The EDQM to SNOMED CT dose form map was developed to support a range of use cases, including:

1. Authoring a SNOMED CT drug extension based on authorised medicinal product information (e.g. SmPC) that uses EDQM dose forms.
2. Mapping a national Medicinal Product Dictionary (MPD) to international SNOMED CT medicine concepts for patient care.
3. Facilitating international interoperability of medication information.
4. Maintaining decision support.
5. Mapping an IDMP-compliant regulatory database to SNOMED CT.

This section describes each of these use cases in more detail.

Authoring a SNOMED CT National Drug Extension

• The national extension wants to represent authorised (real/branded) medicinal products in a SNOMED CT drug extension as Real Clinical Drugs (RCDs), based on the authorised product information, and this authorised product information uses EDQM dose forms.

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps the authoring of the RCDs, because “pharmaceutical dose form” is a definitional attribute of an RCD.

• The national extension may want to have a more granular abstract representation of some authorised (real/branded) medicinal products than is provided by the SNOMED CT international Clinical Drugs (CDs). These more granular CDs use the more granular pharmaceutical dose form concepts than the ones that are used for describing international CDs.

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps authoring these additional CDs, as it contains the more granular pharmaceutical dose form concepts used for real products.

National use of international medicine concepts in patient care

• An organisation wants to map concepts from a national or local Medicinal Product Dictionary (MPD) to international SNOMED CT clinical drugs to support the patient medication process - prescribing/dispensing/administration/recording
  “Prescription” uses abstract concepts (from the international edition), but these must be matched to a local authorised product for dispensing/administration.
• Many or all of the concepts in the MPD use EDQM dose forms as their pharmaceutical dose form.

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps the mapping because “pharmaceutical dose form” is a definitional attribute of a SNOMED CT clinical drug and is usually a stated attribute of the concept in the national/local MPD.  By mapping at the attribute level, much of the medicinal product concept level mapping can be “automated” (at least initially).

International interoperability of medication information

• An organisation wants to map concepts from a national or local medicinal product dictionary (MPD) to international SNOMED CT clinical drugs for interoperability purposes, such as sharing patient medication lists for cross-border patient-care, pharmacovigilance, and clinical research.
• Many or all of the concepts in the MPD use EDQM dose forms as their dose form.

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps the mapping because “pharmaceutical dose form” is a definitional attribute of a SNOMED CT clinical drug and is usually a stated attribute of the concept in the national/local MPD.  By mapping at the attribute level, much of the concept level mapping can be “automated” (at least initially).

Decision support

• An organisation wants to manage its knowledge base of medication decision support data by using “international” medication concepts, so uses SNOMED CT and its structures, either directly or indirectly.
• It then needs to map from the local MPD to SNOMED CT for implementation (if the local MPD is not already mapped to SNOMED CT).
• It may also want to “stream in” IDMP data for processing in its decision support system (as described in the next use case).

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps the mapping because “pharmaceutical dose form” is a definitional attribute of a SNOMED CT clinical drug and is usually a stated attribute of the concept in the national/local MPD.  By mapping at the attribute level, much of the concept level mapping can be “automated” (at least initially).

Note: in many ways, this UC is another view on all of the previous use cases since it involves mapping from local/national MPD to SNOMED CT, using authorised product data etc.

Using IDMP / UNICOM

IDMP (IDenditification of Medicinal Products) is a suite of five international standards for representing medicinal products in the regulatory domain and includes, in ISO 11239, a standard for representing pharmaceutical dose forms.  UNICOM (https://unicom-project.eu/ ) is an EU project helping to ensure that any medicine can be accurately identified globally, to improve patient safety (especially in cross-border healthcare), and, through pharmacovigilance and clinical research, enable better healthcare for all.

• An organisation wants to map data from an IDMP-compliant regulatory database of medicinal products to SNOMED CT concepts.
• An IDMP-compliant regulatory database should use EDQM dose forms as their dose form.

Therefore: a map from EDQM dose forms to SNOMED CT dose forms significantly helps the mapping because “pharmaceutical dose form” is a core part of SNOMED CT medicinal product information.

Note: in many ways, this UC is another view on all four of the previous use cases, but we document it separately because of the importance of UNICOM, especially to our European members.