SlideShare ist ein Scribd-Unternehmen logo
1 von 20
Downloaden Sie, um offline zu lesen
SNOMED CT CSETS
(CONSTRAINED SETS)
– ITS PLACE & ITS USE
Dr SB Bhattacharyya
MBBS, MBA, FCGP
Member, National EHR Standardisation Committee, MoH&FW, GoI
Member, Health Informatics Sectional Committee, MHD 17, BIS
Hony. State Secretary (2015), IMA Haryana
President (2010 – 2011), IAMI
Constrained Set?
■ The word constrain means “to control or limit something” (Cambridge Online
Dictionary)
■ SNOMED CT makes extensive use of refsets (reference sets), for a wide-range
of purposes, each of which have specific purposes
■ Refsets need to conform to certain specific rules and guidelines regarding their
preparation, distribution and maintenance
■ Takes a long time to design one and the designing entity needs to have a
namespace assigned to it
■ This makes the rapid and effective use of SNOMED CT in individual systems
cumbersome at best and impractical at worst
Dr SB Bhattacharyya© 2
Solving this conundrum
■ Since within a system it is pretty much lassiez faire or anything goes, it is wise
to use a constrained set of the SNOMED CT that suits the purpose
■ For example, for gender or laterality, a small list specially created SNOMED CT
code set for that purpose should work excellently (actual list follows in the
next slide)
■ Thus, wherever there is a requirement for a system to have a list presented to
the user for their selection, this small list serves the purpose
■ This limited list is termed a “constrained set” or CSET (a portmanteaux of the
two words that it refers to) by the author
Dr SB Bhattacharyya© 3
Csets for Gender & Laterality
Gender
248152002 | female |
32570681000036106 | indeterminate sex |
32570691000036108 | intersex |
248153007 | male |
407374003 | transsexual |
Laterality
7771000 | left |
24028007 | right |
51440002 | bilateral |
Dr SB Bhattacharyya© 4
Created using Cliniclue®
Explication
■ This constrained list works very well and suits the purpose of helping users to
fill in gender or anatomical side
■ The format of expressions as per the IHTSDO construction rules states that
either of the following is acceptable (only pre-coordinated types are shown
here)
– ConceptId
– ConceptId | Term |
■ Thus, let’s say, for “bilateral” laterality, either of the following works
– 51440002
– 51440002 | bilateral |
Dr SB Bhattacharyya© 5
Explication
■ It is important to debate the merits and demerits of such an approach
■ Not only must the pros and cons be considered but also the end-result should
justify it
■ For starters, let us briefly study the refset approach
■ It should be noted that refsets are meant to be exchanged with external
entities in their entirety and need to be updated after every release –
international or national
■ It should also be noted that by the term “system” it is meant any system that
uses SNOMED CT
Dr SB Bhattacharyya© 6
Refsets
■ Namespace required if refsets are shared with external entities/systems
■ Needs regeneration after every release
■ Can be automated using pre-set scripts (e.g., SQL, Perl, etc.) that needs to be
designed in-house
Dr SB Bhattacharyya© 7
RefSet field structure
NRC, India© 8
RefSet type A RefSet type B RefSet type C
ID ID ID
Effective time Effective time Effective time
Active Active Active
Module ID Module ID Module ID
RefSetID RefSetID RefSetID
ReferencedComponentID ReferencedComponentID ReferencedComponentID
Extra field 1 Extra field 1
Extra field 2
Extra field 3
Versioning
component
Identifier
Additional
fields
Fieldsalwayspresent
The reference
set
The ID of the
component being
referred to
Data Management
■ When data is managed, it is the expressions that are stored and exchanged
■ The expressions have a machine-processable part (ConceptId) and a human-readable
part (Term) of expressions or just the machine-processable part (ConceptId), it is
largely a system designing issue, which is an internal matter
■ Thus, system designers only need to consider that which is necessary to capture,
store, retrieve, display, exchange, processing and querying
■ Anything else is not related to the system functionalities
■ Refsets have largely a governance connotation
Dr SB Bhattacharyya© 9
Comparing Refsets with Csets
Refsets
■ Formal, Exchangeable
■ Not easily reproducible – needs
namespace
■ Needs to be adapted for system
use – cannot be used as-is for
data capture, storage, retrieval,
query and exchange
Csets
■ Informal, Non-exchangeable
■ Easily reproducible – does not
need any namespace
■ Ready-to-use for data capture,
storage, retrieval, query and
exchange
Dr SB Bhattacharyya© 10
Cset
Pros
■ Quick to develop and ready-to-
use
■ Can design, create, deploy and
re-use as per specific system
requirements
Cons
■ Needs a team with properly
trained and experienced
professionals to design and
create
■ Needs updating with every
release – international and
national
Dr SB Bhattacharyya© 11
Logic
■ Since most of the data is required to be captured in pre-coordinated expression forms
(the form as available from international or national releases) that is either ConceptId
only or ConceptId | Term | formats, the system designers need to have access to these
for storing in their databases and used as-is
■ For queries, transitive closure tables are required for data aggregation, else, either
only the ConceptId or only the Term need be used to return the proper records
■ The csets are easy-to-create being mostly built on-the-fly and hardly taking more than
an hour to create moderately complex ones, provided the right domain experts are
available to guide the designers
Dr SB Bhattacharyya© 12
Method
■ A good SNOMED CT tool like ClinClue® or Snow OWL® is required
■ A terminologist would be ideal but it may be tough for system vendors to hire
■ The next best person to do this type of work is a health informatics professional who
familiar with SNOMED CT
■ Alternatively, the following may be considered as a team since this type of work
cannot be done by one person, it will be too error-prone and consequently risky
■ Someone familiar with the tool being used is usually acceptable
Dr SB Bhattacharyya© 13
Method [contd.]
■ Someone well-conversant with SNOMED CT as a whole is required
■ A good DBA who can design the database in such a manner that duplicates are
removed – the way SNOMED CT is modelled, the same term may be present in
different hierarchies
■ A domain expert – specialist, doctor, nurse, dentist, paramedic, etc. – is
required to identify all Terms (preferred as well as synonyms) required for that
domain (clinical finding, procedure, disorder, allergy, etc.) to ensure that all
the necessary terms (both preferred and synonyms) have been incorporated
■ During system use, only the Terms are displayed while the ConceptIds are
stored and/or exchanged with or without the Terms, with the Term to
ConceptId to Term mapping is done at the API level
Dr SB Bhattacharyya© 14
Method [contd.]
■ The best way is to identify the Term that best describes the domain concept
(marital status, laparoscopic procedure, lipid profile, etc.) and construct the
SQL statement that will extract all the necessary subtype children and
descendants that will form the required constrained list of values
■ For maintenance purposes, rebuilding the csets for every subsequent official
release of SNOMED CT, which happens every six months, can be automated by
running these scripts to build a new cset
■ The need to manually check the cset does not go away though to ensure that
all the required concepts and their corresponding preferred terms as well as
synonyms are incorporated
Dr SB Bhattacharyya© 15
Cset field structure (proposed)
Dr SB Bhattacharyya© 16
CSet type A CSet type B
ConceptId ConceptId
Term Term
Effective time
Active
CsetId
Versioning
component
Concept Identifier
Fieldsalwayspresent
Term
Cset Identifier
The CsetId uniquely identifies the Cset that the
ConceptId belongs to. A single ConceptId may be
assigned to multiple Csets as necessary.
Cset Types
Type A
■ Separate tables for each domain
item like Gender, Employment
Status, Drug & Medicament,
Absence findings, etc.
■ No CsetId needed
■ Easy to build and maintain
■ Requires regeneration of separate
tables with every release –
several run cycles
Type B
■ One table where every domain is
uniquely identified through
CsetId that is self-determined
and self-generated
■ Complicated to build and
maintain
■ Requires running several scripts
in series that populates and
updates a single table with every
release – automated single run
cycle
Dr SB Bhattacharyya© 17
References
■ Matter based on ideas formulated by Dr SB Bhattacharyya
■ Some matter sourced from presentations prepared by Dr Karanvir Singh in
consultation with IHTSDO on behalf of National Release Centre, India
Dr SB Bhattacharyya© 18
sbbhattacharyya@gmail.com
Dr SB Bhattacharyya© 19
Dr SB Bhattacharyya© 20
Thanks!

