Purpose
This project marks a shift from the traditional clinical coverage/usage of SNOMED CT for supporting information requirements of healthcare to expanding to include the information requirements for social care. It is acknowledged that there is existing content in SNOMED CT that could be used to support social care but this has not to date been used routinely and proven to be fit for purpose. Potentially the project represents a substantial rework to SNOMED CT, as it currently stands, but the requirements gathering will provide guidance in this matter. The project will require large scale resource allocation, and also involves complexity due to the interplay between healthcare and social care sectors. As such the project should be undertaken with a robust governance process in place which incorporates knowledge and skills of those working in the social care sector to ensure we remove any healthcare bias. If we do not acknowledge from the beginning that social care requirements come from a different perspective we will create content that is not acceptable or usable.
The current landscape of SNOMED CT has been exclusively developed for use in the healthcare domain. The assumption is that the work to enhance SNOMED CT within social care content, will open up the market to social care vendors, thereby meeting the use case requirements of both the health and social care sectors and supporting interoperability and transfer of care.
Scope
The Social Care survey identified 3 priority areas for development which will form the focus of the project. In addition, a further area may naturally need to be included, ‘Services for adults with learning and physical disability’, because this area covers the interface between traditional healthcare services and those provided through social service provision and social care issues that overlap with the 3 priority areas. Therefore, at this time, the areas for targeted content development in the project are as follows:
Focus topic areas
- Older people (Services for older people that includes homecare support, long term care and palliative care)
- Mental health (Services for people with mental health problems)
- Alcohol and substance misuse (Services for people with alcohol and substance misuse problems)
Background
SNOMED International is a not-for-profit organisation that owns and maintains SNOMED CT, the world’s most comprehensive clinical terminology. SNOMED CT enables healthcare information to be exchanged globally for the benefit of patients/citizens, care providers and other stakeholders.
With SNOMED CT, users can record patient data more accurately, exchange patient data both within the health care team and with patients, both locally and across borders, to improve patient outcomes. Further, stakeholders can use SNOMED CT in health data and analytics platforms for clinical, population and management analytics, as well as research to improve health care.
Developments to the SNOMED CT product are enacted at the behest of the SNOMED International Member countries. At their direction and the inclusion of social care by the General Assembly in the 2020-25 strategy, SNOMED International has committed to developing SNOMED CT to support the recording of social care information for individuals and functionality related to the delivery of social care.
At the request of the General Assembly, SNOMED International commissioned a survey of SNOMED International Members focused on social care and SNOMED CT’s ability to support use cases in this new domain. The resulting report defined social care as “the provision of social work, personal care, protection or social support services to children or adults in need or at risk, or adults with needs arising from illness, disability, old age or poverty”. (https://en.wikipedia.org/wiki/Social_Care_in_England.)
To begin to explore the content requirements related to social care, the report highlighted the need to gather user requirements and to take stock of work currently underway in Member countries and SNOMED CT content currently in national extensions. The types of services covered by social care were categorised as follows:
From the survey of Members, the highest priority areas for SNOMED CT development in Social Care were identified as follows:
- Services for older people including home care/support, long term care and palliative care focusing across healthcare and social care
- Services for people with mental health problems
- Services for people with alcohol and substance misuse problems
Project proposal
The project proposal will collate content requirements/use cases internationally, including members who participated in the survey, agree on future changes to SNOMED CT and hand these over to the authoring team. As part of this work we will also leverage the work of the Gravity Project in the US to provide insight into the content area, accepting the limitations of the scope of the project (Social Determinants of Health); whilst this does provide a US centric view, the Gravity project will help to provide an initial definition of the content for an international audience. Initial content requests generated from the Gravity Project have provided high level groupers, which this project will look to expand upon providing a greater level of detail.
The SNOMED International Social Care survey identified a number of countries that are active in this domain currently, and these countries will be key participants in the project and will be a source of expertise to identify requirements/review content/identify content gaps. The countries are Norway, Spain, Denmark, the United Kingdom and the United States (through the Gravity Project).
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Recent space activity
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Social Care Screening Procedures created 2023-Jun-23
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Social Care Assistance Procedures created 2023-Jun-23
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