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Value sets are an integral part of terminology management services at Kaiser Permanente. Value set identification, development, deployment, and maintenance is performed using a custom tool developed within KP. This "Subset Management" tool utilizes the native ontological structure of SNOMED CT and adds KPHC local terminology as additional artifacts within the terminology model. The formal concept definitions of SNOMED CT are used to define and generate the required value sets.  The "CMT Query" tool also uses the hierarchy of SNOMED CT and description logic reasoning to identify value sets of clinician friendly terms used in patient clinical encounters. These value sets are also used within KPHC to drive business intelligence (including CDS), support workflow, and enable data reporting and analytics. As shown in the screen shot below, the queries used to define value sets leverage SNOMED CT defining relationships, such as those using the attributes

Concept
t363698007 |Finding site|
ShowFormatinline
and
Concept
t116676008 |Associated morphology|
.

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KP Query Tool enables subset management using SNOMED CT's hierarchy and defining relationships

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KP uses the native functions provided by Epic to define and maintain CDS rules. This accounts for all criteria used in the rules, such as inclusions and exclusions. A screen shot of the tool used to define these criteria is shown below.

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KP uses Epic's built-in functions to define CDS rules (in this case a best practice advisory).

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