Weitere ähnliche Inhalte

Was ist angesagt?

Introduction to medical coding standards and SNOMED-CT
Introduction to medical coding standards and SNOMED-CTIntroduction to medical coding standards and SNOMED-CT
Introduction to medical coding standards and SNOMED-CTFarzad Jahedi
 
Introduction to Snow Owl - A tool for SNOMED CT
Introduction to Snow Owl - A tool for SNOMED CTIntroduction to Snow Owl - A tool for SNOMED CT
Introduction to Snow Owl - A tool for SNOMED CTSnow Owl
 
SNOMED Bound to (Information) Model | Putting terminology to work
SNOMED Bound to (Information) Model | Putting terminology to workSNOMED Bound to (Information) Model | Putting terminology to work
SNOMED Bound to (Information) Model | Putting terminology to workKoray Atalag
 
Coit20247 ass1 requirementdba1 spec (1)
Coit20247 ass1 requirementdba1 spec (1)Coit20247 ass1 requirementdba1 spec (1)
Coit20247 ass1 requirementdba1 spec (1)Sandeep Ratnam
 

Was ist angesagt? (8)

SNOMED Clinical Terms - Introduction
SNOMED Clinical Terms - IntroductionSNOMED Clinical Terms - Introduction
SNOMED Clinical Terms - Introduction
 
Introduction to medical coding standards and SNOMED-CT
Introduction to medical coding standards and SNOMED-CTIntroduction to medical coding standards and SNOMED-CT
Introduction to medical coding standards and SNOMED-CT
 
SNOMED-CT
SNOMED-CTSNOMED-CT
SNOMED-CT
 
Introduction to Snow Owl - A tool for SNOMED CT
Introduction to Snow Owl - A tool for SNOMED CTIntroduction to Snow Owl - A tool for SNOMED CT
Introduction to Snow Owl - A tool for SNOMED CT
 
