Discussions - Cancer Synoptic Reporting Clinical Project Group

One deliverable from the discussion in Bratislava was to explore the extent of dependency of Nebraska Lexicon(C) on the US extension module since direct sharing with national release centers other than US was being proposed.  I have attached an Excel spreadsheet of RF2 records to the meeting page from our current release which represent all Lexicon(C) concepts with stated relationships to US extension DestinationIds.  There are only 8 concepts and they are all <<404684003|Clinical findings| or <<71388002|Procedures| and represent none of the work to encode cancer checksheets.  Jim

Daniel Karlsson...Do you think there are other more subtle issues I need to pursue?

I include below an email chain following up on an item from the call 3/20 wherein FHIR service documentation was discussed for UK deployment.  Note that Jay's response clearly indicates that there is NO mature FHIR service call that would currently manage the Synoptic report.  I suggest to Scott that this is off the table until such time as UK has a FHIR service standard that would manage the complexity of content of the fully encoded Synoptic report.

Jim

>>> Jay Kola writes:

Hi Jim,

Yes it has been a while! I tried to hide from the SNOMED CT world for a while by being a ’software geek’ - rather unsuccessfully as you can see from my reappearance. Great to hear from you again!

FHIR is the strategic direction of travel in the UK. We are about to reach the end of a major piece of FHIR related work aimed at ‘transfer of care’ - using FHIR to access primary care and secondary care records. As you point out, FHIR is still in evolution and we took the approach of what I call ‘beating FHIR into shape’. So we had clinicians, informaticians, terminologists and vendors round the table looking at FHIR resources and ‘tweaking/extending/constraining’ them for our use. We’ll be sharing some of that work at the April Business Meeting. 

On the back of this follow many other programmes including pathology that’ll be looking at FHIR as the messaging wrapper. It is probably too early to say if we’ll implement a FHIR service for structured datasets like the Synoptic Report, but it’ll is quite likely to be the case. As you know we have the usual challenges re adopting technologies that might cause problems for suppliers, so we will evaluate options. I’d love to find out more about your CDA implementation work. 

Are you attending the April meeting in London?

Regards,
--
Jay Kola,
Business Lead for Terminology & Innovation - Information Representation Services,
Code4Health Innovation Associate,
NHS Digital
                                                                         
Tel: 0113 2542575 
Mobile: 07476334162

Campbell, James R

  >>>Jim Campbell wrote

Hey Jay!
It has been awhile...The issue that Debbie raises is that the Synoptic Pathology Reporting project is developing and validating SNOMED CT Observables coding for the anatomic and molecular pathology observations made by pathologists in the diagnosis of a cancer case.  We have that data set (for colon, breast, lung and melanoma malignancies) live on an HL7 V2 interface at Nebraska Medical Center.  We are planning to produce an implementation guide for an HL7  CDA  structured Synoptic Report document synthesizing and reporting an entire case.  
I know that FHIR service standards are very much in evolution, but Debbie wants to know if UK has/will implemented a FHIR service for such a structured dataset?  They tell me you are the GoTo person for what is being done (and what will be) with SNOMED CT Pathology implementation in the UK.
Jim