Epic's electronic patient record systems use SNOMED CT as a reference terminology through the following mechanisms:
- Mappings between a subset of Epic's standard data elements and SNOMED CT concepts;
- Mappings between diagnoses imported from other code systems (e.g. those used in Intelligent Medical Object's and Health Language's products) and SNOMED CT concepts;
- Mappings from additional data elements to SNOMED CT concepts that can be created by clients using an External Concept Mapping activity.
These mechanisms provide linking behind the scenes, so when clinicians add a diagnosis to the problem list by selecting a familiar term, for example, they automatically select the corresponding SNOMED CT concept. This SNOMED CT encoding creates powerful possibilities within Epic's decision support and reporting facilities.
Decision Support
The Epic system calls its decision support alerts 'Best Practice Advisories'. These customized alerts are programmed to fire according to predetermined triggers, such as specific chief complaints, vital signs, diagnoses or medications, either individually or in combination using inclusionary or exclusionary logic. Best Practice Advisories can thus be used to notify clinicians to tend to important tasks, such as reviewing a patient's allergies, writing orders, and completing charting. They can also present order sets and links to third party information sources refined using the clinical context of the patient record being reviewed.
Epic customers can use SNOMED CT's hierarchical structure to group related records, making the setup for clinical decision support much simpler than would be possible if users had to select records or clinical concepts individually. For example, an administrator creating Best Practice Advisories for diabetic patients could use 73211009 |diabetes mellitus| within the SNOMED CT hierarchy as one of the criteria instead of identifying every subtype of diabetes individually.
Reporting
Within Epic's integrated analytics and reporting suite (i.e. Cogito) customers have achieved benefits by using SNOMED CT's clinical finding hierarchy to aggregate local diagnosis concepts.
The capability has for example been used by oncologists working with cancer-related ICD codes which are unsuited to grouping diagnoses by stage. Using the mapped SNOMED CT codes they are able to facilitate the reporting of staging data by utilizing the SNOMED CT hierarchy.
| Ref | Notes |
|---|---|
| 1 | http://www.epic.com/software |
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