0 An Introduction To Snomed Ct1
0 An Introduction To Snomed Ct10 An Introduction To Snomed Ct1
0 An Introduction To Snomed Ct1
 
SNOMED Bound to (Information) Model | Putting terminology to work
SNOMED Bound to (Information) Model | Putting terminology to workSNOMED Bound to (Information) Model | Putting terminology to work
SNOMED Bound to (Information) Model | Putting terminology to work
 
UKCAT
UKCATUKCAT
UKCAT
 
Coit20247 ass1 requirementdba1 spec (1)
Coit20247 ass1 requirementdba1 spec (1)Coit20247 ass1 requirementdba1 spec (1)
Coit20247 ass1 requirementdba1 spec (1)
 

Andere mochten auch

2010 06 07 - LOINC Introduction
2010 06 07 - LOINC Introduction2010 06 07 - LOINC Introduction
2010 06 07 - LOINC Introductiondvreeman
 
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundationsdvreeman
 
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...Jose Iglesias
 
Snomed CT Code
Snomed CT CodeSnomed CT Code
Snomed CT CodeNortec Ehr
 
Classification schemes, thesauri and other Knowledge Organization Systems - a...
Classification schemes, thesauri and other Knowledge Organization Systems - a...Classification schemes, thesauri and other Knowledge Organization Systems - a...
Classification schemes, thesauri and other Knowledge Organization Systems - a...Antoine Isaac
 
Implementing reusable software components for SNOMED CT diagram and expressio...
Implementing reusable software components for SNOMED CT diagram and expressio...Implementing reusable software components for SNOMED CT diagram and expressio...
Implementing reusable software components for SNOMED CT diagram and expressio...Snow Owl
 
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...Linkages to EHRs and Related Standards. What can we learn from the Parallel U...
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...Koray Atalag
 
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...Health Informatics New Zealand
 
Developing openEHR EHRs - core functionalities
Developing openEHR EHRs - core functionalitiesDeveloping openEHR EHRs - core functionalities
Developing openEHR EHRs - core functionalitiesPablo Pazos
 
Bringing Things Together and Linking to Health Information using openEHR
Bringing Things Together and Linking to Health Information using openEHRBringing Things Together and Linking to Health Information using openEHR
Bringing Things Together and Linking to Health Information using openEHRKoray Atalag
 
Ehr models, standards and semantic interoperability
Ehr models, standards and semantic interoperabilityEhr models, standards and semantic interoperability
Ehr models, standards and semantic interoperabilityDavid Moner Cano
 
Data vs. information
Data vs. informationData vs. information
Data vs. informationBesar Limani
 
Design and implementation of Clinical Databases using openEHR
Design and implementation of Clinical Databases using openEHRDesign and implementation of Clinical Databases using openEHR
Design and implementation of Clinical Databases using openEHRPablo Pazos
 
Enabling Clinical Data Reuse with openEHR Data Warehouse Environments
Enabling Clinical Data Reuse with openEHR Data Warehouse EnvironmentsEnabling Clinical Data Reuse with openEHR Data Warehouse Environments
Enabling Clinical Data Reuse with openEHR Data Warehouse EnvironmentsLuis Marco Ruiz
 

Andere mochten auch (16)

SNOMED CT
SNOMED CTSNOMED CT
SNOMED CT
 
2010 06 07 - LOINC Introduction
2010 06 07 - LOINC Introduction2010 06 07 - LOINC Introduction
2010 06 07 - LOINC Introduction
 
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations
2011 01 27 - Clinical LOINC Tutorial - Intro and Foundations
 
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...
A Study of Semantic Proximity between Archetype Terms based on SNOMED CT Rela...
 
Snomed CT Code
Snomed CT CodeSnomed CT Code
Snomed CT Code
 
Classification schemes, thesauri and other Knowledge Organization Systems - a...
Classification schemes, thesauri and other Knowledge Organization Systems - a...Classification schemes, thesauri and other Knowledge Organization Systems - a...
Classification schemes, thesauri and other Knowledge Organization Systems - a...
 
Implementing reusable software components for SNOMED CT diagram and expressio...
Implementing reusable software components for SNOMED CT diagram and expressio...Implementing reusable software components for SNOMED CT diagram and expressio...
Implementing reusable software components for SNOMED CT diagram and expressio...
 
eHealth Foundations: Can openEHR Provide One Layer?
eHealth Foundations: Can openEHR Provide One Layer?eHealth Foundations: Can openEHR Provide One Layer?
eHealth Foundations: Can openEHR Provide One Layer?
 
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...Linkages to EHRs and Related Standards. What can we learn from the Parallel U...
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...
 
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...
Aleksandar Zivaljevic - Annotation of clinical datasets using openEHR Archety...
 
