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PRD: The New ERA-EDTA Renal SNOMED CT Subset

Introducing the new ERA-EDTA Primary Renal Diagnosis (PRD) terms with SNOMED CT concept mapping. SNOMED CT provides extensive terminology support for patient records, registries, research, and hospital management. This subset includes most existing renal terms and is managed by the UK Renal Terminology Committee.

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PRD: The New ERA-EDTA Renal SNOMED CT Subset

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  1. PRD_TheProject_KS_09102012.ppx

  2. The new ERA-EDTA PRDsUK Renal SNOMED CT subset TheProject Keith SimpsonUKRR Advisor keith.simpson@nhs.net Thanks toERA-EDTA Registry: Kitty Jager Managing Dir and members of the Coding and Terminology Group (UK members Charlie Thomson, Venkat Raman)UKRR: Afzal Chaudhry, Ron Cullen NHS TC Yong Gao, Denise Downs, Ian Arrowsmith, Ed Cheetham:

  3. PRD Headings ERA-EDTA PRD ERA-EDTA Primary Renal Diagnosis (PRD) terms Histology Clinical history Family history Clinical Exam Biochemistry Immunology Urine analysis Imaging Gene test Other criteria & notes SNOMED CT concept identifier for focus concept SNOMED CT fully specified name SNOMED CT expression constraint Mapping to old PRD code Mapping to old PRD term Online Mendelian Inheritance in Man - link ICD10 code ICD10 rubric .

  4. ERA-EDTA Primary Renal Diagnosis .

  5. .

  6. Notes Because we don’t have a definition The evidence<> a definition (yet) The diagnosisThe term we use= the ‘PRD’ .

  7. Notes Because we don’t have a definition The evidence<> a definition (yet) The diagnosisThe term we use= the ‘PRD’ .

  8. PRD SNOMED id Concept mapping of the meaning .

  9. PRD SNOMED id Concept mapping of the meaning .

  10. Why map to SNOMED? .

  11. SNOMED CT Provides Extensive and well supported list of terms currentlanguage translation, literature links eg BMJ, Map of Medicinedecision support, queries using multiple domain hierarchies, secondary functions eg research, hospital management

  12. SNOMED CT Provides Extensive and well supported list of terms currentlanguage translation, literature links eg BMJ, Map of Medicinedecision support, queries using multiple domain hierarchies, secondary functions eg research, hospital managementWill soon be the only terminology supported by the NHS in the UK

  13. Includes foreign language and local terms .

  14. Conveys meaning not just a labelrelationships and attributes like: Is a kidney diseaseIs a … .

  15. .

  16. UK Renal SNOMED CT subset

  17. UK Renal SNOMED CT subset Includes: most of the existing renal terms – about 1100and the new ERA EDTA PRDs Managed by: UK Renal Terminology Committee (RIXG & RA)working with the NHS Terminology CentrePurpose: Patient records, Registries, RADAR, RDGs, research, TheProject .

  18. Renal IT suppliers keen to implement meeting in Bristol 19 Sept 2012

  19. TheProject

  20. TheProject RenalUnits Labs .

  21. TheProject RenalUnits RPV Labs UKRR SRR RaDaR NHSBT BAPN OtherNational data .

  22. hard to managewasteful summarised data can’t be recovered many different file formats perpetuates errorssome unknown >> biaseg RRT start date & unit lost in transferinflexible…

  23. TheProject RenalUnits Patient sees~all their data RPV Labs UKRR Warehouse SRR RaDaR?10-20 gps NHSBT BAPN RPV type data transfer,at least daily OtherNational data .

  24. TheProject RenalUnits Patient sees~all their data RPV Labs UKRR Warehouse SRR RaDaR?10-20 gps NHSBT BAPN OtherNational data .

  25. TheProject RenalUnits Patient moves renal unit RPV Labs UKRR Warehouse SRR RaDaR?10-20 gps NHSBT BAPN OtherNational data .

  26. TheProject RenalUnits Patient moves renal unit RPV Labs UKRR Warehouse All potential participants and renal IT suppliershave agreed in principle SRR RaDaR?10-20 gps NHSBT BAPN OtherNational data .

  27. Summary The new ERA-EDTA PRDsUK Renal SNOMED CT subset TheProject

  28. ICD 10 Hierarchy A bacterial infections B other infections C malignancies D benign neoplasmsE endocrineG CNS …N renal

  29. ICD 10 Hierarchy A bacterial infections incl meningiococcal meningitisB other infections incl H. influenzaC malignancies and sarcoidD benign neoplasmsE endocrineG CNS incl H. influenzae meningitis and Systemic atrophy of CNS in myxoedema…N renal

  30. ICD 10 Nephrotic

  31. ICD 10 Nephrotic N04

  32. ICD10 Terms including ‘renal’one example per letter

  33. ICD10 which language ?

  34. ICD10 which language ?

  35. TheProject For discussion:How a UK renal data warehouse be organised and managed securitydata and clinical governancemanagement – coalitionanonymisation/named dataencryptiondata transfer - ?XML Schema – HL7 data validation ?practical on anonymous data, where to do flexibility – allow new fields = data items to be added by userInclude meta data …

  36. TheProject Granular data Include fields for meta data … date time relative time (pre dose, post dialysis … ) sample if not obvious (venous, arterial blood, venous side of dialyser )result unit of measurement (eg Hb g/L, g/dL, mmol/L) reference range assay method (eg PTH)

  37. TheProject Granular data Diagnoses and procedures – Store at highest level required by initiatorAggregate later where requiredUse SNOMED CT terms & codes (UK Renal Terminology Committee)

  38. TheProject Derived data:store raw data where possible/ practicalderive resultseg BMI, URR …

  39. TheProject InvolvesPatientsRenal units already keen to join Registries (UKRR & SRR)Renal AssociationRPVRaDar Groups Renal IT industriesData GovernanceNHS, DoH, ISD

  40. TheProject Can we develop a project that better supports what we do:Care for patientsQuality improvement- units could devolve some QI to the registries prompts (Tx list), trends (infections) …Run the servicesResearch – basic and epidemiologyTeach & learn

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