2018-12-11 Anesthesia CRG Meeting

Andrew Norton unable to attend initially, apology by email noted.

Martin Hurrell

The process by which HL7 updates are made was discussed.

HL7 membership allows voting and access to protected areas of their website, but much of the content is accessible to all. Corporate and individual memberships exist. 

Recent correspondence on existing standards for anesthesia records.

• ? Need for "Risk of X" concept when documenting patient risks as part of informed consent
• Positioning terms reviewed
• How to express degrees of angle within SNOMED

Terminology is developing in HL7, e.g. towards a compositional grammar for expressing concepts. Ian Green notes that there is not an overarching move towards this and comments that legacy GP systems in the UK are not structured to make this easy. Nevertheless, the group consensus was that pre-coordinated terms were not flexible enough to cope with new devices, language translation, etc.

Ian Green points out that "Risk of X" problem is similar to "Allergy of X", further discussed in this 2016 presentation from Bruce Goldberg: 201658_SNOMED allergy.pdf

Jane Millar

Ian Green discussed the currently-circulated 2020-2025 stakeholder survey. All are invited to participate. Members of the Anesthesia CRG might be interested in particular areas within Anaesthesia (e.g. Devices, Medications) and should mention these where possible.

1. Differences between devices and drugs were noted, and frustration was expressed that these categories were not distinct. However, many modern devices blur the distinction (e.g. drug-eluting stents).
2. Steven Dain noted that ISO 4135 was the industry norm for describing anaesthetic equipment, and this is currently being revised. ISO 19223 relates to ventilator equipment, and will hopefully be finalised and published in the near future. SNOMED should work in sympathy with these.
3. UDI standards are being developed and these will influence activity in this area.

Planning for the business meeting in April is under way.

SNOMED has a communications lead - Kelly Kuru. She is looking for clinical perspectives on the use of SNOMED - does it offer what clinicians need? Any thoughts are welcomed by SNOMED. Steven Dain notes that software implementations often have a more significant effect on the user than the underlying classification.

Interoperability of record systems is advocated. Steven Dain described the MD Fire Project, an initiative from the MDPnP group to promote the adoption of interoperable and secure medical devices.

Patrick McCormick

Patrick reported on the recent AQI Summit, which included a meeting of the AQI Data Definitions Committee. The committee released the AQI NACOR Data Definitions in January 2018.

Ian Green noted that a proposal to review our terminology in this area may be worth considering.

Martin Hurrell noted the interest of HL7 in the area of ventilator settings and Steven Dain noted that ISO 19223 also addresses this area.

The group noted that ISO publications make definitions within their standards openly available (for example, ISO 4135:2001), although other content of the ISO standards is not freely available.

Andrew Marchant

Andrew Marchant

Andrew Norton mentioned inviting UK professional bodies to the April business meeting, perhaps SCATA, RCOA, AAGBI, STA. Patrick McCormick will also consider whether any other interested parties for the USA might contribute.

Set 2019 Meeting Schedule. Patrick McCormick suggested continuing a bi-monthly schedule, meeting at 8pm GMT / 3pm ET on the 4th Tuesday of the month. The next meeting would then be at 8 pm (GMT) on 22nd January 2019.