Developing openEHR EHRs - core functionalities
Developing openEHR EHRs - core functionalitiesDeveloping openEHR EHRs - core functionalities
Developing openEHR EHRs - core functionalities
 
Bringing Things Together and Linking to Health Information using openEHR
Bringing Things Together and Linking to Health Information using openEHRBringing Things Together and Linking to Health Information using openEHR
Bringing Things Together and Linking to Health Information using openEHR
 
Ehr models, standards and semantic interoperability
Ehr models, standards and semantic interoperabilityEhr models, standards and semantic interoperability
Ehr models, standards and semantic interoperability
 
Data vs. information
Data vs. informationData vs. information
Data vs. information
 
Design and implementation of Clinical Databases using openEHR
Design and implementation of Clinical Databases using openEHRDesign and implementation of Clinical Databases using openEHR
Design and implementation of Clinical Databases using openEHR
 
Enabling Clinical Data Reuse with openEHR Data Warehouse Environments
Enabling Clinical Data Reuse with openEHR Data Warehouse EnvironmentsEnabling Clinical Data Reuse with openEHR Data Warehouse Environments
Enabling Clinical Data Reuse with openEHR Data Warehouse Environments
 

Ähnlich wie Snomed ct csets overview

Crud and jad
Crud and jadCrud and jad
Crud and jadHimanshu
 
Requirement specification (SRS)
Requirement specification (SRS)Requirement specification (SRS)
Requirement specification (SRS)kunj desai
 
Conference Room Prototype – a low cost, high value approach to selecting the ...
Conference Room Prototype – a low cost, high value approach to selecting the ...Conference Room Prototype – a low cost, high value approach to selecting the ...
Conference Room Prototype – a low cost, high value approach to selecting the ...Mekon Ltd.
 
Software Engineering - chp2- requirements specification
Software Engineering - chp2- requirements specificationSoftware Engineering - chp2- requirements specification
Software Engineering - chp2- requirements specificationLilia Sfaxi
 
1 Class Today • Print notes and examples • Trusses.docx
1 Class Today • Print notes and examples • Trusses.docx1 Class Today • Print notes and examples • Trusses.docx
1 Class Today • Print notes and examples • Trusses.docxhoney725342
 
SNOMED CT in the clinical data standards landscape
SNOMED CT in the clinical data standards landscape SNOMED CT in the clinical data standards landscape
SNOMED CT in the clinical data standards landscape THL
 
Call Report management
Call Report management Call Report management
Call Report management Ankita Agrawal
 
Alternative Methodologies for Systems Development
Alternative Methodologies for Systems Development Alternative Methodologies for Systems Development
Alternative Methodologies for Systems Development Sunderland City Council
 
Structured systems analysis and design methodology
Structured systems analysis and design methodologyStructured systems analysis and design methodology
Structured systems analysis and design methodologyVatsana Technologies Pte Ltd
 
Presentation1 & 2 Teofilo kisanji University
Presentation1 & 2 Teofilo kisanji UniversityPresentation1 & 2 Teofilo kisanji University
Presentation1 & 2 Teofilo kisanji UniversityITNet
 
Requirements management and traceability for IIBA
Requirements management and traceability for IIBARequirements management and traceability for IIBA
Requirements management and traceability for IIBALeslie Munday
 
Software development life cycle by chitta
Software development life cycle by chittaSoftware development life cycle by chitta
Software development life cycle by chittaChittaranjan Das
 
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)Rasmus Petersen
 
Development Framework & Methods
Development Framework & MethodsDevelopment Framework & Methods
Development Framework & MethodsNay Lynn Aung
 
[Hongsermeier] clinical decision support services amdis final
[Hongsermeier] clinical decision support services amdis final[Hongsermeier] clinical decision support services amdis final
[Hongsermeier] clinical decision support services amdis finalTrimed Media Group
 
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...Dr Talaat Refaat
 
Hospital E-Token Management(outdoor)
Hospital E-Token Management(outdoor)Hospital E-Token Management(outdoor)
Hospital E-Token Management(outdoor)ANISUR RAHMAN
 

Ähnlich wie Snomed ct csets overview (20)

FEA_basics.pdf
FEA_basics.pdfFEA_basics.pdf
FEA_basics.pdf
 
Crud and jad
Crud and jadCrud and jad
Crud and jad
 
Requirement specification (SRS)
Requirement specification (SRS)Requirement specification (SRS)
Requirement specification (SRS)
 
Conference Room Prototype – a low cost, high value approach to selecting the ...
Conference Room Prototype – a low cost, high value approach to selecting the ...Conference Room Prototype – a low cost, high value approach to selecting the ...
Conference Room Prototype – a low cost, high value approach to selecting the ...
 
