Re: Moving towards the use of SNOMED CT in place of local codes for better interoperability
Dear Vebjørn, 1-AFAIK Each documented item in the EHR is following the pattern: Question=Answer Archetype/Template nodes define the Question. The Data Element in the Archetype/Template defines the Answer. Between the two organisations behind LOINC and SNOMED there is an agreement to use LOINC for coding the question. And use SNOMED to code the answer. CIMI is using this convention. This brings me to: Question = Answer use LOINC = use SNOMED 2-Local code sets versus International codes. Interoperability (interpretability) demands that in the end we all use the same Basic Models/standards in our Semantic stacks. Always there will be reasons to create local codes/classifications for specific purposes. Interoperability (interpretability) demands that these local codes/classifications need to be mapped to International models/standards. Gerard Freriks +31 620 34 70 88 +31 182 22 59 46 gf...@luna.nl Kattensingel 20 2801 CA Gouda the Netherlands > On 8 Mar 2019, at 09:07, Vebjørn Arntzen via openEHR-clinical > wrote: > > Hi, Dileep > > There are nodes in archetypes where it could, and perhaps should, be > recommended to use terminology where possible. In many of them, there already > is such recommendations. For example in Problem/Diagnosis name in the > archetype Problem/Diagnosis: > Identification of the problem or diagnosis, by name. > Comment: Coding of the name of the problem or diagnosis with a terminology is > preferred, where possible. > > And in Severity category in Symptom/Sign, the coded text are already binded > to SNOMED-CT: > Mild [The intensity of the symptom or sign does not cause interference with > normal activity.] > [SNOMED-CT::162468002] (Symptom mild (finding)) > Moderate [The intensity of the symptom or sign causes interference with > normal activity.] > [SNOMED-CT::162469005] (Symptom moderate (finding)) > Severe [The intensity of the symptom or sign causes prevents normal activity.] > [SNOMED-CT::162470006] (Symptom severe (finding)) > > If it is preferred to use a local valueset instead, or to extent the number > of codes, the datatype is a choice of either Coded text, or Text, to allow > for this. It's mentioned in the comment of that element: > Comment: Defining values such as mild, moderate or severe in such a way that > is applicable to multiple symptoms or signs plus allows multiple users to > interpret and record them consistently is not easy. Some organisations extend > the value set further with inclusion of additional values such as 'Trivial' > and 'Very severe', and/or 'Mild-Moderate' and 'Moderate-Severe', adds to the > definitional difficulty and may also worsen inter-recorder reliability > issues. Use of 'Life-threatening' and 'Fatal' is also often considered as > part of this value set, although from a pure point of view it may actually > reflect an outcome rather than a severity. In view of the above, keeping to a > well-defined but smaller list is preferred and so the mild/moderate/severe > value set is offered, however the choice of other text allows for other value > sets to be included at this data element in a template. Note: more specific > grading of severity can be recorded using the 'Specific details' SLOT > > Terminologies come and go, what's popular today may not be popular tomorrow. > And as for SNOMED, there is a substantional fee to be paid to use them, which > not all countries in the world are willing (or able) to pay. This is why > there are mostly recommendations to use*a terminology*, and not a specific > named one. > > If you find elements where it should be mentioned to use terminology where > possible, please add a change request for that archetype. > > > ___ openEHR-clinical mailing list openEHR-clinical@lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
SV: Moving towards the use of SNOMED CT in place of local codes for better interoperability
