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Date

20230401

Document Version

1.0

Release Status

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SNOMED CT Managed Service - New Zealand Extension package license
SNOMED CT Managed Service - New Zealand Extension package license
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Page At A Glance

Table of Contents


Introduction

Te Whatu Ora - Health New Zealand works with health agencies and their industry partners to develop SNOMED CT® reference sets, maps, language reference sets and other content for digital health solutions in Aotearoa New Zealand.

The SNOMED CT New Zealand Extension packages these components for release every April and October, to be used with the latest designated SNOMED CT International Edition release.

The content can be downloaded from our member licensing and distribution service, viewed online using the SNOMED CT browser or accessed via FHIR® API using the NZ Health Terminology Service

We welcome your feedback and participation. For more information about SNOMED CT implementation in New Zealand, see our website or join our standards channel at forum.hinz.org.nz.

Background

This document provides a summarized description of the content changes included in the April 2023 production release of the SNOMED NZ Extension package.

It also includes technical notes detailing any known issues.

This SNOMED NZ Extension package is dependent upon and should therefore be consumed in conjunction with the SNOMED CTInternational Edition January 2023 release.

Content development activity

Summary

Content from the SNOMED CT International Edition January 2023 release has been incremented, using additional components for use in New Zealand. 

The April 2023 release includes updates to the previously released content in the SNOMED NZ Extension and introduces some new content.

This release includes new content in the following areas.

Health consumer information

The New Zealand health consumer information reference set consists of common terms used on websites and in patient information leaflets to describe diseases, tests and treatments (other than medicines) in a form consumers and whānau can understand. This content has been developed in partnership with Health Navigator.

Family planning

The New Zealand Family Planning reference set identifies common symptoms, diagnoses and procedures that are referred to when seeing patients for their sexual and reproductive health. This content has been developed in partnership with New Zealand Family Planning.

Minor procedures

A collection of five reference sets has standard codes for recording minor procedures performed in outpatient clinics. Reporting the procedure performed for the five purchase units listed below will reduce the number of new purchase units required for specific procedures and will allow more accurate counting of some procedures – for example, when NNPAC data is linked to hospital costing data.

The five reference sets are:

  • New Zealand purchase unit code S00008 minor operation reference set
  • New Zealand purchase unit code S25006 ear, nose and throat minor operation reference set
  • New Zealand purchase unit code S30008 gynaecology minor procedure reference set
  • New Zealand purchase unit code S40008 eye procedure reference set
  • New Zealand purchase unit code S60007 plastic surgery minor procedure reference set

CanShare

Te Aho o Te Kahu (Cancer Control Agency) has produced a collection of 72 reference sets for recording, sharing and querying cancer data on the CanShare platform. The collection includes Anti-Cancer Therapy - Nationally Organised Workstreams (ACT-NOW) reference sets, histology reference sets for haematolymphoid tumours (based on the WHO Classification of Tumours, 5th edition), TNM cancer staging reference sets for breast and haematologic malignancies (based on the AJCC cancer staging manual, 8th edition) and general reference sets used across a range of cancer data.

New and updated content

Concept statistics

The SNOMED NZ National Release Centre promoted 12 new concepts to the SNOMED CT International Edition January 2023 release.

Table 1. New concepts in the SNOMED International January 2023 release by hierarchy

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Total number of concepts12
Clinical finding (finding)4
Procedure (procedure)4
Qualifier value (qualifier value)4


There are 362 new concepts in our April 2023 release.

Table 2. New concepts in the SNOMED NZ Extension April 2023 release by hierarchy

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Total number of concepts

362

Body structure (body structure)

68

Clinical finding (finding)

28

Observable entity (observable entity)

1

Procedure (procedure)

129

Qualifier value (qualifier value)

9

Record artifact (record artifact)

3

SNOMED CT Model Component (metadata)

86

Situation with explicit context (situation)

21

Staging and scales (staging scale)

17


Description statistics 

The SNOMED NZ NRC promoted 4 new descriptions to the SNOMED International Edition January 2023 release.

There are 1253 new descriptions in our April 2023 release.

For a statistical breakdown of the content of the SNOMED NZ Extension and the April 2023 release please visit release statistics site.


Reference sets

There are 138 reference sets in the April 2023 release including 79 new reference sets. The new reference sets cover family planning, health consumer information and CanShare reference sets.

For more information about New Zealand reference sets, please visit our website.

The New Zealand reference set list is available in Appendix 1, table 1.1.

