K-HIS

Collaborative Strategy for Developing Content for the SNOMED CT Korean Extension with Clinical Societies under KAMS (Korean Academy of Medical Sciences)

APAC

Collaboration, Data quality, Mapping, Pre/postcoordination

The Korean Ministry of Health and Welfare (MOHW) issued the Standard Terminology and Data Exchange Standards for Healthcare Data in 2023 to ensure data interoperability. The Korea Core Data for Interoperability (KR CDI) defines the minimum dataset for healthcare data exchange. To standardize KR CDI value sets using standard terminologies such as SNOMED CT and LOINC, the Korea Health Information Service (KHIS) commissioned clinical societies to develop standardized terminology sets. However, challenges in standardization limited their use and dissemination.

To address these challenges and prepare for the first release of the SNOMED CT Korean Extension, the Korean National Release Center (NRC) designated by MOHW and operated by KHIS has begun active engagement in Korean Extension content management. The Korean NRC conducted a pilot project in partnership with the Korean Academy of Family Medicine (KAFM) aiming to validate effective collaboration with clinical societies for developing standardized terminology sets.

KAFM developed terminology sets for past medical history, family history, smoking, and alcohol use which were mapped to SNOMED CT. The Korean NRC reviewed the map and authored new concepts based on priorities identified during the review. Four reference sets were created using the SNOMED CT Reference Set Tool. This collaboration resulted in adding 83 Korean descriptions and 18 new concepts to the SNOMED CT Korean Extension.

In addition to these outcomes, this pilot project produced a generalizable process of collaboration with the clinical societies, supporting continued expansion of the Korean Extension and contributing to national health data interoperability.

Description

The primary scope of this pilot project involved developing standardized terminology sets through a strategic collaboration between the Korean NRC and a selected clinical society, KAFM. This collaboration aimed to establish and validate a generalizable process for future partnerships with other clinical societies in developing other standardized terminology sets.

Previously, standardized terminology sets aligned with the KR CDI were developed independently by clinical societies under the KAMS, with research projects commissioned by KHIS to each clinical society. However, this approach faced limitations in standardization and dissemination, highlighting the need for expertise in standard healthcare terminologies such as SNOMED CT. To address these challenges, KHIS, which operates the Korean NRC, expanded the NRC's role to engage directly in terminology standardization.

This project covered defining roles and workflows, standardizing terms by mapping to SNOMED CT, and developing reference sets. KAFM proposed terminology sets in four domains: past medical history, family history, smoking and alcohol use. The Korean NRC mapped source terms to SNOMED CT concepts using the SNOMED CT Browser International Edition. Terms related to past medical history and family history were mapped to SNOMED CT concepts with situation with explicit context semantic tag, while those related to smoking and alcohol use were mapped to ones with finding or observable entity tags. New concepts were authored and added to the SNOMED CT Korean Extension via SNOEMD International Authoring Platform. Ultimately, four reference sets were developed using the SNOMED CT Reference Set Tool 2.0 and added to the Korean Extension.

The pilot project between the Korean NRC and the KAFM led to formalization of a scalable and generalizable collaboration model between the Korean NRC and other clinical societies. This established the foundation for sustainable SNOMED CT Korean Extension content development.

Scope

SNOMED CT was selected for several key reasons.

First, SNOMED CT concepts are easily searchable using SNOMED CT Browser. When identifying semantically equivalent concepts for the source terms, various search strategies such as using the first three characters of a term or exploring various synonyms could be employed to find the most appropriate match. This enabled the project team to effectively standardize source terms, specifically the values generated to create standardized terminology sets by the Korean Society of Family Medicine.

Second, new SNOMED CT concepts can be modeled and added to the SNOMED CT Korean Extension using SNOMED International Authoring Platform. Until now, Korean Extension was not officially released to the public, limiting the practical use of newly added concepts. However, Korea is planning to release its first official version of the Korean Extension in July 2025. This is expected to significantly expand the use and implementation of the Korean Extension concepts.

Third, SNOMED CT reference sets tailored to specific use cases can be developed using the SNOMED CT Reference Set Tool 2.0 (RT2). While RT2 facilitated development of multiple reference sets, there was previously no mechanism for public distribution. With the upcoming release of the Korean Extension, reference sets for various standardized terminology sets can be made publicly available to support diverse user needs.

How SNOMED CT will be used

SNOMED CT was utilized to map values derived by researchers from the Korean Academy of Family Medicine in the process of creating standardized terminology sets for past history, family history, smoking and alcohol use. SNOMED CT Browser International Edition was searched to identify semantically equivalent concepts. When appropriate SNOMED CT concepts were not available, the Korean NRC used SNOMED International Authoring Platform to model and add new concepts to the SNOMED CT Korean Extension. Once all the source terms are mapped to SNOMED CT concepts, SNOMED CT Reference Set Tool 2.0 was used to create reference sets for past history, family history, smoking and alcohol use.