SNOMED CT Cardiology Reference Set Development, Malaysia. SNOMED CT Conference Amsterdam, The Netherlands October 2014
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1 SNOMED CT Cardiology Reference Set Development, Malaysia SNOMED CT Conference Amsterdam, The Netherlands October 2014
2 Content developmental process of the first SNOMED CT Reference Set (refset) development using the National Cardiovascular Disease (NCVD) Registry; establish methodology to be replicated in future refset; evaluation of tools; Implementation strategy & stakeholders involvement for early buy-in and early deliverables; MyHDW as a way forward
3 Malaysian Health Data Warehouse (MyHDW) A Way Forward
4 MyHDW: Definition and Characteristics A trusted source of truth of comprehensive healthcare data structured for query and analysis Optimized for analysis and reporting * Integrated, interoperable and comprehensive health data * Build based on national health informatics standards Overarching healthcare system governance Information available in right time Build once use many Support many reporting and analysis tools and interfaces Highest level of data quality through appropriate methods, tools and techniques Implements secure and privacy sensitive access Focus on Secondary Usage of health data MyHDW
5 MyHDW MyHDW: Category of Use & Data Sources
6 SNOMED CT in MyHDW: SNOMED Malaysian Health Data Warehouse (MyHDW) SNOMED CT coded database Mi-Harmony (Mapping & Coding) Uncoded database
7 Mi-Harmony Usage Model Existing HIS MIMOS Systems HIS TPC OHCI S LHR/ MyHIX Pa5ent/Disease Registries SPP SMRP SIMKA Un- coded Databases MyLOCA SNOMED CT Coding Phase Mapping Engine Codification Engine SNOMED- CT Coded Databases ETL Data Aggregation MALAYSIA HEALTH DATA WAREHOUSE (MyHDW) RefSets Server Data Consolidation Cube Generatio n
8 Mi-Harmony System Architecture 2 DB Schema ehis-snomed Mapping Reference Sets 1 Reverse Engineering (RE) Mapping tables RefSet Authoring tool 3 EHR sampled Database SNOMED Codification SNOMED-CT Coded Data 8
9 SNOMED CT Cardiology Reference Set The Development
10 SNOMED CT Conference October 2012 Strategy: Lessons Learnt Intention MyHDW BDA IHTSDO September 2013 SNOMED CT Conference 2013 IHTSDO Business Meeting April 2014 Team Player NRC Malaysia ICT Experts Domain experts Cardiology Scope Deliverable Early Result Buy-in
11 Tool Review: Tool review 10 Browsers & Authoring tools Factors: long-term financial implication, cost for human resource development, functions Tool decision: IHTSDO Workbench
12 First Workshop: Tripartite arrangement: Clinical domain experts, MIMOS, HIC + IHTSDO 2 sessions of 3-day workshops First session: Understanding SNOMED CT, potential benefits, video session and plan formulation by Domain experts Second session: Develop initial refset - online browsers
13 Lessons Learnt 1 SNOMED CT Conference October 2012 IHTSDO September 2013 SNOMED CT Conference 2013 IHTSDO Business Meeting April 2014 Presented Cardiology Refset s first draft to IHTSDO representatives over online discussion Lessons learnt: Information Model: understanding it and its requirement; and Too early in tripartite arrangement not cost effective to the clinicians Moving forward: Learned about Information Model of the registry Learned more about SNOMED CT Concept Model Revision of Cardiology Refset by NRC Malaysia and MIMOS Approach Domain experts when clarification of clinical terms in registry/actual meaning/workflow needed
14 Lesson Learnt 2 SNOMED CT Conference October 2012 IHTSDO September 2013 SNOMED CT Conference 2013 Presented Cardiology Refset s revised draft during SNOMED CT Conference 2013 Lessons Learnt Application of logical model in the refset development Approaches to postcoordination Designed method of developing and endorsing a refset IHTSDO Business Meeting April 2014
15 The Methodology 1. Information Model Decipher NCVD registry form Arrange the terms in registry into proper clinical terminology 2. Present to domain expert Matching SNOMED CT concepts: Clinical meaning to the terms in registry and in SNOMED CT Clear any reservations Used IHTSDO Workbench 3. Consensus & Endorsement Concensus among domain experts Endorsed by Head of Cardiology Malaysia
16 1. Information Model 2. Present to domain expert 3. Consensus & Endorsement
17 1. Information Model 2. Present to domain expert 3. Consensus & Endorsement
18 Finalized Method SNOMED CT Conference October 2012 IHTSDO September 2013 SNOMED CT Conference 2013 IHTSDO Business Meeting April 2014 Method and Refset presented to members of IHTSDO during Business Meeting April 2014 Method was acknowledged by IHTSDO Next: Future refsets: Oncology, SMRP (HIMS) Mi-Harmony Concurrent work: Harmonizing activity for SNOMED CT with MyHDW, LOINC, ICD, MyHDD Collaboration with University Malaya - implementation at userinterface level
19 Take Home Message SNOMED CT is aligned with ministry or national initiative NRC sets overarching strategy: Early result, maintain buy-in; Stakeholder engagement: Who, When, How; Domain experts own goal motivates and maintain buy-in; Continuous skill development in SNOMED CT; Team work: tripartite arrangement; Method: Information model à Present & Clarify à Endorse; Start small, validate, replicate, expand; Start right the first time.
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21 Thank you from NRC Malaysia 30 th October 2014 Ismat Mohd Sulaiman, Md Khadzir Sheikh Ahmad, NRC Malaysia
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