Thursday, July 23, 2009

The SNOMED-CT Problem List has arrived

As promised in my earlier blog, the National Library of Medicine has created a "best practices" subset of SNOMED-CT which is highly usable by clinicians for documenting the symptoms and conditions used on a typical Problem List.

I've discussed previously the hazards of using ICD-9 as problem list vocabulary. It's an administrative billing vocabulary, not a clinical observation vocabulary.

You need a free SNOMED license (if you're in one of the countries that has licensed SNOMED, such as the US) to retrieve the SNOMED Problem List document.

The present subset is based on datasets submitted by 7 institutions - Beth Israel Deaconess Medical Center, Intermountain Healthcare, Kaiser Permanente, Mayo Clinic, Nebraska University Medical Center, Regenstrief Institute and Hong Kong Hospital Authority.

We're implementing this problem list vocabulary in our home grown systems first, then we'll work with eClinicalWorks to incorporate it into their EHR. We'll test it extensively with a few clinicians and then roll it out broadly if we achieve a good balance of functionality and clinician satisfaction.

The HIT Standards Committee will likely recommend SNOMED-CT as the preferred problem list vocabulary, so this release by the NLM is very important to all EHR stakeholders.

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