Hi, Dileep There are nodes in archetypes where it could, and perhaps should, be recommended to use terminology where possible. In many of them, there already is such recommendations. For example in Problem/Diagnosis name in the archetype Problem/Diagnosis: Identification of the problem or diagnosis, by name. Comment: Coding of the name of the problem or diagnosis with a terminology is preferred, where possible. And in Severity category in Symptom/Sign, the coded text are already binded to SNOMED-CT: * Mild [The intensity of the symptom or sign does not cause interference with normal activity.] [SNOMED-CT::162468002] (Symptom mild (finding)) * Moderate [The intensity of the symptom or sign causes interference with normal activity.] [SNOMED-CT::162469005] (Symptom moderate (finding)) * Severe [The intensity of the symptom or sign causes prevents normal activity.] [SNOMED-CT::162470006] (Symptom severe (finding)) If it is preferred to use a local valueset instead, or to extent the number of codes, the datatype is a choice of either Coded text, or Text, to allow for this. It's mentioned in the comment of that element: Comment: Defining values such as mild, moderate or severe in such a way that is applicable to multiple symptoms or signs plus allows multiple users to interpret and record them consistently is not easy. Some organisations extend the value set further with inclusion of additional values such as 'Trivial' and 'Very severe', and/or 'Mild-Moderate' and 'Moderate-Severe', adds to the definitional difficulty and may also worsen inter-recorder reliability issues. Use of 'Life-threatening' and 'Fatal' is also often considered as part of this value set, although from a pure point of view it may actually reflect an outcome rather than a severity. In view of the above, keeping to a well-defined but smaller list is preferred and so the mild/moderate/severe value set is offered, however the choice of other text allows for other value sets to be included at this data element in a template. Note: more specific grading of severity can be recorded using the 'Specific details' SLOT Terminologies come and go, what's popular today may not be popular tomorrow. And as for SNOMED, there is a substantional fee to be paid to use them, which not all countries in the world are willing (or able) to pay. This is why there are mostly recommendations to use*a terminology*, and not a specific named one. If you find elements where it should be mentioned to use terminology where possible, please add a change request for that archetype. [cid:image003.png@01D4D58E.5DD835F0][cid:image002.png@01D4D58E.00DB9590] Kind regards Vebjørn Arntzen Enterprise architect, RN ICT-dept, Oslo universitetssykehus HF and Coordinator, National governance of archetypes in Norway, Nasjonal IKT HF Tlf: +47 41 43 75 89 Primary email: varnt...@ous-hf.no<mailto:varnt...@ous-hf.no> email2: veb...@nasjonalikt.no<mailto:veb...@nasjonalikt.no> Twitter: @ArntzenRN Norwegian archetypes: www.arketyper.no<http://www.arketyper.no/> Norwegian governance of archeteypes at Twitter: @arketyper_no Fra: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] På vegne av Dileep V S Sendt: 8. mars 2019 02:09 Til: For openEHR clinical discussions Emne: Moving towards the use of SNOMED CT in place of local codes for better interoperability Hi, Many of the archetypes in the CKM use local codes extensively (Diagnosis certainty in problem diagnosis, severity category in symptom sign etc.). SNOMED CT seems to include reasonable replacements for a large number of these already. Will it not make sense for reducing the use of local codes in archetypes as that will improve interoperability of OpenEHR modeled data beyond the OpenEHR ecosystem and also reduce management overhead for the modelling community? Do we have any specific reasons for not leaving such nodes as text with recommendations for use of coding terminology? regards [https://drive.google.com/uc?id=0BxQc41y9yqs6bkE5a1JQQVBjZG8] Dileep V S Founder HealtheLife Ventures LLP m: +91 9632888113 a: 106, Innovation Centre, IIIT, Electronics City, Bangalore 560100 w: healthelife.in<http://healthelife.in/> e: dil...@healthelife.in<mailto:dil...@healthelife.in> ___ openEHR-clinical mailing list openEHR-clinical@lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
Moving towards the use of SNOMED CT in place of local codes for better interoperability
Hi, Many of the archetypes in the CKM use local codes extensively (Diagnosis certainty in problem diagnosis, severity category in symptom sign etc.). SNOMED CT seems to include reasonable replacements for a large number of these already. Will it not make sense for reducing the use of local codes in archetypes as that will improve interoperability of OpenEHR modeled data beyond the OpenEHR ecosystem and also reduce management overhead for the modelling community? Do we have any specific reasons for not leaving such nodes as text with recommendations for use of coding terminology? regards Dileep V S *Founder* HealtheLife Ventures LLP m: +91 9632888113 a: 106, Innovation Centre, IIIT, Electronics City, Bangalore 560100 w: healthelife.in e: dil...@healthelife.in ___ openEHR-clinical mailing list openEHR-clinical@lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
