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Hi all, I'm currently based in New Zealand and am working for a Vendor. I've also recently joined a newly developed working group based on a national government initiative with the Ministry of Health - the SNOMED implementation working group. From the first meeting of this group, it was suggested that there be a defined National Adoption Maturity Model for SNOMED. At present, I am referencing the "Building a Business Case for SNOMED CT" guide to help develop a draft document. Before I go any further, I want to know whether there are other countries or even a repository of international documents that reference SNOMED CT adoption models. If anyone knows of existing adoption models or approaches that have been considered, I'd appreciate if you could share or suggest ways to approach this.

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EHR
Added by Ray Rahul on Jul 27, 2016

For general awareness what is suggested that might be shared with patient without complicating issues? Quite often patients have lot of queries on their disease and other matter. May be this might help them to get a ready reply. Any guidance ?

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This is anonymized version of a message received by the IHTSDO Helpdesk ... what do you think about this and how would you respond? "We are implementing a system using SNOMED CT to replace an existing code system. We know that SNOMED CT identifiers are intended to be used as codes but SNOMED CT has Description Identifiers, Concept Identifiers  and Relationship Identifiers. We are not sure which of these to store as the code in patient records. Probably not the Relationship Identifiers ... is that correct? However what about the other two identifiers which should we store or should we store both?  Please could you give us advice on this and explain why we should use one and not the other. Thanks."

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Comment Last useful answer, Apr 20, 2016. All contributions
I would council very strongly against the recording of Description Identifiers.  The Concept Id carries the meaning and a significant number of descriptions are ambiguous, even within the hierarchy. I would go so far as to say that you should only ever display the preferred term for selection (search over all descriptions, display only the matching concepts, and only display the preferred term). Then, if you want to know what the clinician saw when the Concept Id was recorded, you can (should) also record the actual text. Also, and this should go without saying, but several large vendors allow this, do not allow the user to edit this text.  If you need to support additional or clarifying text, use a separate field.  
DMR and SNOMED
Added by Michael Hosking on Jan 18, 2016

My name is Michael and I'm from Australia working for a large regional hospital. We're implementing a hybrid Digital Medical Record (DMR) system as a risk mitigation strategy for a 'paper light' hospital in preparation for an EMR. Our DMR system has custom business rules and workflow for most aspects of eForms ('apps') and scanned paper forms. I am in discussions with our government to roll out an 'Ontoserver', hosted in the cloud, which includes clinical terminology beyond SNOMED CT-AU (this includes Australian Medicines Terminology AMT, LOINC, SNOMED rule based maps to ICD 10). Initially we are aiming for a phased approach with active data fields and 'agile' SNOMED look-ups. I'm looking at getting a better understanding of what implementations of SNOMED CT exist in non-EMR/EHR systems. More specifically Digital Medical Records (ie. eForms). My main question is surrounding this topic, does anyone know of such implementations? Also, our solution is cloud based (Microsoft Azure) which incorporates an ECM (Enterprise Content Management) system also including workflow. This is to assist with community, non-clinical areas and legacy systems. I would be interested in any systems such as this that integrate SNOMED CT and how it is used/implemented. Thanks in advance for your contribution to the discussion/question.

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Comment Last useful answer, Mar 8, 2016. All contributions
Hi Michael, There are indeed many other implementation of SNOMED CT in the world and we continually try to persuade more people to post information about their implementations. We have been somewhat successful in the last couple of months with 75 implementations new recorded. However, it is still a fact that several large scale implementations are not registered (For example in the Kaiser Permanente, Veterans Administration). Another useful resource for looking at information about some implementation is the presentations at the annual SNOMED CT Expo (formerly Showcase). All the presentations from these events 2011-2015 are accessible (as PDF downloads) through publicly accessible pages on our E-Learning Server https://elearning.ihtsdotools.org/course/view.php?id=8&section=1. While some of the presentation are of a technical nature many are also reports of practical implementations. Kind Regards David Markwell IHTSDO Head of Education.

This discussion thread is the place to post projects, promote discussion and facilitate collaboration for all things SCT Implementation. Discussion on this thread may contribute to meeting discussion. Questions welcome.

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Comment Last useful answer, Aug 1, 2016. All contributions
Hi Ray, Patient data archival policy should obey your local legislations and guidelines which similar to the paper records. That's not something related to SNOMED CT. For your second question...... Please be aware that SNOMED CT does not generate any limitations to your EHR system. It is your EHR system may have some limitations by using SNOMED CT. So, you cannot tell users they cannot do this and that because SNOMED CT has been used. The only thing that you need to declare is the SNOMED CT licensing information somewhere inside your EHR. You should be able to see the similar at http://browser.ihtsdotools.org/ http://browser.ihtsdotools.org/  J

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