CSAC September 2, 2003

George Kim, MD

Harold Lehmann, MD, PhD

SNOMED CT¨ - a gentle introduction

• Standard NOmenclature of MEDicine – Clinical Terms is a:

• Comprehensive medical reference terminology
• Product of SNOMED® International, a division of the College of American Pathologists (CAP).
• Combination of two vocabularies: SNOMED RT® and the UK National Health Services Clinical Terms Version 3 (Read Codes) and was released December 2001.

• On July 1, 2003: National Library of Medicine/HHS signed a 5 year contract with CAP to make SNOMED CT® available for free through the Unified Medical Language System¨ (UMLS) as a major step to achieving interoperability in the health system (part of the eGov Consolidated Health Informatics (CHI) Initiative).

• SNOMED CT® has over 40 years of R & D in US/UK, demonstrated completeness of coverage in numerous studies and is currently incorporated into two large systems: UK National Health System and US Kaiser PermanenteÕs Convergent Medical Terminology (CMT).

• SNOMED CT® is a powerful vocabulary for describing medical concepts completely and to great detail (small granularity). The same concept may be expressed in different ways as core (pre-coordinated) and/or compound (post-coordinated) concepts and attributes. There is extensive cross mapping to other frequently used medical vocabularies with provision for extension to "local" terminologies and dictionaries.

• SNOMED CT® is being incorporated into UMLS® and will be ready for release from the National Library of Medicine in Q1 2004. Tools and training for dealing with the vocabulary will be available from SNOMED¨ International and from the National Library of Medicine (via UMLS¨).

• Challenges confronting developers will be the establishment of the infrastructure needed for SNOMED CT® to operate successfully, the migration of legacy data and applications into SNOMED CT®-friendly formats, the maintenance of the terminology and local extensions and the diffusion of system-wide acceptance of SNOMED CT® related changes.

(A hyperlinked version of this outline and the attached resource list will be posted on the Division of Health Sciences Website: http://dhsi.med.jhmi.edu).

Resources:

SNOMED® International: http://www.snomed.org

Source for SNOMED CT®  information, including product description, users groups, references to research papers, press releases and presentations. Contact information for support and training.

National Library of Medicine: Unified Medical Language System® (UMLS): http://umlsks.nlm.nih.gov

Source for UMLS files, programming and lexical tools to manipulate tables for use in different environments. Training is organized through the National Network of Medical Libraries: http://nnlm.gov/mar/online/description.html

References:

Cimino JJ, "Desiderata for Controlled Medical Vocabularies in the Twenty-First Century," Methods Inform Med 1998; 37: 394-403

Dolin R, "Kaiser Permanente's 'Convergent Medical Terminology'", SNOMED User Group Meeting, San Antonio, Texas, November 8, 2003.

URL: http://www.snomed.org/Users_group/Presentations2002/SNOMED_at_KP/sld001.htm

(Last checked 08-19-2003).

Markwell D, "SNOMED® Clinical Terms-Technical Design/Using SNOMED® Clinical Terms in clinical statements," Presentation CEN TC251, Berlin – 4 February 2001.

National Health Information Infrastructure 2003, Conference Materials from "Developing a National Action Agenda for NHII", June 30-July 2, 2003, Washington DC.

URL: http://www.nhii-03.s-3.net/materials.htm

(Last checked 08-18-2003).

National Health Service, SNOMED Clinical Terms® - resource page.

URL: http://www.nhsia.nhs.uk/snomed/pages/pastevents.asp

(Last checked 08-19-2003).

Price C, "Forming the Foundation for Enterprise-wide Applications of SNOMED CT: The UK National Health Service," ", SNOMED User Group Meeting, San Antonio, Texas, November 8, 2003.

URL: http://www.snomed.org/Users_group/Presentations2002/Colin%20Price/

(Last checked 08-19-2003).

SNOMED CT¨ Product Profile, SNOMED International, January 2003.

URL: http://www.snomed.org/SNOMEDCT_Product_Profile_0603.pdf

(Last checked 08-18-2003).

SNOMED® International Users Group Conference, SNOMED CT® Goes Live! November 8, 2003, San Antonio, Tx.

URL: http://www.snomed.org/Users_group/Presentations2002/Presentations.htm

(Last checked 08-19-2003).

Spackman K, "SNOMED CT Goes Live: A Vision for the Future of Health Care Information," SNOMED User Group Meeting, San Antonio, Texas, November 8, 2003.

URL: http://www.snomed.org/Users_group/Presentations2002/Kent%20Spackman

(Last checked 08-19-2003).