Software Engineering - chp2- requirements specification
Software Engineering - chp2- requirements specificationSoftware Engineering - chp2- requirements specification
Software Engineering - chp2- requirements specification
 
Op mode
Op modeOp mode
Op mode
 
1 Class Today • Print notes and examples • Trusses.docx
1 Class Today • Print notes and examples • Trusses.docx1 Class Today • Print notes and examples • Trusses.docx
1 Class Today • Print notes and examples • Trusses.docx
 
SNOMED CT in the clinical data standards landscape
SNOMED CT in the clinical data standards landscape SNOMED CT in the clinical data standards landscape
SNOMED CT in the clinical data standards landscape
 
Call Report management
Call Report management Call Report management
Call Report management
 
Alternative Methodologies for Systems Development
Alternative Methodologies for Systems Development Alternative Methodologies for Systems Development
Alternative Methodologies for Systems Development
 
Ahmar_Abrar
Ahmar_AbrarAhmar_Abrar
Ahmar_Abrar
 
Structured systems analysis and design methodology
Structured systems analysis and design methodologyStructured systems analysis and design methodology
Structured systems analysis and design methodology
 
Presentation1 & 2 Teofilo kisanji University
Presentation1 & 2 Teofilo kisanji UniversityPresentation1 & 2 Teofilo kisanji University
Presentation1 & 2 Teofilo kisanji University
 
Requirements management and traceability for IIBA
Requirements management and traceability for IIBARequirements management and traceability for IIBA
Requirements management and traceability for IIBA
 
Software development life cycle by chitta
Software development life cycle by chittaSoftware development life cycle by chitta
Software development life cycle by chitta
 
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)
SOA guest lecture at DIKU by Dr. Rasmus Petersen (Dec 17 2015)
 
Development Framework & Methods
Development Framework & MethodsDevelopment Framework & Methods
Development Framework & Methods
 
[Hongsermeier] clinical decision support services amdis final
[Hongsermeier] clinical decision support services amdis final[Hongsermeier] clinical decision support services amdis final
[Hongsermeier] clinical decision support services amdis final
 
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...
DECISION SUPPORT SYSTEMS- ANIMAL PRODUCTION APPLICATIONS_Dr Talaat Refaaat_ A...
 
Hospital E-Token Management(outdoor)
Hospital E-Token Management(outdoor)Hospital E-Token Management(outdoor)
Hospital E-Token Management(outdoor)
 

Mehr von SB BHATTACHARYYA

Anonymised oncology opd records research analysis report (slide share)
Anonymised oncology opd records research analysis report (slide share)Anonymised oncology opd records research analysis report (slide share)
Anonymised oncology opd records research analysis report (slide share)SB BHATTACHARYYA
 
A short srs for achieving ehr interoperability
A short srs for achieving ehr interoperabilityA short srs for achieving ehr interoperability
A short srs for achieving ehr interoperabilitySB BHATTACHARYYA
 
Icd and snomed ct – how they compare
Icd and snomed ct – how they compareIcd and snomed ct – how they compare
Icd and snomed ct – how they compareSB BHATTACHARYYA
 
Icd to snomed ct mapping observations & inferences
Icd to snomed ct mapping observations & inferencesIcd to snomed ct mapping observations & inferences
Icd to snomed ct mapping observations & inferencesSB BHATTACHARYYA
 
Smartcare the new avatar of healthcare
Smartcare   the new avatar of healthcareSmartcare   the new avatar of healthcare
Smartcare the new avatar of healthcareSB BHATTACHARYYA
 
Hertfordshire records - DOHAD - an assessment
Hertfordshire records - DOHAD - an assessmentHertfordshire records - DOHAD - an assessment
Hertfordshire records - DOHAD - an assessmentSB BHATTACHARYYA
 
Medical classification coding vs clinical terminology coding
Medical classification coding vs clinical terminology codingMedical classification coding vs clinical terminology coding
Medical classification coding vs clinical terminology codingSB BHATTACHARYYA
 
Snomed ct - the language for interoperable ehr
Snomed ct -  the language for interoperable ehrSnomed ct -  the language for interoperable ehr
Snomed ct - the language for interoperable ehrSB BHATTACHARYYA
 

Mehr von SB BHATTACHARYYA (10)

Anonymised oncology opd records research analysis report (slide share)
Anonymised oncology opd records research analysis report (slide share)Anonymised oncology opd records research analysis report (slide share)
Anonymised oncology opd records research analysis report (slide share)
 
A short srs for achieving ehr interoperability
A short srs for achieving ehr interoperabilityA short srs for achieving ehr interoperability
A short srs for achieving ehr interoperability
 
Understanding snomed ct
Understanding snomed ctUnderstanding snomed ct
Understanding snomed ct
 
Icd and snomed ct – how they compare
Icd and snomed ct – how they compareIcd and snomed ct – how they compare
Icd and snomed ct – how they compare
 
Icd to snomed ct mapping observations & inferences
Icd to snomed ct mapping observations & inferencesIcd to snomed ct mapping observations & inferences
Icd to snomed ct mapping observations & inferences
 
Smartcare the new avatar of healthcare
Smartcare   the new avatar of healthcareSmartcare   the new avatar of healthcare
Smartcare the new avatar of healthcare
 
Hertfordshire records - DOHAD - an assessment
Hertfordshire records - DOHAD - an assessmentHertfordshire records - DOHAD - an assessment
Hertfordshire records - DOHAD - an assessment
 
Clinical data analytics
Clinical data analyticsClinical data analytics
Clinical data analytics
 
