Content Managers Advisory Group

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Goals for project

  • Identify those which are internationally interoperable; recognising each country has a different approach i.e. may be lexically same but potential different semantics,
  • Establish which is the correct format - consider translation
  • Create a policy which applies to these and future requests for new content in this area
  • Decide which are realm specific and return to National extension

Spreadsheet: https://docs.google.com/spreadsheets/d/1mWfR4crPukxWPNkq__jarIPl2qtgjRhcS1bmL9P7omY/edit?usp=sharing

First stage review: Referral and registration

Deadline - January 31st, 2019

3 areas have been prioritised for review:

  • Tab: Administrative status - 309012006 |Referral statuses (finding)| and subtypes
  • Tab: Administrative status - 307827002 |Registration status (finding)| and subtypes
  • Tab: Administrative procedures - 3457005 |Patient referral (procedure)| and subtypes

In the spreadsheet, please answer these questions for each:

  • Do you have a use case?
  • Can you provide a definition?
  • Which is correct grammatical format/tense e.g. "referred to" or "referral to" - establish most appropriate and internationally applicable.
  • Provide any other information which may be of use. "

Actions: 

Date

Requested action

Requester(s)

Response required by:

Comments

14 December 2018As noted above

Sheree Hemingway, Monica Harry

  • Camilla Wiberg Danielsen Administrative content stage one review as noted on this page. Excel spreadsheet will be provided  
  • Daniel Karlsson Administrative content stage one review as noted on this page.  
  • Sheree Hemingway Administrative content stage one review as noted on this page.  
  • Elze de Groot Administrative content stage one review as noted on this page.  
  • Karina Revirol Administrative content stage one review as noted on this page.  
  • Linda Parisien Administrative content stage one review as noted on this page.  
  • Matt Cordell Administrative content stage one review as noted on this page.  
  • Olivier Bodenreider Administrative content stage one review as noted on this page.  
  • Jostein Ven Administrative content stage one review as noted on this page.  
  • Theresa Barry Administrative content stage one review as noted on this page.  


Second stage review: Referral and registration

Deadline - April 2nd, 2019

3 areas have been prioritised for review: Areas To be advised

  • Tab: Administrative status 
  • Tab: Administrative status 
  • Tab: Administrative procedures

In the spreadsheet, please answer these questions for each:

  • Do you have a use case?
  • Can you provide a definition?
  • Which is correct grammatical format/tense e.g. "referred to" or "referral to" - establish most appropriate and internationally applicable.
  • Provide any other information which may be of use. "

Actions: 

Date

Requested action

Requester(s)

Response required by:

Comments

12 March 2019As noted above and discussed on the CMAG call 12 March 2019

Sheree Hemingway, Monica Harry

  • Camilla Wiberg Danielsen Administrative content stage two review as noted on this page. Please use the excel spreadsheet that was provided for stage one.  
  • Daniel Karlsson Administrative content stage two review as noted on this page.  
  • Sheree Hemingway Administrative content stage two review as noted on this page.  
  • Elze de Groot Administrative content stage two review as noted on this page.  
  • Karina Revirol Administrative content stage two review as noted on this page.  
  • Linda Parisien Administrative content stage two review as noted on this page.  
  • Matt Cordell Administrative content stage two review as noted on this page.  
  • Olivier Bodenreider Administrative content stage two review as noted on this page.  
  • Jostein Ven Administrative content stage two review as noted on this page.  
  • Theresa Barry Administrative content stage two review as noted on this page.  






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5 Comments

  1. Matt Cordell

    We exclude the majority of these concepts, as they are groupers of little clinical value. Meaningful concepts aren't found until lower down, and many of these are arguably just "clinical findings" not "administrative statuses". For example "Prevention status"... several subtypes down there are concepts like 170578008|Poor hypertension control (finding)| and 314828009|Epilepsy control poor (finding)|. But a concept like 237622006|Poor glycemic control (disorder)|  is unrelated to these "statuses".

    Many of these "status" concepts could probably be rephrased as findings, e.g. 243857008|Epilepsy monitoring status (finding)| could be "Finding of Epilepsy management"

    The meaning of most/all of the concepts in the spreadsheet is so broad as to be meaningless (the subtypes hint at the intent). It would seem to be more effective to start from the bottom up.
    Provide a list of the "leaf concepts" with their aggregate parents, and indicate if these are true "administrative statuses" or "(other) clinical findings" to something else (e.g. SWEC).

    307844003|Minor surgery status (finding)|. This concept has just one immediate subtype |Minor surgery done (finding)|. Why isn't it just a subtype of 443938003|Procedure carried out on subject (situation)|

    In the end, there's likely only a handful of genuine "admin statuses". We've got an Admin hierarchy in SNOMED CT-AU, though I'm not sure how adopted it is, as many concepts overlap/replicate HL7 and other codesets that are already in use.

  2. Daniel Karlsson

    In general, we would not use these aggregate concepts  from SNOMED CT, but rather use the specific service, person, etc. concepts. E.g. instead of 306100008 |Referral by relative (procedure)| we would use e.g. 444148008 |Person in family of subject (person)| in a specific element in a referral information model. Likely, neither of these concepts would be used in Sweden.

  3. Linda Parisien

    Referral Statuses (finding):

    CA stakeholders may rather use the HL7 element to capture the status instead of the terminology.  I would keep the Referred by person (finding) and Referred to service (finding) sub-hierarchies since they may be used into the continuum of care to capture the information from/to the receiveing or referred organisation.

    Registration status (finding):

    Does not seem to be used in Canada. I agree to inactivate content that seem to be extension specific.


  4. Jostein Ven

    Unfortunately, our clinical resources have not yet been able to prioritise a full review of the Excel spreadsheet.

    Since Norway is just starting to assess SNOMED CT for various use cases, it is difficult to say very much concrete about the usability of these concepts for Norway. We do not use them today. The concepts seem to be at a high level and as such they are probably not very useful. At a more detailed level we may have a different situation, but we would have to look more closely at the relevant use cases. So we agree with both Matt and Daniel. As regards Lindas response, we are also looking into HL7 (FHIR), and need to align our terminology with that paradigm. We have many existing national administrative terminologies (small "vocabularies") , and we are also currently assessing the role of those terminologies related to administrative content in SNOMED CT (i.e. whether or not we should build SNOMED CT content for administrative concepts). 

  5. Linda Parisien

    Second Stage Review: Administrative procedure (proc) - Patient Referral

    Here are my two cents on the content found for the descendents of "Patient referral (procedure)".

    • We, in Canada are not using the pattern "Referral by X". We are rather using "Referral to X" or "Referral for X". Is the pattern "Referral by X" often used by other countries?
    • The English not being my first language, I'm not sure what is the meaning of "Patient referral for X"? Does it mean it is a referral made by the patient? or made by a healthcare professional about the patient?
    • Clean up the "referral of patient to X" - this is intended that it is a referral of a patient
    • Clean of the "patient referral to X" - this is intended that it is a referral of a patient
    • Harmonize the "Refer to X" to become "Referral to X"
    • Harmonize the "Refer for X" to become "Referral for X"
    • Clarify and harmonize the self-referral concepts