Luke Roberts is a specialist in SNOMED CT implementation and application at Guy’s and St Thomas’ NHS Foundation Trust.
The challenges faced by general practice today are enormous. We are contending with the fallout from the COVID-19 pandemic, significant staff shortages, and patient populations who are ageing and increasing in complexity.1,2 We need to become more efficient while improving care quality and safety.
How can we do this? SNOMED CT holds some of the answers, but many practices are unaware of its full potential.
What is SNOMED CT?
SNOMED CT is the world’s most comprehensive clinical terminology and is mandated for use in the UK.3,4 It supports the standardised recording and encoding of patient information, including diagnoses, procedures, and medications. The terminology is designed to be usable in any electronic health record system.
You may recognise codes and terms like this: 195967001 |Asthma (disorder)|.5 These are called concepts in SNOMED CT. Every concept represents a clinical entity with a unique code and a series of descriptions indicative of its meaning.2
“SNOMED CT is more than just a list of codes and descriptions; it is an ontology.”
SNOMED CT is more than just a list of codes and descriptions; it is an ontology. Every concept has a computer-understandable meaning called a logical definition.2,6 By using these definitions, thousands of different concepts can be linked together through parent–child relationships and other defining characteristics. As computers understand these definitions, we can unleash their processing power to support our clinical and operational decision making.
What are the benefits of SNOMED CT?
SNOMED CT can help us work smarter, not harder. Some practices utilise third-party products and consultancy to apply their SNOMED CT data. This can be costly and introduce unwanted dependencies where this function could be managed and served in-house.
Here are three significant benefits:
• the creation of high-quality and reusable data;
• automation of reporting and cohort identification; and
• reliable data sharing between systems, staff groups, and care providers.
High-quality and reusable data
What are the implications for your patients if you make decisions using incomplete or erroneous data? Answers can range from minimal to life-changing! When SNOMED CT is effectively implemented, clinical staff can efficiently and accurately document and code relevant information in a universally-understood format. As this data is structured, instantly usable, and of high quality, the data can be recycled rapidly. For different use cases, there is no need to ‘reinvent the wheel’ at significant cost and time. The same data can feed national reporting, case mix analysis, clinical audit, risk evaluation, and finance.
Automation of reporting and cohort identification
“A priority is to raise awareness of the importance and uses of SNOMED CT.”
How much time have you spent manually reviewing patient notes to find relevant information buried within pages of the free-text narrative? SNOMED CT can help you steal this time back. SNOMED CT has its own ‘query’ mechanism, which means we can accurately, quickly, and easily manipulate the terminology to help define and identify relevant patient cohorts for audit, reporting, and billing.2
SNOMED CT data is also robust and specific enough to support predictive and prescriptive analytics, which is critical for the growing movement towards delivering greater preventative and individualised medicine.
Reliable data sharing
Have you ever wished you had more information about your patient’s care from other providers? SNOMED CT data is intended to seamlessly flow to and from hospitals and other care providers using commonplace data technologies and infrastructure with appropriate data governance oversight.4 Such data transfer reduces the time spent on unnecessary administrative processes and supports the effective continuation of care. Imagine the benefits of having a shared problem list between your practice and local hospital(s). Crucially, data sharing forms a safety net for identifying hidden populations, such as those with a learning disability and autism,7 and preventing adverse outcomes.
What can I do?
A priority is to raise awareness of the importance and uses of SNOMED CT. SNOMED International have helpful resources and training courses aimed at all levels of understanding and needs.8 Quick and easy wins can be derived using the terminology to automate data processes and support data reuse for clinical audit, reporting, and analytical activities.
Early engagement with clinical partners and relevant third parties will be beneficial in taking steps towards meaningful and reliable data sharing. Working closely with your health record provider is paramount. Successful data sharing will lead to large-scale quality, safety, and productivity improvements.
References
1. Gruneir A, Griffith LE, Fisher K, et al. Increasing comorbidity and health services utilization in older adults with prior stroke. Neurology 2016; 87(20): 2091–2098.
2. Roberts L, Lanes S, Cooper C. SNOMED CT: a potential powerhouse in the health record revolution. British Journal of Healthcare Management 2022; 28(9): 225–231.
3. SNOMED International. 5-step briefing. https://www.snomed.org/snomed-ct/five-step-briefing (accessed 17 Oct 2022).
4. NHS Digital. SCCI0034: SNOMED CT. 2020. https://digital.nhs.uk/data-and-information/information-standards/information-standards-and-data-collections-including-extractions/publications-and-notifications/standards-and-collections/scci0034-snomed-ct (accessed 17 Oct 2022).
5. NHS Digital. The NHS Digital SNOMED CT browser. 2022. https://termbrowser.nhs.uk (accessed 17 Oct 2022)
6. SNOMED International. SNOMED CT starter guide. 2022. https://confluence.ihtsdotools.org/display/docstart/snomed+ct+starter+guide (accessed 17 Oct 2022).
7. Department of Health and Social Care. Building the right support for people with a learning disability and autistic people. 2022. https://www.gov.uk/government/publications/building-the-right-support-for-people-with-a-learning-disability-and-autistic-people (accessed 17 Oct 2022).
8. SNOMED International. Education. https://www.snomed.org/snomed-ct/education (accessed 17 Oct 2022).
Featured photo by Pietro Jeng on Unsplash.
