Promoting interoperability between SNOMED CT and ICD-11: lessons learned from the pilot project mapping between SNOMED CT and the ICD-11 Foundation.

OBJECTIVE: To explore the feasibility and challenges of mapping between SNOMED CT and the ICD-11 Foundation in both directions, SNOMED International and the World Health Organization conducted a pilot mapping project between September 2021 and August 2022. MATERIALS AND METHODS: Phase 1 mapped ICD-11 Foundation entities from the endocrine diseases chapter, excluding malignant neoplasms, to SNOMED CT. In phase 2, SNOMED CT concepts equivalent to those covered by the ICD-11 entities in phase 1 were mapped to the ICD-11 Foundation. The goal was to identify equivalence between an ICD-11 Foundation entity and a SNOMED CT concept. Postcoordination was used for mapping to ICD-11. Each map was done twice independently, the results were compared, and discrepancies were reconciled. RESULTS: In phase 1, 59% of 637 ICD-11 Foundation entities had an exact match in SNOMED CT. In phase 2, 32% of 1893 SNOMED CT concepts had an exact match in the ICD-11 Foundation, and postcoordination added 15% of exact match. Challenges encountered included non-synonymous synonyms, mismatch in granularity, composite conditions, and residual categories. CONCLUSION: This pilot project shed light on the tremendous amount of effort required to create a map between the 2 coding systems and uncovered some common challenges. Future collaborative work between SNOMED International and WHO will likely benefit from its findings. It is recommended that the 2 organizations should clarify goals and use cases of mapping, provide adequate resources, set up a road map, and reconsider their original proposal of incorporating SNOMED CT into the ICD-11 Foundation ontology.

Terminology Adoption in Family Medicine Service - Start of Journey.

A proposal on terminology adoption for the Problem and Encounter Reason capturing in the Hong Kong Hospital Authority Family Medicine Module was suggested. Given the complexity of the project, mapping had been conducted as preparatory work in the early phase of development.

Is it Possible to Make Everyone Talk in the Same Language?

Speaking the same language is a vital pre-requisite in verbal communication. The same applies in sharing health information among medical professionals in rendering care to patients. The Hospital Authority of Hong Kong developed its own clinical vocabulary table (HACVT) for clinicians to document diagnoses and procedures directly in the Clinical Management System (CMS) since 1996. HACVT is referenced to international classifications and reference terminologies, with local terms added and is built according to the principles of terminology management [1]. This poster describes the process of data standardisation within the organisation in the past years to achieve data interoperability through different adoption methods of HACVT.

Development and maintenance of a controlled vocabulary via an electronic collaborative platform.

The development of electronic health records and clinical information systems has been progressing at a quickened pace in recent years. With such change, the use of standard vocabulary has aroused much interest. However, classification code sets are developed for their distinctive purposes, no single vocabulary set could satisfy the needs of all specialties; moreover, local customization would be inevitable. This poster describes how a controlled vocabulary with contribution from frontline clinicians was set up in Hong Kong Hospital Authority (HA). The adoption of an electronic maintenance portal with collaboration of representatives from all institutions would also be discussed. The use of such table has helped to maintain the interoperability of captured data between departments, specialties and institutions.

Building a womb-to-tomb health record in Hong Kong--an application of information architecture.

The Hospital Authority developed the Information Architecture (IA) model in 2002 to support a fast, robust, flexible and accurate electronic patient record (ePR) to meet the high-tempo health care environment in Hong Kong. With several successful applications in sharing data that were created for the same patients in various systems, the IA model was further developed to extend the longitudinal ePR to include one's fetal data as entered in the mother's record. This paper describes how various IA elements: Section, View, Form, Group, Entity, Content, Document supports the building of a true womb-to-tomb ePR for the HA patients. The future focus of Information Architecture in the HA will include building a Information Architecture Management System and linking the ePR with other patient records in the community.