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Overview

The allergy project has utilised SDP (Structure/Disposition/Process) model for reorganisation of hierarchical structure for allergy related content in SNOMED CT. NOTE: |Allergy to X| modeling and terming normalization will be performed to a great extent using script development. Input to formalize |Allergy to X| modeling and terming guidelines was provided by internal resources plus Bruce Goldberg (Consultant Terminologist as SME). Review/publishing of updated content to be performed by internal resources (assumed to be primarily Toni Morrison and Yongsheng Gao; Bruce Goldberg will be consulted as needed for exceptions and irregularities).

2017 Project ScopeDeliverablesRelease
1.

Reorganization of structure for allergy related content

Allergy to X / allergic reaction / allergic disorder - three patterns only first pattern allergy to x being worked on

  1. Content normalization work on concept pattern Allergy to X only, in progress.
  2. Updating of editorial guidance to align with current content for Hypersensitivity condition, allergy, allergic reaction. Reviewed concept model for allergy to X and proposed an alternative approach. The implementation will depend on the final decision on the model.Guideline signed off by JC, Bruce Goldberg to assist with normalisation of existing concepts to comply with terming and modeling guidelines (ensuring that concepts do not infer Causative agent attributes in addition to what is stated because that makes the concepts unsuitable for use in a decision support implementation.) starting Aug 10. The amount of work (est 1,800 concepts) needs to be broken down into 2017 releases
  3. Proposal and evaluation of changes to concept model for allergy/hypersensitivity  
  4. Implementation of changes for concept model and update of editorial guide  
  5. Proposed concept model change to align content with ICD-11. The implementation will depend on the decision on approval of the model.The implementation of updating existing content needs to be planned for 2017.

  1. On hold and transferred the task to 2018 item 1 due to lack of tooling support. 
  2. Documentation Completed July 2016, work for 2017 (1,800) dependent on tool and resource availability
  3. Completed
  4. Completed. The newly approved terming and modeling guidelines have been submitted for inclusion in the Editorial Guide
    *Volunteer effort Bruce Goldberg
  5. Completed model by Bruce Goldberg at October 2016 ECE meeting. The implementation was transferred to 2018 item 1 to progress with allergy remodeling in PROD.
2

Member Priority -Allergies – content, subsets, implementation guidance and governance

Interoperable deployment of SNOMED CT in support of Electronic Health Record (EHR) adverse sensitivity data (which encompasses allergy, non-allergic hypersensitivity and intolerance) is inconsistent and fails to support interoperability across IHTSDO member realms. This arises due to confusion regarding the scope and definition of adverse sensitivity data, uncertainty regarding the reference models for defining relevant data records and inconsistency in guidance for the appropriate value sets from SNOMED CT that should populate those records.

This allergy project will:

• extend previous (and current) IHTSDO work on definitions of adverse sensitivity events,

• survey and summarize the relevant interoperability standards,

• advise the IHTSDO community regarding best practice deployment of allergy data within the EHR

• Identify the SNOMED CT resets (value sets) that would constitute best practice for use in electronic health records.

Several Standards Development Organizations (SDOs) such as HL7 and epSOS have also provided some material to assist implementers, however without formal or informal collaboration with IHTSDO. A more formal arrangement in collaborative efforts and/or guidance would be beneficial for implementers of SNOMED CT.

  1. The Project Charter was submitted by Palle Gerry Petersen, in 2015 . It is unclear as to what final deliverables were agreed. The Project Charter lists progress caveats on dependencies for resource(s) and funding.The MapSIG and Implementation SIG are the owners of this initiative.

    Other Map & Implementation Group Initiatives

  2. Development of implementation guide.
  3. Refsets(value sets) by volunteer effort
  1. STOPPED - It is not relevant anymore due to the Sig being disbanded as well as Point 3 replacing the need/objective.
  2. Completed
  3. Completed - Allergy clinical reference group agreed to take the responsibility to maintain the value sets in the current spreadsheet format.
2018Project ScopeDeliverablesRelease
1Implementation of the new Allergy/hypersensitivity concept model

Implement the new concept model for allergy model//hypersensitivity by template based batch changes and manual changes to modeling and descriptions for 2000 concepts

Completed majority changes in the January 2019 release.

The rest will be completed in July 2019 item 1.

2Review and update Editorial guide and content for allergy content following the assessment of impact from the redesign of drug/substance hierarchy
  1. Assessment of impact from the proposed redesign of substance hierarchy
    • Inactivation of allergen concepts
  2. Develop and update the Editorial guide for hypersensitivity conditions and intolerance to substance
  1. Partially completed in January 2019. The remaining will be addressed in Jul2019/Jan2020 item 3
  2. Completed January 2019 release

2019Project ScopeDeliverablesRelease
1

Complete the revision of hypersensitivity conditions

  1. Revision of Hypersensitivity reactions - 140 concepts
  2. Revision of 40275004|Contact dermatitis (disorder)| and any other allergic disorders
July 2019
2

Develop and update Editorial Guide

  1. Allergy to bases vs. modifications
  2. Hypersensitivity to products/devices editorial guide and use cases
July 2019
3Inactivation of substance concepts related to allergy contentInactivation of allergen concepts in substance hierarchy (incremental)

July 2019, Jan 2020

4

Clinical quality assurance of content

Review allergy concepts which are not truly allergic disposition  - resource Allergy CRG

  1. Editorial guide for decision and references

July 2019, Jan 2020

5

Explore potential enhancement to concept model

  1. Use causative agent as default model for hypersensitivity condition - resource at ECE
  2. Modeling pattern for hypersensitivity to X (due to/after exposure to Y) - resource at ECE

July 2019,

Jan 2020

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