Language reference sets

Language reference sets are created to define preferred terms and synonyms associated with each concept. There are three language reference sets in the April 2023 release.

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Language Reference Set Name

SNOMED CT Concept ID (SCTID)

Members

Maori [International Organization for Standardization 639-1 code mi] language reference set (foundation metadata concept)

291000210106


 157

New Zealand English language reference set (foundation metadata concept)

271000210107


1266965

New Zealand English patient friendly terms language reference set (foundation metadata concept)

281000210109


162

New Zealand CanShare language reference set (foundation metadata concept)

231621000210105

1662

Maps

Five maps between SNOMED CT and other code systems are contained in the April 2023 release.

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Map Name

SNOMED CT Concept ID (SCTID)

Members

ACC translation table map (foundation metadata concept)

401000210101

12794

MSD translation table map (foundation metadata concept)

411000210104

58133

NZMT medicinal product to SNOMED CT map (foundation metadata concept)

311000210107

2125

READ v2 to SNOMED CT map (foundation metadata concept)

31000210106

88273

SNOMED CT to READ v2 map (foundation metadata concept)

41000210103

66966

Technical notes

Known issues 

Known issues are content or technical issues where the root cause is understood and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the product lifecycle.  

The following known issues were identified, and agreed to be resolved in the next editing cycle:

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Notice of changes to the International Edition release schedule

The SNOMED CT International Edition has moved to a monthly release cycle. These more frequent releases of SNOMED CT will realize several benefits, including:

  • The potential to be able to get content changes into the terminology in a shorter time frame.
  • The fostering of better interoperability, as a result of entities being able to consume release content that is more aligned with other organizations.
  • The prevention of circular dependencies that occur in longer projects, due to the move towards smaller, more manageable authoring projects.
  • More automated validation services, as a result of the inherent removal of the Alpha/Beta stages in the Release cycle.

Whilst most users will continue unaffected (as they can simply continue to download the releases every 6 months as always), this transition will necessarily involve a few changes to process/packages:

  • Delta files have been removed from releases of the SNOMED CT International Edition and SNOMED NZ Extension. A Delta Generation service will be provided for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here:
  • The ICD-O/ICD-10 Maps will continue to be published in each Monthly International Edition release package (in line with that month's content) for the foreseeable future, unless we experience issues with the new process in Production, and they need to be removed at a later date.

The first monthly Release of the SNOMED CT International Edition was published on the 28th February 2022 with the Delta files having been removed, and therefore they will be removed from the New Zealand Extension from the April 2022 Release onwards.

Please note - While the SNOMED CT International Edition is moving to monthly releases, the New Zealand Extension of SNOMED CT will remain on the current bi-annual release schedule of April and October for 2023.

Appendix 1

Table 1.1 Reference sets in the SNOMED NZ Extension April 2023 release

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SNOMED CT Concept ID

(SCTID)

SNOMED CT Preferred Term

Members

351000210106

New Zealand adverse reaction manifestation reference set

1887

253671000210109

New Zealand AJCC cancer staging manual edition reference set

2

253701000210108

New Zealand AJCC carcinoma of breast clinical M category reference set

3

253531000210106

New Zealand AJCC carcinoma of breast clinical N category reference set

11

253741000210106

New Zealand AJCC carcinoma of breast clinical stage group reference set

9

253491000210106

New Zealand AJCC carcinoma of breast clinical T category reference set

16

253721000210100

New Zealand AJCC carcinoma of breast pathological M category reference set

1

253551000210100

New Zealand AJCC carcinoma of breast pathological N category reference set

16

253751000210109

New Zealand AJCC carcinoma of breast pathological stage group reference set

9

253511000210104

New Zealand AJCC carcinoma of breast pathological T category reference set

16

253651000210101

New Zealand AJCC clinical M category reference set

15

253471000210107

New Zealand AJCC clinical N category reference set

19

253681000210106

New Zealand AJCC clinical stage group reference set

140

253451000210104

New Zealand AJCC clinical T category reference set

39

253251000210103

New Zealand AJCC grade reference set

9

253711000210105

New Zealand AJCC haematologic malignancy clinical M category reference set

2

253541000210103

New Zealand AJCC haematologic malignancy clinical N category reference set

9

253501000210101

New Zealand AJCC haematologic malignancy clinical T category reference set

11

253731000210103

New Zealand AJCC haematologic malignancy pathological M category reference set

1

253561000210102

New Zealand AJCC haematologic malignancy pathological N category reference set

9

253521000210109

New Zealand AJCC haematologic malignancy pathological T category reference set

11

253771000210101

New Zealand AJCC haematology chronic lymphocytic leukemia or small lymphocytic lymphoma stage group reference set

