Country / Region
Americas
Tags
Clinical Practice, Collaboration, Data quality, Mapping
The Canadian Institute for Health Information (CIHI) and Canada Health Infoway are partnering to modernize health information flows and create a connected health system in Canada. Early progress toward this goal was delivered in CIHI's published draft Version 1 of the Pan-Canadian Health Data Content Framework (PCHDCF). The PCHDCF is a comprehensive data content standard with common data architecture for all health-related data. Its core subset of essential data required for interoperability is known as the Canadian Core Data for Interoperability (CACDI).
Health systems need standardized and disaggregated social data to implement systemic changes that advance health equity. Behavioural health data allow for holistic patient care in realms of prevention, risk management, and tailored interventions. Through a co-design process, CIHI is leading development of social care data elements and their value sets with logical data models, for representing sociodemographic, social determinants of health and behavioural health domains. This builds on CIHI's previous equity-focused data standards work and with reference to other international guiding standards.
New SNOMED CT CA concepts and synonyms are being requested to fulfill Canadian context requirements. These new concepts can be elected for SNOMED CT International versions, thereby strengthening the coverage of SNOMED CT terms in the social and behavioural health domain for the entire SNOMED CT community to benefit from.
Social and behavioural health-focused data content standards developed within the Connected Care initiative allow for meaningful information exchange across clinical and social care systems enabling patient-centred and equity-based care and which can be leveraged internationally.
Description
Work on the Pan-Canadian Health Data Content Framework includes defining social and behavioural health (lifestyle) data standards. Disaggregated socio-demographic and social risk and needs data allows for tailoring of patient specific health interventions. This will also provide an opportunity to aggregate data to measure health inequities affecting communities and populations to support systemic improvements.
Structured data value sets are being adopted, adapted from other published standards or created anew where gaps exist. Value sets selected for representing data elements within social and behavioural domains are composed of SNOMED CT CA, LOINC, ICD-10-CA and HL7 codes.
All value set work is driven by consensus with inputs from technical and terminological expertise and external consultation with clinicians, patients, policy makers, and researchers. Value sets are published and maintained on the Canada Health Infoway's FHIR Terminology Server (OntoServer).
In the next draft publication of the Pan-Canadian Health Data Content Framework (Sep 2025) we aim to develop Canadian-context value sets for:
* sociodemographic data elements such as race, ethnicity, Indigenous identity, gender, service language and for assessment of SDOH data elements such as housing stability, education attainment, access to food and access to transportation).
* Behavioural health (lifestyle) risk assessment domains such as tobacco, vaping, alcohol and other substance use
* social risk and social need assessment such as housing stability, educational attainment, income, access to food, transportation, utilities
Future development work will define and develop standardized value sets for social care related diagnosis, patient goals and interventions.
Scope
SNOMED CT is being used for its foundation as an international clinical reference terminology that allows for the development of value sets that will standardize data collection and facilitate interoperability. For the purpose of the Pan-Canadian Health Data Content Framework, the Canadian edition of SNOMED CT CA is used to ensure the availability of Canadian specific content. This is in alignment with our national setting and context and encourages reuse of these optimized terms across different domains and settings across Canadian jurisdictions.
How SNOMED CT will be used
Several value sets composed of SNOMED CT CA concepts are being leveraged for the PCHDCF. Value set development includes adopting or adapting published value sets or composing new value sets where gaps are identified. Through a Request for Change process, new SNOMED CT CA concepts and/or synonyms are being requested to fulfill Canadian context requirements. This new SNOMED CT CA content can be potentially elected for SNOMED CT International versions. In this process we are strengthening the coverage of SNOMED CT terms in the social and behavioural health domain for the entire SNOMED CT community to benefit from.
Why SNOMED CT will be used
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