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SNOMED CT - Should Sweden join now or wait?

Sammanfattning

One of the necessary components for good, safe care is that the information that is communicated between people (patients, users and health service personnel), to computers and between computers is uniform and clear and that the context and content are not lost in the communication process.

The National Board of Health and Welfare set up a working group in April 2006 to examine the question of Swedish involvement in the future development of the concept system SNOMED CT (Systemized Nomenclature of Medicine, Clinical Terms).

The inquiry came about following an invitation sent by the College of American Pathologists (CAP) and National Health Service, Connecting for Health (NHS CfH) in the UK, to a large number of countries regarding a new international organisation for the further development and management of SNOMED CT. The organisation is known as SNOMED Standards Development Organisation (SSDO).

The inquiry is based primarily on material that is in the public domain and which has been published - scientific articles, conference reports, evaluations and project reports - as well as material from WHO (World Health Organization), educational visits to Denmark and material from the SNOMED CT organisation. The inquiry group also interviewed representatives from the health service and universities.

The inquiry describes the need for a common concept system in the Swedish health service and expectations about what such a system should contribute. Also reported are facts about SNOMED CT and international experience in the form of applications and evaluations.

Sweden as a nation must decide which path it will follow, where the alternatives are either to become involved in collaboration surrounding SNOMED CT or follow its own line. The choice of direction must be linked to the desired level of ambition in the future use of information systems within the health service and what time frame we have with regard to development. Among our neighbouring Nordic countries, Denmark is part of the international SNOMED CT collaboration. Finland, Iceland and Norway have yet to decide.

There is a great lack of published usable references related to the practical use of SNOMED CT that could act as guidance in conjunction with implementation.

SNOMED CT is the concept system which currently has the broadest coverage but despite this it cannot satisfy all needs within the health service. Becoming part of the international SNOMED CT collaboration should be seen as a development project in itself, which is in turn part of other national development work. If SNOMED CT is to be used, it must be translated into Swedish and adapted to Swedish conditions.

National translation and adaptation of SNOMED CT must be done in such a way that it also satisfies the local, national and Nordic terminology and classification requirements.

SNOMED CT is not a replacement for future work on classifications and linguistic definitions of concepts and terms.

Without the aid of computers and modelling of relations, the design and maintenance of SNOMED CT is a practical impossibility. Working with SNOMED CT requires knowledge and resources for management and maintenance on the national, regional and local level.

A low level of knowledge of SNOMED CT together with unrealistic expectations or an underestimation of the work required on different levels are aspects that must be taken into account in the planning if SNOMED CT is to be introduced and used in the Swedish health service.

The inquiry group has made an assessment that a concept system equivalent to a "complete" SNOMED CT will be needed if the health service is to develop and if the use of information systems is to be effective and positive in the long term. The people who were interviewed support this assessment in their statements. There is also a broad consensus that there is a need for national responsibility and a uniform concept apparatus for health service documentation.

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Publiceringsår: 2006
Artikelnummer: 2006-131-32
Format: POD
Antal sidor: 48
Språk: Engelska
Pris (inkl. moms): 76 kr

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