NEHTA launches the first release of SNOMED CT-AU®
NEHTA launched the first release of SNOMED CT-AU® in December 2009 to Australian licence holders. Read what Paul Frosdick, Chief Terminologist at NEHTA has to say about SNOMED CT-AU® and the role he plays in the development of e-health in Australia.
As NEHTA’s Chief Terminologist, what is your responsibility?
My responsibility is basically to ensure that the clinical information components released by NEHTA are clinically and technically fit for purpose. In terms of clinical terminology that includes SNOMED CT-AU®, the Australian Medicines Terminology and other potential coding schemes.
What is SNOMED CT-AU®?
In simple terms, SNOMED CT-AU® is to be a common clinical language which will form the basis of all Australian e-health communications. It is based on the international version of SNOMED CT (Systemised Nomenclature of Medicine-Clinical Terms), which was formed by amalgamating the UK’s Clinical Terms Version 3 (The Read Codes) and the US’ leading clinical terminology SNOMED RT. In 2007 the International Health Terminology Standards Development Organisation (IHTSDO) bought the rights to SNOMED CT. IHTSDO is essentially a co-operative of 12 of the world’s leading e-health countries, including Australia, New Zealand, the UK, US, Canada, Sweden, Denmark and Holland, and membership of this organisation allows us to license SNOMED CT without charge to users.
How does SNOMED CT-AU® work?
SNOMED CT-AU® is a comprehensive, single language that can be shared and understood by any clinical computer system and by the clinician using that system. This means your GP’s system will be able to talk to and understand the system at the hospital, the pharmacy or the physiotherapist. At its simplest, it is a numerical code and a string of words that identify any unique idea within the clinical setting, be it a paracetemol tablet or a heart attack.
What are the benefits of a single, shared language?
The ultimate benefit will be the ability to share vital health information between different systems and settings and remove the need for handwritten records, leading to significantly better patient care and improved health outcomes. Even before we achieve this goal, SNOMED CT-AU® still offers many benefits in a stand-alone system because it links ideas and you can attach medical protocols to these ideas. For example, if we know that drug ‘X’ should never be used in a patient with ‘Y’ condition, systems using the links provided can create a protocol which immediately presents this information to the clinician. This significantly reduces opportunities for human error. In modern practice no clinician can remember everything they need to know, but what they should be able to do is make informed decisions based on accurate information. Safe, high quality healthcare is all about having the right information, for the right patient, at the right time. SNOMED CT-AU® consistently provides the information element of this trinity.
What relevant experience do you bring to this role?
I was a pharmacist in the acute sector of the UK’s National Health Scheme (NHS) for 15 years before I became involved in health informatics in 2000. For the last six years in the UK I was responsible for drug terminologies in the Read Codes, their migration into SNOMED CT and other managerial responsibilities across the NHS’ terminology service.
What made you decide to come to Australia and be part of this country’s e-health revolution?
Initially, when Australia was considering joining the International Health Terminology Standards Development Organisation (IHTSDO), I was seconded to NEHTA for a two-year term. When that secondment ended I made a decision to stay in Australia because I wanted see SNOMED CT come to fruition and because I genuinely believe Australia has the potential to make e-health a success.
How are you developing SNOMED CT for Australian use?
There are three things we are doing to develop SNOMED CT-AU®. Firstly, we are hiding away the ideas that are not pertinent to Australia or those that have been superseded. By discouraging use of the information that is no longer useful we are giving ourselves a clean slate to start with. Next we are dividing the data into bite-sized chunks, based on their appropriateness for each clinical setting. We have managed to whittle down the emergency department requirements to a chunk of about 4000, which is much more ‘consumable’. Finally we are localising it by adding in words and ideas that are parochial or unique to Australia. For example, only in Australia are you likely to get poisoned by the bite of a brown snake, so this ‘idea’ needs to be reflected in the terminology.
How far advanced is the development of SNOMED CT-AU®?
In its raw format SNOMED-CT has more than 350,000 concepts, or ideas, almost a million different strings of text to recognise these ideas and some 1.5 million logical relationships between these ideas. We have started to ‘slice and dice’ the data into bite-sized chunks and the first version of SNOMED CT-AU® was released in the first week of December 2009.
Is SNOMED CT-AU® to be released as a software package?
No, SNOMED CT-AU® is not stand-alone software. Rather it is software that needs to be built into other systems by software developers. Essentially, it will become the standard, underpinning language of any clinical software system. Under NEHTA’s licensing arrangements, SNOMED CT is available without charge for e-health software developers to use in their Australian products.
Will SNOMED CT-AU® ever be complete?
Because ideas constantly change SNOMED will never be completely finished, but eventually it will just need regular maintenance and updating.
For more information on SNOMED CT-AU®, access the Clinical Terminology pages
http://www.nehta.gov.au/connecting-australia/clinical-terminologies/clinical-terminology