The U.S. Department of Health and Human Services (HHS) has announced recently that the Department will participate in an international effort to promote the  rapid adoption of standard clinical terminology, for promoting the worldwide development of electronic health records.

This move will make the U.S. join the club comprising Australia, Canada, Denmark, Lithuania, the Netherlands, New Zealand, Sweden, and the United Kingdom, as members of the new International Health Terminology Standards Development Organization (IHTSDO), which has acquired Systemized Nomenclature of Medicine (SNOMED) Clinical Terms (SNOMED CT) from the College of American Pathologists (CAP).

SNOMED Clinical Terms (SNOMED CT) is a dynamic, scientifically validated clinical healthcare terminology and infrastructure that makes healthcare knowledge more usable and accessible. The SNOMED CT core terminology provides a common language that enables a consistent way of capturing, sharing and aggregating health data across specialties and sites of care. Among the applications for SNOMED CT are electronic medical records, ICU monitoring, clinical decision support, medical research studies, clinical trials, computerized physician order entry, disease surveillance, image indexing and consumer health information services.

SNOMED CT is considered to be the most comprehensive, multilingual clinical healthcare terminology available in the world. When implemented in software applications, SNOMED CT represents clinically relevant information consistently, reliably and comprehensively as an integral part of producing electronic health records.

International implementation of SNOMED CT is perceived as a serious effort in  engaging nations to persuade towards electronic health records, and throw open new opportunities for international collaboration in research and public health surveillance. Says HHS Secretary Leavitt, “The use of a standard terminology will enable the use of health information across borders, facilitate public health surveillance and support evidence-based research.”

SNOMED CT is important as a ‘core terminology’ that provides a ‘common language’, enabling a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

According to the SNOMED CT January 2007 fact sheet, the system has more than 3,08,000 active concepts with formal logic-based definitions organized into top-level hierarchies and more than 7,77,000 active English language descriptions for flexibility in expressing clinical concepts, and more than 9, 24,000 defining relationships to enable consistency of data retri and analysis. It is also available in Spanish and German language editions.

In an interesting development, the College of American Pathologists (CAP) is renaming its SNOMED International division. The division will now be called SNOMED Terminology Solutions and this follows the announcement of setting up of International Health Terminology Standards Development Organisation (IHTSDO) that acquired the intellectual property rights of SNOMED Clinical Terms� (SNOMED CT�) and its antecedents from the CAP.

SNOMED Terminology Solutions focuses on education, training and consulting related to SNOMED CT, and its implementation. Education and training programmes include live and web teleconference education that detail SNOMED CT’s content and structure.

Consulting services include assistance in implementing SNOMED CT into systems; mapping code sets to SNOMED CT; building and maintaining SNOMED CT subsets and extensions; content development; validation; migration from earlier versions of SNOMED and project-specific coding.

Says CAP President Thomas Sodeman, MD, FCAP: “As global adoption of SNOMED CT continues to increase, the demand for its implementation into electronic health applications grows. SNOMED Terminology Solutions assist in terminology implementation as well as educating the marketplace about SNOMED CT’s role in daily use of clinical terminology.” SNOMED Terminology Solutions will also own products not acquired by the IHTSDO, including the SNOMED CT Subset Editor Kit, the SNOMED-Encoded CAP Cancer Checklists and CAP Cancer Protocols. It also will retain ownership of domain-specific subsets and cross mappings.

Adds Kevin Donnelly, SNOMED’s Vice President and General Manager: “SNOMED Terminology Solutions will leverage CAP’s 40 years of experience in the development of SNOMED to aid clients in meeting all of their healthcare terminology needs. We are already working with clients around the world to provide terminology solutions to enable semantically interoperable electronic healthcare records.”

With IHTSDO vested with the responsibility for SNOMED CT’s ongoing maintenance, development, quality assurance, and distribution, CAP SNOMED Terminology Solutions will now be doing so under a three-year contract with the IHTSDO.  

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