Medical classification coding vs clinical terminology coding
Medical classification coding vs clinical terminology codingMedical classification coding vs clinical terminology coding
Medical classification coding vs clinical terminology coding
 
Snomed ct - the language for interoperable ehr
Snomed ct -  the language for interoperable ehrSnomed ct -  the language for interoperable ehr
Snomed ct - the language for interoperable ehr
 

Kürzlich hochgeladen

CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHY
CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHYCECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHY
CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHYRMC
 
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdfCompliatric Where Compliance Happens
 
Artificial Intelligence in Healthcare: Challenges, Risks, Benefits
Artificial Intelligence in Healthcare: Challenges, Risks, BenefitsArtificial Intelligence in Healthcare: Challenges, Risks, Benefits
Artificial Intelligence in Healthcare: Challenges, Risks, BenefitsIris Thiele Isip-Tan
 
Health literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxHealth literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxPamela McKinney
 
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptx
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptxNEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptx
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptxHanineHassan2
 
Diseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxDiseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxEMADABATHINI PRABHU TEJA
 
Introduction to Evaluation and Skin Benefits
Introduction to Evaluation and Skin BenefitsIntroduction to Evaluation and Skin Benefits
Introduction to Evaluation and Skin Benefitssahilgabhane29
 
person with disability and pwd act ppt.pptx
person with disability and pwd act ppt.pptxperson with disability and pwd act ppt.pptx
person with disability and pwd act ppt.pptxMUKESH PADMANABHAN
 
Assisted Living Care Residency - PapayaCare
Assisted Living Care Residency - PapayaCareAssisted Living Care Residency - PapayaCare
Assisted Living Care Residency - PapayaCareratilalthakkar704
 
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES 11
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES  11FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES  11
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES 11crzljavier
 
Artificial Intelligence: Diabetes Management
Artificial Intelligence: Diabetes ManagementArtificial Intelligence: Diabetes Management
Artificial Intelligence: Diabetes ManagementIris Thiele Isip-Tan
 
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....sharyurangari111
 
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete Health
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete HealthLiving Well Every Day: Lyons Wellness Practice | Nurtures Your Complete Health
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete HealthLyons Health
 
Hematinics and Erythropoietin- Pharmacology of Hematinics
Hematinics and Erythropoietin- Pharmacology of HematinicsHematinics and Erythropoietin- Pharmacology of Hematinics
Hematinics and Erythropoietin- Pharmacology of Hematinicsnetraangadi2
 
Identifying Signs of Mental Health Presentation (1).pptx
Identifying Signs of Mental Health Presentation (1).pptxIdentifying Signs of Mental Health Presentation (1).pptx
Identifying Signs of Mental Health Presentation (1).pptxsandhulove46637
 
Empathy Is a Stress Response - Choose Compassion instead
Empathy Is a Stress Response - Choose Compassion insteadEmpathy Is a Stress Response - Choose Compassion instead
Empathy Is a Stress Response - Choose Compassion insteadAlex Clapson
 
ARTHRITIS.pptx Prepared by monika gopal Tutor
ARTHRITIS.pptx Prepared  by monika gopal TutorARTHRITIS.pptx Prepared  by monika gopal Tutor
ARTHRITIS.pptx Prepared by monika gopal TutorNehaKewat
 

Kürzlich hochgeladen (20)

SCOPE OF CRITICAL CARE ORGANIZATION
SCOPE OF CRITICAL CARE ORGANIZATIONSCOPE OF CRITICAL CARE ORGANIZATION
SCOPE OF CRITICAL CARE ORGANIZATION
 
CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHY
CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHYCECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHY
CECT NECK NECK ANGIOGRAPHY CAROTID ANGIOGRAPHY
 
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf
2024 Compliatric Webianr Series - Contracts and MOUs from a HRSA Perspective.pdf
 
Artificial Intelligence in Healthcare: Challenges, Risks, Benefits
Artificial Intelligence in Healthcare: Challenges, Risks, BenefitsArtificial Intelligence in Healthcare: Challenges, Risks, Benefits
Artificial Intelligence in Healthcare: Challenges, Risks, Benefits
 
Health literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptxHealth literacies in marginalised communities LILAC 24.pptx
Health literacies in marginalised communities LILAC 24.pptx
 
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptx
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptxNEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptx
NEONATAL RESPIRATORY CARE FROM A PHYSIO POV.pptx
 
Diseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptxDiseases of the Respiratory System (J00-J99),.pptx
Diseases of the Respiratory System (J00-J99),.pptx
 
Introduction to Evaluation and Skin Benefits
Introduction to Evaluation and Skin BenefitsIntroduction to Evaluation and Skin Benefits
Introduction to Evaluation and Skin Benefits
 
person with disability and pwd act ppt.pptx
person with disability and pwd act ppt.pptxperson with disability and pwd act ppt.pptx
person with disability and pwd act ppt.pptx
 
Assisted Living Care Residency - PapayaCare
Assisted Living Care Residency - PapayaCareAssisted Living Care Residency - PapayaCare
Assisted Living Care Residency - PapayaCare
 
