Meaningful Use Stage 2 Update: Deploying SNOMED CT to provide decision support in the EHR
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1 Meaningful Use Stage 2 Update: Deploying SNOMED CT to provide decision support in the EHR James R. Campbell MD University of Nebraska Medical Center Implementation Showcase October 31, 2014
2 Disclosure I receive no financial support from any interests vending electronic health records or vocabulary services
3 Agenda Meaningful Use Stage 2: Overview Terminology specifications required MU Deployment of SNOMED CT and LOINC for decision support in Epic Issues with use of SNOMED CT and LOINC in decision support
4 Meaningful Use Business case for the EHR University of Nebraska
5 Meaningful Use Stage 1: 14 core; 5/10 menu Standards specified: Problem list: SNOMED CT or ICD-9-CM CPOE decision support: FDB, Medispan E-prescribing: NCPDP Lab results to PH: LOINC, HL7v2.X Summary of care: CCD (HIPAA: ICD-9-CM; CPT/HCPCS, CDT)
6 Stage 2: 17 core; 3 menu; CQMs NCPDP Script v10.6 RxNORM, FDB LOINC, OMB value sets LOINC, SNOMED CT observables SNOMED CT code set HL7 Infobutton,???
7 Stage 2 CDA CCD R2(document) HL LOINC HL XDR/XDM CDA CCD R2 CVX code set
8 CDA HITSP C32: Continuity of Care Document(CCD) Document types and sections: LOINC Demographics: LOINC, SNCT Obs, OMB codes Payers Advance Directives Support Functional Status Problems: SNCT CF, Ev, Sit Family History: SNCT CF, Soc Social History: LOINC, SNCT Obs Allergies: RxNORM, NDF-RT, SNCT Subs, CF, Pharm, Qual Medications: RxNORM Medical Equipment Immunizations: CVX, MVX Vital Signs: LOINC, SNCT Obs Results: LOINC Procedures: HCPCS, SNCT Proc Encounters Plan of Care
9 CCD Body Entries Temperature is 36.9 C <section> <code code="8716-3" codesystem=" " codesystemname="loinc"/> <title>vital Signs</title> <text>temperature is 36.9 C</text> <entry> <observation classcode="obs" moodcode="evn"> <code code=" " codesystem=" " codesystemname="snomed CT" displayname="body temperature"/> <statuscode code="completed"/> <effectivetime value=" "/> <value xsi:type="pq" value="36.9" unit="cel"/> </observation> </entry> </section> 9
10 Stage 2 SNOMED CT XDR/XDM CCD R2 SNOMED CT LOINC
11 MU stage 2 Vocabulary Standards 2014 SNOMED CT International July 2012 and US extension March 2012 ICD-*-CM LOINC v2.40 or later RxNORM vaugust 2012, FDB CVX, MVX code set vjuly 11, 2012 CPT; HCPCS ISO languages and country codes
12 Agenda Meaningful Use Stage 2: Overview Terminology specifications required MU Deployment of SNOMED CT and LOINC for decision support in Epic Issues with use of SNOMED CT and LOINC in decision support
13 Reference Standards in Epic SNOMED CT: HLX master file supports concept identifiers and descriptions -including US extension along with subtype ( IS-A ) relationship; mapping from EDG by third party LOINC: LNC master file supports concept identifiers and long name; LRR mapped by site RxNORM: mapping to ERX supported by FDB interoperability module includes NDC codes ICD-*-CM: mapping provided by IMO third party HCPCS: mapped by Epic CVX: master table LIM mapped by site
14 Decision Support in Epic Epic Grouper technology Problem oriented record summaries Health maintenance alerts Best practice alerts Registries and population management tools Data Warehousing Cogito data warehouse GPC: i2b2 research data warehouse
15 Groupers Reporting and decision support in Epic can employ vocabulary (SNOMED CT subtypes; ICD-9-CM, FDB, HCPCS) to create groupers Compiled into code sets to build decision Use criteria Case: Select all patients with problem of congestive heart failure Use to build Case: a CHF registry Display problem oriented lab summary if Use Case: any problem of Hypertension appears on Place a Health Maintenance alert on the the problem list chart of Use all patients Case: with diabetes to trigger Create alerts for Use a specialty screening Case: view labs of the problem list for your Create oncology a Best physicians Practice Alert for patients with any diagnosis of heart failure not on a beta blocker
16 Groupers SNOMED CT IS-A for: Clinical findings, Events, Situations, Social history problem list Procedures surgical history ICD-9-CM numerical code range for diagnoses or problem list FDB for pharmaceutical or treatment class NO LOINC Results or Orders SNOMED CT observables - Physical findings are NOT integrated with Clinical LOINC
17 Creating Groupers: Diabetes Choose the parent node in a hierarchy subtree of SNOMED CT Specify the inclusion of the sets with boolean logic statements (AND, OR, NOT) The sets are compiled at creation and with vocabulary updates Groupers can be included in report writing, queries and decision logic just like term references
18 Diabetic Problem View
19 Health Maintenance Alerts
20 SNOMED CT, LOINC and Epic Epic has integrated the semantics of the SNOMED Is_a relationship into reporting and decision support technology for the user community Epic has expanded support for US extension in compliance with meaningful use Model system components include many precompiled Grouper records in standard reports and MU monitoring; build of additional SNOMED concept groupers easy to implement
21 Decision support use cases NOT supported Infectious disease cases by causative organism All lab results for a specified procedure regardless of methodology All lab results for a specified order panel All physical findings which are components of the respiratory exam
22 Cogito Radar dashboards Reporting workbench Clarity data extract Data warehouse SlicerDicer
23 Greater Plains Collaborative: i2b2 Clarity data extract ExtraxtTransformLoad to standards-based Star Schema i2b2 data warehouse for clinical research
24 Agenda Meaningful Use Stage 2: Overview Terminology specifications required MU Deployment of SNOMED CT and LOINC for decision support in Epic Issues with use of SNOMED CT and LOINC in decision support
25 SNOMED CT and Epic Defining relationships and qualifiers need to be deployed in grouper functionality to support full SNOMED CT semantics New term submission and extension concept management needs to be negotiated and standardized with Epic research data team Procedures under discussion with Epic for fully defining SmartData elements NOT well deployed Research data model for Cogito under discussion
26 SNOMED CT/LOINC: Decision support for Observables Integrated and harmonized Observables ontology fully classified needed for Physical findings, Laboratory and Radiology results Epic Grouper technology needs to be extended to employ these harmonized semantics Informatics community needs to be informed of these developments
27 Questions?
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