Implications of using SNOMED CT for result values

In laboratory test result reporting, the semantic relationship between the identification of the observation and its value is that the asserted value "refines" or "qualifies" the meaning of the laboratory test that is specified in the identification of the observation. In other words, how a particular result should be reported depends upon what is being used as an identification of the observation. This is true regardless of whether SNOMED CT is used.

When SNOMED CT is used for a coded result value, this understanding of the semantic relationship is consistent with the use of refinement as specified in the SNOMED CT Concept Model.

Examples

Example 1: Reportable Condition Mapping Table (RCMT)-Lab Test & Results. CDC Vocabulary Server

The Reportable Condition Mapping Table (RCMT) provides mappings between reportable conditions and their associated LOINC laboratory tests and SNOMED results.

The RCMTs use standards suggested for the meaningful use measure "reportable lab result reporting to public health". They can be used to filter the output of clinical labs for test results that are of interest to public health.

Figure 5.2.3-1: CDC Vocabulary Server (PHIN VADS). RCMT Tree (Navigator) e.g: Tuberculosis

Table 5.2.3-1: Relationships - Condition and Lab Tests/Results Notifiable Event (Disease/Condition) Code list: Tuberculosis

Example 2: CIMI

The Clinical Information Modeling Initiative (CIMI) is an international collaboration dedicated to improving the interoperability of healthcare information systems through shared implementable clinical information models. CIMI's goal is to provide a common format for detailed specifications for the representation of health information content so that semantically interoperable information may be created and shared in health records, messages, and documents.

Figure 5.2.3-2: CIMI archetype map for laboratory results report

Figure 5.2.3-3: CIMI Modelling Taskforce Report

Example 3: Value set for Microorganisms/Infectious agents (PHIN-VADS CDC)

Microbiology reporting is a common example of laboratory tests that are reported with coded result values (i.e. the microorganism identified). Use of SNOMED CT to code such results enables reporting and decision support capabilities.

Table 5.2.3-2: Value Set Code PHVS_Microorganism_CDC