5

253761000210107

New Zealand AJCC haematology Hodgkin or non-Hodgkin lymphoma stage group reference set

7

253821000210106

New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical M category reference set

2

253611000210100

New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical N category reference set

9

253571000210108

New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical T category reference set

8

253841000210100

New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological M category reference set

1

253631000210107

New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological N category reference set

9

253591000210107

New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological T category reference set

8

253801000210103

New Zealand AJCC haematology mycosis fungoides or sezary syndrome stage group reference set

10

253781000210104

New Zealand AJCC haematology paediatric Hodgkin lymphoma stage group reference set

7

253791000210102

New Zealand AJCC haematology paediatric non-Hodgkin lymphoma stage group reference set

4

253811000210101

New Zealand AJCC haematology plasma cell myeloma stage group reference set

3

253831000210108

New Zealand AJCC haematology primary cutaneous B cell or T cell (non-MF/SS) lymphoma clinical M category reference set

2

253851000210102

New Zealand AJCC haematology primary cutaneous B cell or T cell (non-MF/SS) lymphoma pathological M category reference set

1

253581000210105

New Zealand AJCC haematology primary cutaneous B-cell or T-cell (non-MF/SS) lymphoma clinical T category reference set

10

253601000210102

New Zealand AJCC haematology primary cutaneous B-cell or T-cell (non-MF/SS) lymphoma pathological T category reference set

10

253641000210104

New Zealand AJCC haematology primary cutaneous haematology B cell or T cell (non-MF/SS) lymphoma pathological N category reference set

5

263581000210104

New Zealand AJCC haematology stage group reference set

17

253661000210103

New Zealand AJCC pathological M category reference set

13

253481000210109

New Zealand AJCC pathological N category reference set

20

253691000210108

New Zealand AJCC pathological stage group reference set

139

253461000210101

New Zealand AJCC pathological T category reference set

38

253621000210105

New Zealand AJCC primary haematology cutaneous B cell or T cell (non-MF/SS) lymphoma clinical N category reference set

