Conference Call Details

Meeting time is 2019-01-22 20:00 UK; 15:00 US ET (1900 UTC)

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Discussion items

1Introductions and apologies

2Anesthesia Quality Institute (US) National Anesthesia Clinical Outcomes Registry (NACOR) requesting comment on Data Definitions


The comment period ends on February 1, 2019. The data dictionary will be published in Spring 2019, for use later in the year.

AQI have reviewed terminology including dental terminology and e-PreOp and provided new definitions so that they may be incorporated in NACOR. The comment/ review process is ongoing (see the link above), and public comments are sought by 1st February.

Paediatric terminology is under review and a new adult term "Myocardial Injury" has been included. Introduction of "Myocardial Injury" has required an update of the term "Myocardial Infarction".

Scales to describe cooperative behaviour (e.g. Frankl) were discussed, and terms such as "pre-cooperative behaviour" were noted. These are also proposed for inclusion.

The term "Troponin Leak" was discussed, and it was noted that this term may be widely used in some clinical situations. However, raised Troponin levels are not yet considered sufficiently specific/ predictive by many for everyday diagnostic use.

More detailed timing descriptions are noted for analysing theatre usage, e.g. "toes in" and "toes out". We believe that many, if not all, of these will be represented in SNOMED already.

A long term need for automated transfer of data from the anaesthetic record was recognised, with the benefit of supporting audit, research and Quality Improvement. Similar needs are recognised by Martin Hurrell in work that HL7 groups are doing. Opportunity for co-operation was noted.

All comments on the proposed inclusions to NACOR are welcome.

3SNOMED updates

QI work at SNOMED is a significant priority at the moment, and will proceed over the next few releases of SNOMED. Other work may be afforded lower priority during this time.

See this link: Quality Initiative - Progress

A reduction in the number of "primitive concepts" in SNOMED is sought, as many are not defined with sufficient detail and present usage difficulties. Grouping of attributes will also change, details TBC, with the work scheduled for July.

Work on Medical Devices will be another major initiative in future.

Equivalence tables are generated every 6 months, this will fall to an annual schedule.

4SNOMED Meeting in April 2019

The Anaesthesia CRG has requested time at the London meeting - Wednesday 10th April is confirmed (a.m. and p.m.) for Anaesthesia. Monica may not be able to attend in the morning, but will be present that day.

AN reasserted the need for involvement in SNOMED from the UK's professional bodies, and believes that we should invite bodies such as the RCoA to participate in SNOMED discussions. There was general agreement that this was desirable. PMcC will join if possible. Political and professional recognition of technologies/ systems such as SNOMED and HL7 will support development in electronic anaesthesia records.

The meeting will provide an opportunity to review the NACOR definitions.

5Minutes of previous meetingMinutes from 2018-12-11 Anesthesia CRG Meeting.
6Matters arising from the minutesNone.
7Any other business
8Next meeting

The group proposed 26th March 2019.

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