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Extension Authoring and Promotion

Added by Debbie Onos on Aug 19, 2020

I hope this is the right place! Clarity around content authored in an extension and then promoted to be included in the International Release. What to do with description IDs, relationship IDs, and language IDs.

Status: Resolved 1615 View 4 Comment Comments enabled In the category: Undefined

Comment Last useful answer, Aug 24, 2020. All contributions

Peter G. Williams

Hi donos Yes you're right. Where international components (concepts, descriptions, relationships) use the same identifier for promoted content, there's no need for you to do anything because the newer effective time in the international edition will override those in your extension. However in this case where only the concept id has been taken over and the other components were given new identifiers, then it would be correct to inactivate the equivalent (other-ids) components in your own extension so that they do not appear to be duplicates. Best Wishes, Peter CC lbird sroy

SCT conversion to ICD-10

Added by Anna Rossander on Mar 12, 2020

We want to use SCT in our new EHR (Millennium) but need to report diagnoses in ICD-10 SE for statistics, reimbursement etc. What different options are there for doing this? Can we do it within M? Should we do it outside M? Is there any software to support this? Please share your experiences of this (good or bad) so we can make a wise choice of way forward. Great thanks in advance!

Status: In discussion 1590 View 1 Comment Comments enabled In the category: Undefined

Comment Last contribution, Mar 12, 2020. All contributions

Jeffrey Chen

That's also something has been done by NSW Health in Australia. I'm not working in the public hospital system for many years but believe the diagnosis will be pick up by clinician from the SNOMED CT list in Cerner and other eMR systems. The SNOMED CT concept id will be mapped to ICD-10-AM code then generate AR-DRG code for hospital funding (Activity-Based Funding). The process is done through the medical record department (now called health information service). Also, NSW Health has its own data warehouse system (called health information exchange) which get all sorts of information from electronic systems including Cerner. Then the collaborated data can be used for QA, dashboard, reporting, and research purpose. To answer your question: 1, SNOMED CT to ICD-10 mapping should be able done inside or outside Cerner. The information may need to be transferred to a separate system or data warehouse for grouping. The choice depends on your system infrastructure. 2, As you need a diagnosis reference set in Cerner, the tool to generate the SNOMED CT reference set is required. Otherwise, you may use an existing diagnosis reference set from any NRC. You may also need a mapping tool as the SNOMED CT to ICD-10 SE may not available, and you also need to maintain the updates. I believe SNOW OWL MQ is the recommended tool for those purposes.

use of Snomed CT in Millennium

Added by Anna Rossander on Mar 12, 2020

How can SCT be used within M? We are at the beginning of an implementation of M and are pretty lost when it comes to support for SCT in M. We get different answers depending on who we ask. is there a character limit for terms that will trunctate SCT terms? does M store the concept-ID and/or the descripition-ID or none of those? (the screenshots I have seen have displayed description-ID) Can M handle synonymity; ie different terms are displayed in different parts of the system and are s

Status: In discussion 963 View 2 Comment Comments enabled In the category: Undefined

Comment Last contribution, Mar 13, 2020. All contributions

Kylynn Loi

I have some experience looking the Cerner Millenium implementation in Queensland, Australia. They have a standardised build implemented over a number of sites around the state. SCT is being used in Millenium for Problems and Alerts, and Procedures Not that i'm aware of The description ID is displayed, but both the description ID and concept ID is stored in the back-end There is different search functionality available in different components of Millenium. In some search components, synonymy cannot be used, search results will display all matching synonyms as descrete lines (regardless if they belong to the same concept which makes it the search return long and feel like there is a lot of redundancy) and it will return in alphabetical order. I am not sure about it's capability across different parts of the system I do not believe so. I think you need to export it out and do queries outside the Millenium system Not that i have seen. Cerner is able to consume extensional reference sets published by our NRC as part of our extension bundle. These need to be processed and put into the SCT package which gets loaded into the Millenium. Hope that's helpful

What is the source of the diagnoses and procedures history in your hospital?

Added by Filip Veldeman on Mar 11, 2020

Do you puzzle it together by copy/pasting info from previous letters? Or do you have one shared, jointly managed source of truth? If one common source: is it free text, or structured? If structured: do you use Snomed CT concepts? If so: do you search in all relevant hierarchies or in a managed clinical vocabulary? do you manage this in a problem list subset? do you manage your terminology inside our outside your Electronic Medical Record? (I know, it's a lot of questions, but I'm

Status: In discussion 1194 View 2 Comment Comments enabled In the category: Undefined

Comment Last contribution, Mar 12, 2020. All contributions

Jeffrey Chen

1, we use an in-house developed system to record personal and their family health history. It's stored in a structured database table which contains a few basic data elements: date/age of diagnosis, kinship, and diagnosis. 2, we use ICD-10 as the diagnosis code instead of SNOMED CT and looking to use a reference set to replace the ICD-10 code list. 3, we are not planning to use hierarchies as it is really hard for our biostatistician to do data analysis. SAS and R are their best friends. 4, yes, we do manage our own problem list as we are specialised in melanoma treatment and only record what the clinicians' interest in. 5, we are currently managing the reference set inside eMR and planning to introduce a terminology server like system to manage the terminology binding in multiple code systems.

	Topic	Status	Author	Like	View	Replies	Creation date	Last Reply	Contributors	Category
Question	Extension Authoring and Promotion	Resolved	Debbie Onos	0	View 1615	Comment 4	1597872269000 Aug 19, 2020 21:24	Aug 31, 2020 13:46	4	Undefined
Question	SCT conversion to ICD-10	In discussion	Anna Rossander	0	View 1590	Comment 1	1584016247000 Mar 12, 2020 12:30	Mar 12, 2020 22:40	1	Undefined
Discussion	use of Snomed CT in Millennium	In discussion	Anna Rossander	1	View 963	Comment 2	1584003905000 Mar 12, 2020 09:05	Mar 13, 2020 01:39	2	Undefined
Question	What is the source of the diagnoses and procedures history in your hospital?	In discussion	Filip Veldeman	0	View 1194	Comment 2	1583942961000 Mar 11, 2020 16:09	Mar 12, 2020 10:53	2	Undefined

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Anna Rossander

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Jeffrey Chen

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Jorge Rangil

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Kylynn Loi

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Peter G. Williams

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