5

72671000210109

New Zealand alcohol consumption reference set

3

421000210109

New Zealand ambulance clincial impression refset

176

61241000210100

New Zealand biological substance common allergen reference set

207

253111000210109

New Zealand cancer data absent reason reference set

5

253301000210109

New Zealand cancer ECOG status reference set

6

253331000210104

New Zealand cancer ER expression reference set

2

253281000210108

New Zealand cancer grading system reference set

1

253871000210105

New Zealand cancer haematology treatment intent reference set

5

253351000210105

New Zealand cancer HER2 expression reference set

2

253241000210101

New Zealand cancer laterality reference set

5

253341000210107

New Zealand cancer PR expression reference set

2

253321000210101

New Zealand cancer prognostic scoring system reference set

17

253291000210105

New Zealand cancer recurrence type reference set

5

253861000210104

New Zealand cancer solid tumour treatment intent reference set

6

253311000210106

New Zealand cancer staging system reference set

11

253361000210108

New Zealand cancer treatment intent reference set

8

91000210107

New Zealand cardiology reference set

63

61251000210102

New Zealand chemical substance common allergen reference set

619

191000210102

New Zealand child developmental services reference set

137

241000210102

New Zealand child health assessment reference set

186

471000210108

New Zealand clinical specialty reference set

157

61271000210105

New Zealand common pharmaceutical dose form reference set

12

61281000210107

New Zealand common pharmaceutical dose frequency reference set

12

61291000210109

New Zealand common pharmaceutical dose unit reference set

11

61231000210108

New Zealand COVID-19 adverse event from immunisation reference set

60

261000210101

New Zealand disability reference set

96

61261000210104

New Zealand edible substance common allergen reference set

419

61000210102

New Zealand emergency care diagnosis reference set

1466

71000210108

New Zealand emergency care presenting complaint reference set

158

321000210102

New Zealand emergency care procedure reference set

74

141000210106

New Zealand endocrinology reference set

263

263311000210103

New Zealand family planning reference set

250

181000210104

New Zealand general paediatric reference set

441

131000210103

New Zealand general surgery reference set

97

101000210108

New Zealand gynaecology reference set

147

263301000210100

New Zealand health consumer information reference set

84

451000210100

New Zealand health occupation reference set

87

461000210102

New Zealand health service type reference set

228

501000210102

New Zealand laboratory order reference set

956

72621000210105

New Zealand maternity Apgar score reference set

33

72631000210107

New Zealand maternity complementary therapies reference set

21

72601000210102

New Zealand maternity complications reference set

34

72611000210100

New Zealand maternity disorders reference set

49

72661000210103

New Zealand maternity family history reference set

12

72591000210107

New Zealand maternity findings reference set

159

72581000210105

New Zealand maternity mode of delivery reference set

6

72571000210108

New Zealand maternity outcomes reference set

8

72541000210103

New Zealand maternity previous complications reference set

47

72551000210100

New Zealand maternity previous disorders reference set

59

72531000210106

New Zealand maternity previous findings reference set

50

72521000210109

New Zealand maternity previous mode of delivery reference set

10

72511000210104

New Zealand maternity previous outcomes reference set

9

72501000210101

New Zealand maternity previous procedures reference set

23

72561000210102

New Zealand maternity procedures reference set

57

72641000210104

New Zealand maternity screening and tests reference set

31

72651000210101

New Zealand maternity substances reference set

13

391000210104

New Zealand microorganism reference set

18571

50931000210104

New Zealand nephrology reference set (foundation metadata)

99

72691000210108

New Zealand non-medicinal drug reference set

16

72681000210106

New Zealand non-medicinal drug use reference set

6

251000210104

New Zealand notifiable disease reference set

97

50941000210107

New Zealand ophthalmology reference set

64

192081000210101

New Zealand priority score reference set (foundation metadata concept)

7

251621000210109

New Zealand purchase unit code S00008 minor operation reference set

71

251631000210106

New Zealand purchase unit code S25006 ear, nose and throat minor operation reference set

62

251641000210103

New Zealand purchase unit code S30008 gynecology minor procedure reference set

34

251651000210100

New Zealand purchase unit code S40008 eye procedure reference set

47

251661000210102

New Zealand purchase unit code S60007 plastic surgery minor procedure reference set

18

121531000210107

New Zealand radiology procedures reference set

914

192071000210103

New Zealand referral status reference set

7

121000210100

New Zealand rheumatology reference set

126

253131000210102

New Zealand SACT basis of diagnosis reference set

2

253401000210100

New Zealand SACT disease response reference set

4

253411000210103

New Zealand SACT dose adjustment reason reference set

18

263511000210105

New Zealand SACT dose form reference set

3

253421000210108

New Zealand SACT dose unit reference set

22

253121000210104

New Zealand SACT observation code reference set

21

253371000210102

New Zealand SACT overall discontinue reason reference set

11

253381000210100

New Zealand SACT patient factor discontinue reason reference set

9

253441000210102

New Zealand SACT route of administration reference set

24

253391000210103

New Zealand SACT toxicity discontinue reason reference set

15

121521000210105

New Zealand severe acute respiratory syndrome coronavirus 2 symptoms reference set

19

481000210105

New Zealand site of care reference set

9

72731000210103

New Zealand smoking intervention reference set

5

72741000210106

New Zealand smoking status reference set

4

441000210103

New Zealand surgical complication reference set

147

192091000210104

New Zealand suspicion of cancer reference set (foundation metadata concept

4

72721000210100

New Zealand vaping status reference set

7

263341000210102

New Zealand WHO classification of tumours haematolymphoid B cell lymphoid proliferation or lymphoma histology reference set

89

263331000210105

New Zealand WHO classification of tumours haematolymphoid histiocytic dendritic cell neoplasm histology reference set

12

263321000210108

New Zealand WHO classification of tumours haematolymphoid myeloid proliferation or neoplasm histology reference set

76

263361000210101

New Zealand WHO classification of tumours haematolymphoid stroma derived neoplasm of lymphoid tissue histology reference set

6

263351000210104

New Zealand WHO classification of tumours haematolymphoid T cell and NK cell lymphoid proliferation or lymphoma histology reference set

42

253231000210109

New Zealand WHO classification of tumours haematolymphoid tumour histology reference set

224




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Draft Amendment History


Version

Date

Editor

Comments

0.1

  

Andrew AtkinsonInitial draft created
0.2

 

Lea MiharsaFirst draft
1.0

 

Alastair KenworthyFinal draft





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Approvals


Final Version

Date

Approver

Comments

0.2

Lea MiharsaApproved
1.0

 

Alastair KenworthyApproved