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES 11
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES  11FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES  11
FINAL PROJECT IN EMPOWERMENT TECHNOLOGIES 11
 
Artificial Intelligence: Diabetes Management
Artificial Intelligence: Diabetes ManagementArtificial Intelligence: Diabetes Management
Artificial Intelligence: Diabetes Management
 
Annual Training
Annual TrainingAnnual Training
Annual Training
 
The Power of Active listening - Tool in effective communication.pdf
The Power of Active listening - Tool in effective communication.pdfThe Power of Active listening - Tool in effective communication.pdf
The Power of Active listening - Tool in effective communication.pdf
 
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....
Toothpaste for bleeding gums and sensitive teeth. Teeth whitening, Mouthwash....
 
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete Health
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete HealthLiving Well Every Day: Lyons Wellness Practice | Nurtures Your Complete Health
Living Well Every Day: Lyons Wellness Practice | Nurtures Your Complete Health
 
Hematinics and Erythropoietin- Pharmacology of Hematinics
Hematinics and Erythropoietin- Pharmacology of HematinicsHematinics and Erythropoietin- Pharmacology of Hematinics
Hematinics and Erythropoietin- Pharmacology of Hematinics
 
Identifying Signs of Mental Health Presentation (1).pptx
Identifying Signs of Mental Health Presentation (1).pptxIdentifying Signs of Mental Health Presentation (1).pptx
Identifying Signs of Mental Health Presentation (1).pptx
 
Empathy Is a Stress Response - Choose Compassion instead
Empathy Is a Stress Response - Choose Compassion insteadEmpathy Is a Stress Response - Choose Compassion instead
Empathy Is a Stress Response - Choose Compassion instead
 
ARTHRITIS.pptx Prepared by monika gopal Tutor
ARTHRITIS.pptx Prepared  by monika gopal TutorARTHRITIS.pptx Prepared  by monika gopal Tutor
ARTHRITIS.pptx Prepared by monika gopal Tutor
 

