Summary
Under care of <professional> (finding) content is being considered for inactivation (with return the relevant extension where applicable) as it is seen as realm specific content. The meaning of the term used to represent the clinician or service may vary between countries. Prior to undertaking this step the CMAG is being asked if this demotion of content would cause an issue for members.
Please see the subtypes under the following concepts:
- Under care of team (finding)
- Under care of person (finding)
- Under care of service (finding)
Actions:
| Date | Requested action | Requester(s) | Response required by: | Comments |
|---|---|---|---|---|
| Requested 11th April 2018. | Please advise if the demotion of this content to the relevant extensions would cause an issue for your country. |
| Please post your final responses in the Country response table below. Discussion comments can be made as comments. |
Relevant documents
Links
2018-04-11 - CMAG Meeting: Face to face in London, England
PCP-49 - Getting issue details... STATUS
Country response
| Country | Date | Response |
|---|---|---|
| Sweden | 2018-04-23 | Has nothing in the extension in this group. Also, no content in our maintained and under-development refests. |
| Denmark | 2018-04-25 | Not in use in Denmark. |
| UK | 2018-04-26 | Is there any further information on the decision around this please. I've looked at the tracker which states "Ed Panel decision: Pattern not accepted, considered to be realm specific especially with respect to social care." We have extension content in this space and there is a significant amount of core content that is not realm specific e.g. 305439002 | Under care of counselor (finding), 305485004 | Under care of geneticist (finding), 305613006 | Under care of physiotherapist (finding). Is this content also to be retired or just the realm specific? |
| NZ | 2018-05-01 | No concerns raised in New Zealand |
| AU | 2018-05-03 | I'm not aware of any sites using this content, but they could well be? Although the specific definition of the 'profession' could vary between countries - I think the terms are still valid. Using the UK example: 305439002 | Under care of counselor (finding) - counselor mean something slightly different in AU compared to other countries (registered/training etc). But I can see it being useful, and not sure how else we or other countries would name it? What is the problem with it remaining in core? (it seems a low value change). |
| CA | 2018-05-04 | Not in use in Canada. |
| NL | 2018-05-08 | We do have some content of this in our extension, for example Under care of heart transplantation team (finding). But these concept are more to be able to model 'guidance or support after a heart transplantation' in the finding hierarchy. So we are OK when you inactivate the content and we will find a solution for this  |
| UK | 14-05-2018 | Thank you for clarifying that all content in this space is proposed for inactivation. As mentioned in the CMAG meeting this could cause issues for us and I don't see the issue with it remaining in the core. I would like to take this to our UK SNOMED CT Edition committee on the 5th June for a complete response. |
| Member countries without a CMAG rep |
CMAG response
| Date | CMAG Response | Next steps |
|---|---|---|
Final outcome:
Date:
12 Comments
Cathy Richardson
Elaine Wooler is there anything further on this from the UK or am I able to moved this topic to the resolved folder? Thanks, Cathy.
Elaine Wooler
Hi Cathy
The UK Edition Committee meeting was last week so I'll see if there was anything else from this.
Elaine Wooler
Hi Cathy
This was actually discussed in a wider context as this content should not be looked at in isolation as I mentioned in London. We were actually looking at producing in the UK draft editorial guidance around how to manage the entire family of referred to/seen by/under care of/discharged from. Would it be useful for SNOMED International to look at that guidance once available? Just not sure now is the time to retire this content but if you had to then we would want it back here to manage this workflow suggestion.
Best wishes
Elaine
Cathy Richardson
Hi Elaine,
The timing of inactivation of this content has not yet been set. Also when do you anticipate the draft guidance would be available.
Regards,
Cathy
Camilla Wiberg Danielsen
Hi Elaine, Although we do not use these concepts in Denmark presently, I think that if the UK editorial guidance gives some hint of different meanings (or similarities) of the above mentioned it would be of interest from a translation perspective. /Camilla
Zac Whitewood-Moores
Cathy Richardson I am not sure whether this is being progressed or other nations have expressed an interest in the content. We have wide usage in the UK in primary care, however its development is incomplete and it would be good to see more completeness across the care pathway. However Under care of would appear to be a care activity 'in progress' and thus a situation, procedure with explicit context seems more appropriate (this probably applies to some of the other findings). In the NHS in England, Treatments Functions and Main Specialties are contained within DCB0028: Treatment Function and Main Specialty Standard - NHS Digital Many of these are common across Europe and in many cases the globe so it seems sensible to keep them international or at least the Community edition. This and similar content would benefit from representation modelled with appropriate services in the future to facilitate equivalence checking between pre and post-coordinated content. I recognise that some areas of modelling are restricted by the current concept model, or indeed absence of one covering some areas of content, however many areas of healthcare will benefit from greater consistency of coverage across SNOMED CT.
Cathy Richardson
Zac Whitewood-Moores Just wanted to let you know that your post here has been seen. We'll be responding shortly.
Elze de Groot
I'm too late to react on this item. In the Netherlands we use the parent concepts for example 'under care of team'. We have subtypes in our extension, we don't use the subtypes in the Core. We created for example 'Under care of heart transplantation team' to register the care of a patient during and after the transplantation.
Zac Whitewood-Moores
Yes we have a few more, but most current content relates to specialties, whereas many places organise around services now, certainly in the UK. So a cardiology service, rather than an individual cardiologist, reflecting the multidisciplinary nature of care better than a single figurehead.
Matt Cordell
The past few months I've been involved in reviewing a related set of concepts used in our Service Registration project, and a number of other implementations. Specifically
The feedback related from users was around the organisation of concepts, terms used, and ambiguity.
I expect most countries could have use cases for this content, but it's going to be difficult to get global consensus on what concepts mean. Each country has their own training, registration and care pathways that determine a lot of this.
Perhaps this content is probably best left for members to look after themselves? (ie. it's not core).
I'm planning to implement some local changes in the new year for the above sub-heirarchies
Elze de Groot
I agree with Matt. The concepts we have of 'under care' are fine in our extension and in the Netherlands the definition is clear. The word 'service' is a difficult word to understand in the Netherlands and to find a similar 'thing' for. Therefore it was also hard to translate. It looks like these are country specific terms.
Jim Case
Use of these terms in the US seem to be extremely rare.
KP has only used one concept one time.
UNMC has used three concepts one time each.