healthcare-associated infections and antibiotics, which local electronic health record systems can access.
A product sheet in English is available: AntiInfection Tool Fact Sheet
Location: Stockholm, Sweden
Networks of Biobanks has the aim to coordinate all the activities developed by biobanks, including technical protocols and the harmonization of the ethical and legal framework. The Information Management Systems (IMS) specific for biobanks offers to do an efficient management of donors and donations, to manage associated information (clinical, epidemiological, pathological, etc. or as specific project), and to control on the sample processing with the Implementation of both the MIABISdefinitions as well as SPREC and BRISQ standards.
Norlin L, Fransson MN, Eriksoon M, Merino-Martinez R, Anderberg M, Kurtovic S, Litton JE. A minimum data set for sharing biobanks amples, information, and data – MIABIS. Biopreservation and Biobanking 2012
Betsou F, Lehmann S, Ashton G, Barnes M, Benson EE, Coppola D, et. al. Standard preanalytical coding for biospecimens: defining the sample PREanalytical code. International Society for Biological and Environmental Repositories (ISBER). 2010 ;19(4):1004-11
Moore HM, Kelly AB, Jewell SD, et. al. Biospecimen reporting for improved study quality (BRISQ). Cancer Cytopathol. 2011 Apr 25;119(2):92-101
Location: Madrid, Spain
Connect payers and providers in Kenya through a central health information exchange.
We are breaking down the barriers between home, primary and hospital based care to provide consistent, high quality and better value care for patients. One way we are working is to use Health Information Exchange standards to share data between hospital and general practice records.
Location: London, United Kingdom
Switzerland will use SNOMED CT within 4 years nationally and is a member of SNOMED International since early 2016. The current use cases focus on exchange of medical information within a national electronic patient record.
Current use cases and include:
Provide an electronic vaccination record to the public (www.myvaccines.ch). Integrated expert software to check of missing vaccinations according to the national recommendations of the Swiss immunization plan (http://www.bag.admin.ch/impfinformation/06311/index.html?lang=de).
To redesign the immunizations’ module in the CWS of ICS for both primary and hospital care, and making its information interoperable.
Location: Torrassa, L’Hospitalet de Llobregat, Barcelona, Spain
The projects major target is the setting-up of a technical functionality for the regular operation of electronic laboratory notifications according to the German law on the preventions of infections (IfSG). For that purpose a certain real-time operation shall be implemented in the German federal state of North Rhine-Westphalia.
Location: Mönchengladbach, Germany
Moorfields Eye Hospital decided to develop their own application to be used across all 13 of their sites as a way to reduce duplication of data entry, ensure recording in a consistent manner, to improve the sharing of information and the ability to search records from any site.
This Moorfields Eye Hospital case study at http://systems.hscic.gov.uk/data/uktc/training/mfields_fnl.pdf provides an overview of their achievements.
The Open Eyes development is an open source initiative which can be found at: http://www.openeyes.org.uk/.
Location: Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
The objective is to share the experiences of implementation of SNOMED CT in different healthcare centres and organizations through the website:
Location: Catalonia, Spain
The Swedish Association for Local Authorities and Regions (SALAR) is responsible for standardizing the content in national clinical quality registries to promote automated data transfer from EHR systems to the registries. The work started in 2015 and approximately 25% of the registers (in total 107) have been mapped to SNOMED CT and other terminologies and coding systems.
A film (in English) about the registries is available:
Location: Örebro, Sweden
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.
The project eCG tries to provide interoperability between electronic standards that are connected to commercial activities in the German Health Care System. The central purpose lies in the creation of a common valid implementation guideline. This instrument enables the boundless exchange of electronic data at its best. Therefore, actors and transactions will be determined – to map their integration into the procurement process.
Location: Heidelberg, Germany
A pilot project involving eight distinct specialties has demonstrated that there are benefits for specialists to work with clinical terminologists to ensure that the terminology reflects best current practice and to ensure clinical ownership of the terms within defined speciality subsets. One specialty has been able to gather sufficient clinical data in SNOMED CT to demonstrate benefits in terms of subsequent data analysis and acquisition of knowledge beneficial to the commissioning of the specialty.
The project has demonstrated a requirement for co-ordinated clinical involvement in the on-going development and support of SNOMED CT overseen by the Royal Colleges and specialty groups within them. The next steps involve further subset development and testing by specialties and trusts. This should include the development and analysis of quality indicators predicated upon clinician recorded data using SNOMED CT.
Within the project there has also been some interaction with groups that engage with patients and carers. Early indications are that there will also be benefits to patients and carers from the consistency and visibility achieved through developing and publishing specialty subsets, especially when they can view their patient record.
Location: Leeds, United Kingdom
ITServer is a terminology server that allows you to manage and navigate the different local and standard terminologies such as SNOMED CT, ICD-9-MC, ICD-10, LOINC, etc. Moreover, it’s a tool that allows you to normalize the information, map between different terminologies/catalogs, create subsets, etc. It also offers a wide range of Web Services in CTS2 that facilitate the integration and sharing of information with heterogeneous systems.
Location: Calle de Serrano, Madrid, Spain
Language and medical terminology is a major hurdle tot standardising medical comprehension and diagnosis. A proof of concept tot master this is www.medisentio.com multilingual website for professionals It masters 3 languages, 60.000 synonyms and +9000 diagnoses