VIDAL Group (2 of 2)

Using SNOMED CT to support Allergy Checking in an international medicinal product dictionary

EMEA

Global/International, Implementation, Mapping, Patient safety, Translation

VIDAL Group is pursuing the integration of SNOMED CT terminology as a key component of its own allergy decision support functionality. VIDAL aims to provide to vendors the possibility to use SNOMED CT allergy concepts as an entry parameter for the VIDAL clinical decision support.

This presentation focuses on using SNOMED CT allergy concepts and VIDAL allergy knowledge. VIDAL provides allergy checking to a number of countries and the knowledge is used across these but there is also a need to manage the allergy concepts of the International Edition and those belonging to National Extensions, which should only be used within that country.

This work will address the considerations that were taken into account to define the map requirements and it will also analyse the difficulties encountered during the implementation of the project, especially during the mapping process. It may also be possible to make suggestions for the development of international content from the analysis of the different allergy content in National Extensions.

Description

This presentation is concerned with the use of the SNOMED CT Substance hierarchy and the SNOMED CT Allergy concepts in the Findings hierarchy and how these can be used as inputs to an allergy checking decision support module in an international medicinal product dictionary. This gives customers the flexibility to record allergies using SNOMED CT concepts or VIDAL's own allergy concepts to access the allergy checking knowledge.

Scope

There are two possible terminologies that were considered in addition to SNOMED CT, the Substance Registry System (SRS) managed by the EMA, and the Global Substance Registry System (G-SRS) provided by the US National Institutes of Health. Both are used by regulatory authorities when describing medicines, but both are not as suitable for this allergy work as SNOMED CT, primarily because SNOMED CT has a substance hierarchy that has relationships between substances and substance classes, and it has allergy recording concepts in the Findings hierarchy, and the causative agent relationship between these. Also, in some of the countries where we provide clinical decision support, recording of allergies in patient records using SNOMED CT concepts is recommended. So using SNOMED CT for this is not just desirable, it is necessary for us to do this for our customers.

How SNOMED CT will be used

The substance concepts in VIDAL medicinal product dictionary, which are used to describe the full composition (including excipients) of all the medicinal products in the different countries that we serve, can be mapped to the corresponding SNOMED CT Substance concepts. Using the causative agent relationship, it is then possible to infer a mapping between our substance concepts and SNOMED CT allergy concepts in the Findings hierarchy that are used by some of our customers to record allergies in their patient records. We can then also infer mappings between our allergy classes, which describe cross sensitivities as well as direct sensitivities, and offer our customers our allergy checking decision support using our knowledge.