2021-07-27 Anesthesia CRG Meeting

Apologies Terri Monk  Erica Culp  user-619d4

Jane Millar

Monica Harry

SNOMED Autumn Meeting and Expo 28-29th October 2021 (online) - registration open

Clinical webinars 26-27 October :  Clinical Meeting 27th October 1230 UTC. SNOMED CT support for cancer care

Consider request(s) for meeting time (e-mail from Fleur McBriar  26/07/21) - To be confirmed following discussion at clinical leads meeting 11th August

Monica Harryreported that there is considerable activity in additions to SNOMED CT in the following areas: Rare diseases (Orphanet), genomics, Kaiser Permanente CMT, Organisms, restructuring of substance hierarchy.

Jane Millar reported on the following collaboration efforts:

Increasing membership of EU states, a number of webinars having been held which were well attended

EU 2020-25 funding for member states to support membership of SNOMED International

Unicom - an EU drugs project and draft ISO standard to bring consistency to representation of medications

Recent G7 Health Ministers meeting - agreement on the use of an International Patient Summary - an HL7 project and ISO standard, with a SNOMED CT termset to support the initiative

Collaboration with multiple professional bodies including the Academy of Nutrition , Periodontal medicine professional bodies, nursing organisations including NANDA and ICNP. SNOMED will be distributing ICNP, first release October 2021. The nursing CRG is now active again.

Discussion of request #  761787                 number of lumens

Monica Harrynoted that there is no currently no model to support device recording in the way proposed.  Members of the Anesthesia CRG noted that this would be applied to multiple types of catheters and that this approach seemed preferable to pre-coordination .

Martin Hurrell will share the HL7 Anaesthesia Domain analysis model which illustrates the object attribute value method  describing lumens of vascular catheters.

Monica Harry to discuss further with Chief Terminologist

Completed ventilation modes  Vent modes 19223 batch template 200721.xls

These have now been submitted from a batch template to the SNOMED request system. Andrew Nortonand Monica Harrywould meet online as necessary to discuss structure of terms and other issues from the submission.  AN will send MH link to online ISO19223 indicating where tables E1 &E2 that contain main structure of the mode concepts

Ventilation patterns for discussion vent patterns 19223 batch template.xls

This spreadsheet has been completed but some uncertainty as to potential clinical use. Steven Dainfelt that these would not be be primary method of recording clinical information in records.  Will be held on file pending further discussion

Discussion of adjuncts for inclusion in SNOMED CT19223 Adjuncts.1b.2020-12-16T09.docx

Agreed that these should be modelled for inclusion in SNOMED CT. Noted that NIV has been set as a boolean variable for manufacturers.

Discussion of recommendations for existing mode terms similar or identical to ISO19223 term requests

FHIR Implementation guide for anesthesia records, project scope statement, involvement of other groups and stakeholders

Draft PP FHIR IG anaes.docx

The HL7 Anesthesia SIG has now been dissolved and incorporated into the Devices working group.  Discussion had taken place on the planned development of version 2 of the anaesthesia record domain analysis model and a FHIR implementation guide for anaesthesia records. The Devices working group had agreed these should be amalgamated into one project. A draft project proposal has been produced. Devices WG would be the HL7 project sponsor. It would be advantageous if SNOMED would also act as a project co-sponsor.

It was noted there was universally little agreement  on common structure and rendering of anesthesia records.

The need for significant clinical engagement and support from professional bodies was noted, which had proven difficult in the past. Initially approaches are being made to the ASA EMIT (emerging media and information technology) committee and to SCATA (Society for Computing and Technology in Anaesthesia). Beyond that, support would be required from governing bodies of the profession such as ASA, CAS and RCoA. Martin Hurrell was asked to consider a descriptive document that could be used to inform and gain support from professional bodies.

Steven Dainreported that a draft of ISO 4135 - Anesthesia and Respiratory equipment - Vocabulary is at a draft stage and planned for publication in English, French and German . This would prove a useful resource.  He also suggested trying to locate and engage (probably now retired) Dr Neil Feinglass - originator of the Cerner Anaesthesia record