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The first step is to identify the data elements that may require SNOMED CT coding. These data elements may already be defined in national reporting requirements Footnote ref Footnote ref n 2
, as part of a healthcare data standard you are using (e.g. a HL7 FHIR profile Footnote ref n 23
or openEHR archetypes Footnote ref n 4
), or you may be developing a new information model (or data set) for this purpose. Your requirements for coded content will depend on your specific use case and the data items in your information model. In addition, different countries, regions, and hospitals may apply different clinical techniques or practices, which can also result in differing coding requirements. Therefore, deciding which subsets to implement requires clarification of the scope of content needed, by answering questions such as: Footnote ref n 5
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Examples of Named Subset | ||
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Category | Subset | Name |
Provider and Facility Details (PRFPFD) | Site of care subset | CV19-PRFPFD-SiteOfCare |
Patient Demographics (PAT) | Marital status subset | CV19-PAT-MaritalStatus |
Marital status subset including subtypes | CV19-ASSPAT-MaritalStatus-withSubtypes | |
Clinical Assessment (ASS) | Symptoms subset | CV19-ASS-Symptoms |
Symptoms subset including subtypes | CV19-ASS-Symptoms-withSubtypes |
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Provider and Facility Details (PRFPFD)
Patient Demographics (PAT)
Clinical Assessment (ASS)
Tests and Investigations (INV)
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Some of the international subsets have been developed Gloss
Gloss | ||||
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For each extensionally-defined subset, where the members have subtypes, we provide two versions:
- One
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- subset which includes only the listed members. This version supports use cases (e.g. reporting, data integration) that require more abstract concepts.
- One
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- subset which includes the members listed and all the subtypes of each of these members. This version supports use cases that may require more specific values (e.g. data collection where more clinical detail is required).
- Please note that this second type of subset is automatically generated from the corresponding subset with listed members. No manual curation has been performed, and therefore these subsets may contain concepts that are not relevant for the context of use.
Step 3 - Review and Adapt
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- Remove any concepts that are not required for your use case
- Add any concepts missing from the subset that may be required for your specific use case
- Please note, if the concept you require is not included in the SNOMED CT Edition you are using, please follow the content request processes in each country. For more information, refer to the relevant SNOMED International Member page.
- SNOMED International National Release Centers and other authorized users may request additions or changes to the SNOMED CT International Edition via the SNOMED CT Content Request Service. For more information, refer to the CRS User Guide or contact info@snomed.org.
- Remove any concepts that are not included in the SNOMED CT versioned edition being used. This may involve
- Checking the effective time of each international concept to ensure that it is less than or equal to the International Version used by your local SNOMED CT edition
- Checking that any extension concepts are published in the SNOMED CT edition you are using
- Ensure that your subset aligns with best practice principles for subset creation.
- For example, this may involve checking that all members of the subset belong to a single hierarchy (in most cases), and that no two members subsumesubsume each other (in most cases).
- For more information, please watch our e-learning presentation on this topic - Subset Creation Principles.
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In response to an immediate need for COVID-19-specific concepts, various Member countries have developed concepts within their national SNOMED CT Extensions. Some of these extension concepts are documented in this guide, for the interest of other Members, see 4. Extension Content for COVID-19. Please note, however, that extension concepts should only be used when the module in which they are published is included in the implemented SNOMED CT Edition. SNOMED CT extension concepts are not included in the subsets downloadable from the Reference Set tool.
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