Snomed ct csets overview

  • 1. SNOMED CT CSETS (CONSTRAINED SETS) – ITS PLACE & ITS USE Dr SB Bhattacharyya MBBS, MBA, FCGP Member, National EHR Standardisation Committee, MoH&FW, GoI Member, Health Informatics Sectional Committee, MHD 17, BIS Hony. State Secretary (2015), IMA Haryana President (2010 – 2011), IAMI
  • 2. Constrained Set? ■ The word constrain means “to control or limit something” (Cambridge Online Dictionary) ■ SNOMED CT makes extensive use of refsets (reference sets), for a wide-range of purposes, each of which have specific purposes ■ Refsets need to conform to certain specific rules and guidelines regarding their preparation, distribution and maintenance ■ Takes a long time to design one and the designing entity needs to have a namespace assigned to it ■ This makes the rapid and effective use of SNOMED CT in individual systems cumbersome at best and impractical at worst Dr SB Bhattacharyya© 2
  • 3. Solving this conundrum ■ Since within a system it is pretty much lassiez faire or anything goes, it is wise to use a constrained set of the SNOMED CT that suits the purpose ■ For example, for gender or laterality, a small list specially created SNOMED CT code set for that purpose should work excellently (actual list follows in the next slide) ■ Thus, wherever there is a requirement for a system to have a list presented to the user for their selection, this small list serves the purpose ■ This limited list is termed a “constrained set” or CSET (a portmanteaux of the two words that it refers to) by the author Dr SB Bhattacharyya© 3
  • 4. Csets for Gender & Laterality Gender 248152002 | female | 32570681000036106 | indeterminate sex | 32570691000036108 | intersex | 248153007 | male | 407374003 | transsexual | Laterality 7771000 | left | 24028007 | right | 51440002 | bilateral | Dr SB Bhattacharyya© 4 Created using Cliniclue®
  • 5. Explication ■ This constrained list works very well and suits the purpose of helping users to fill in gender or anatomical side ■ The format of expressions as per the IHTSDO construction rules states that either of the following is acceptable (only pre-coordinated types are shown here) – ConceptId – ConceptId | Term | ■ Thus, let’s say, for “bilateral” laterality, either of the following works – 51440002 – 51440002 | bilateral | Dr SB Bhattacharyya© 5
  • 6. Explication ■ It is important to debate the merits and demerits of such an approach ■ Not only must the pros and cons be considered but also the end-result should justify it ■ For starters, let us briefly study the refset approach ■ It should be noted that refsets are meant to be exchanged with external entities in their entirety and need to be updated after every release – international or national ■ It should also be noted that by the term “system” it is meant any system that uses SNOMED CT Dr SB Bhattacharyya© 6
  • 7. Refsets ■ Namespace required if refsets are shared with external entities/systems ■ Needs regeneration after every release ■ Can be automated using pre-set scripts (e.g., SQL, Perl, etc.) that needs to be designed in-house Dr SB Bhattacharyya© 7
  • 8. RefSet field structure NRC, India© 8 RefSet type A RefSet type B RefSet type C ID ID ID Effective time Effective time Effective time Active Active Active Module ID Module ID Module ID RefSetID RefSetID RefSetID ReferencedComponentID ReferencedComponentID ReferencedComponentID Extra field 1 Extra field 1 Extra field 2 Extra field 3 Versioning component Identifier Additional fields Fieldsalwayspresent The reference set The ID of the component being referred to
  • 9. Data Management ■ When data is managed, it is the expressions that are stored and exchanged ■ The expressions have a machine-processable part (ConceptId) and a human-readable part (Term) of expressions or just the machine-processable part (ConceptId), it is largely a system designing issue, which is an internal matter ■ Thus, system designers only need to consider that which is necessary to capture, store, retrieve, display, exchange, processing and querying ■ Anything else is not related to the system functionalities ■ Refsets have largely a governance connotation Dr SB Bhattacharyya© 9
  • 10. Comparing Refsets with Csets Refsets ■ Formal, Exchangeable ■ Not easily reproducible – needs namespace ■ Needs to be adapted for system use – cannot be used as-is for data capture, storage, retrieval, query and exchange Csets ■ Informal, Non-exchangeable ■ Easily reproducible – does not need any namespace ■ Ready-to-use for data capture, storage, retrieval, query and exchange Dr SB Bhattacharyya© 10
  • 11. Cset Pros ■ Quick to develop and ready-to- use ■ Can design, create, deploy and re-use as per specific system requirements Cons ■ Needs a team with properly trained and experienced professionals to design and create ■ Needs updating with every release – international and national Dr SB Bhattacharyya© 11
  • 12. Logic ■ Since most of the data is required to be captured in pre-coordinated expression forms (the form as available from international or national releases) that is either ConceptId only or ConceptId | Term | formats, the system designers need to have access to these for storing in their databases and used as-is ■ For queries, transitive closure tables are required for data aggregation, else, either only the ConceptId or only the Term need be used to return the proper records ■ The csets are easy-to-create being mostly built on-the-fly and hardly taking more than an hour to create moderately complex ones, provided the right domain experts are available to guide the designers Dr SB Bhattacharyya© 12
  • 13. Method ■ A good SNOMED CT tool like ClinClue® or Snow OWL® is required ■ A terminologist would be ideal but it may be tough for system vendors to hire ■ The next best person to do this type of work is a health informatics professional who familiar with SNOMED CT ■ Alternatively, the following may be considered as a team since this type of work cannot be done by one person, it will be too error-prone and consequently risky ■ Someone familiar with the tool being used is usually acceptable Dr SB Bhattacharyya© 13
  • 14. Method [contd.] ■ Someone well-conversant with SNOMED CT as a whole is required ■ A good DBA who can design the database in such a manner that duplicates are removed – the way SNOMED CT is modelled, the same term may be present in different hierarchies ■ A domain expert – specialist, doctor, nurse, dentist, paramedic, etc. – is required to identify all Terms (preferred as well as synonyms) required for that domain (clinical finding, procedure, disorder, allergy, etc.) to ensure that all the necessary terms (both preferred and synonyms) have been incorporated ■ During system use, only the Terms are displayed while the ConceptIds are stored and/or exchanged with or without the Terms, with the Term to ConceptId to Term mapping is done at the API level Dr SB Bhattacharyya© 14
  • 15. Method [contd.] ■ The best way is to identify the Term that best describes the domain concept (marital status, laparoscopic procedure, lipid profile, etc.) and construct the SQL statement that will extract all the necessary subtype children and descendants that will form the required constrained list of values ■ For maintenance purposes, rebuilding the csets for every subsequent official release of SNOMED CT, which happens every six months, can be automated by running these scripts to build a new cset ■ The need to manually check the cset does not go away though to ensure that all the required concepts and their corresponding preferred terms as well as synonyms are incorporated Dr SB Bhattacharyya© 15
  • 16. Cset field structure (proposed) Dr SB Bhattacharyya© 16 CSet type A CSet type B ConceptId ConceptId Term Term Effective time Active CsetId Versioning component Concept Identifier Fieldsalwayspresent Term Cset Identifier The CsetId uniquely identifies the Cset that the ConceptId belongs to. A single ConceptId may be assigned to multiple Csets as necessary.
  • 17. Cset Types Type A ■ Separate tables for each domain item like Gender, Employment Status, Drug & Medicament, Absence findings, etc. ■ No CsetId needed ■ Easy to build and maintain ■ Requires regeneration of separate tables with every release – several run cycles Type B ■ One table where every domain is uniquely identified through CsetId that is self-determined and self-generated ■ Complicated to build and maintain ■ Requires running several scripts in series that populates and updates a single table with every release – automated single run cycle Dr SB Bhattacharyya© 17
  • 18. References ■ Matter based on ideas formulated by Dr SB Bhattacharyya ■ Some matter sourced from presentations prepared by Dr Karanvir Singh in consultation with IHTSDO on behalf of National Release Centre, India Dr SB Bhattacharyya© 18
  • 20. Dr SB Bhattacharyya© 20 Thanks!