Date

20220421

Document Version

1.0

Release Status


  

  










Page At A Glance





Approvals


Final Version

Date

Approver

Comments

0.1


Terance Shird

Approved

1.0

 

Theresa BarryApproved



Download .pdf here:








Draft Amendment History


Version

Date

Editor

Comments

0.1

 

Andrew AtkinsonInitial draft created
0.9

 

Theresa BarryFinal draft
1.0

 

Theresa BarryFinal fixes to stats etc



Introduction

SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

The International Health Terminology Standards Development organisation (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.

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

The same content can be viewed online using the SNOMED CT browser, and eHealth Ireland website


Background

This document provides a summarized description of the content changes included in the April 2022 Production release of the SNOMED Clinical Terms® Managed Service Ireland Extension package.

It will also include technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.

This Ireland Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® January 2022 International Edition release.

Scope

This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.


Content Development Activity

Summary

Content from the SNOMED CT® January 2022 International Edition release has been included, alongside additional components for use in Ireland. 

This extension contains concepts, relationships and reference sets for healthcare professionals. 

New and Updated Content

New content in this release:

This is the 7th SNOMED CT Irish Edition Production release.


New and updated content

Concept statistics

File

Changes

Concept

35 records added/updated + 1 records inactivated

Description (EN)

87 records added/updated + 0 records inactivated

Language (EN)

3157 records added/updated + 8776 records inactivated

Inferred Relationship

67 records added/updated + 2 records inactivated

OWL Expression

35 records added/updated + 1 records inactivated 

TextDefinition

0 records added/updated 

Association Reference

1 records added/updated + 0 record inactivated

AttributeValue

4 records added/updated + 0 record inactivated  

RefsetDescriptor 

7 records added (for new refsets this cycle)



The SNOMED Irish National Release Centre published 

Table 1.1 New concepts in the Irish Edition April release

Total number of concepts

35

Assessment scales

3

Disorder

1

Finding

1

Foundation metadata concept

1

Medicinal Product1
Observable entity1
Procedure

7

Record artifact8
Regime/therapy3
Situation2
Supplier1



Table 1.2

Relationships


Total active relationships87
Inactivation's 0
Total active descriptions87

 Refer to Appendix 1, Table 1.2 to view the new relationships

 This content was derived through the Dataset Specification Process (DSMP )and includes concepts from


Table 1.3

Reference sets 

Chronic Disease Management Refset

0 records added/updated 

Coronavirus Refset

0 records added/updated  

Gynaecology Discharge Summary Refset

0 records added/updated  

Irish National Early Warning Score Refset

0 records added/updated   

Make Every Contact Count Ireland refset

0 records added/updated

Safeguarding Ireland refset

0 records added/updated

eServices Ireland refset

0 new record added/updated

Ireland Nursing & Midwifery Quality
Care-Metrics Dataset refset Ireland

1 new record added, 1 updated + 1 record inactivated

Antimicrobial stewardship Performance

Indicator Measurement System (APIMS) Data Set for Ireland

202 new records for this brand new refset

Dentistry Refset Ireland

667 new records for this brand new refset 

Lymphodema  Ireland Refset

17 new records for this brand new refset 

National Ambulance Service  Ireland Refset

111 new records for this brand new refset 

Patient Flow  Datset Ireland Refset

247 new records for this brand new refset 

Public Health Nurse clinical caseload dataset  Ireland refset

91 new records for this brand new refset 


Table 1.4

Text Definitions

Text definitions (metadata)3


Table 1.5


Content Promoted through CRS from IPU and acute medicines management programme

Sept content 1/10/2021 2
November content 12/11/2021 33
January content 9/2/202215
March content 29/3/202235
Total since Oct 2021 release:103


Table 1.6

Content Promoted from other extensions to SNOMED International

Content promoted from other extensions3




The SNOMED Irish National Release Centre promoted 103 new concepts and these will be available in the SNOMED CT May 2022 International Edition release.

Refer to Appendix 2, Table 1.2 to view 

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.  

For the SNOMED CT Managed Service - Ireland Extension Release, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:

Resolved Issues

Resolved Issues are those where the resolution has been discussed and agreed, and has been implemented in time for this release. 

For the SNOMED CT Managed Service - Ireland Extension Release, the following Issues were Resolved: 

Notice of changes to the International Edition Release Schedule

As you may already know SNOMED International have transitioned to a monthly delivery schedule for the International Edition of SNOMED CT. The move towards 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 both International and Managed Service release packages, including the Ireland 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 Ireland Extension from the April 2022 Release onwards.

Please note - While the SNOMED CT International Edition is moving to monthly releases, the Ireland Extension of SNOMED CT will remain on the current bi-annual release schedule of April and October for 2022.



 

Appendix 1

Table 1.1 New concepts

11621000220104Irish Maternity Early Warning System (assessment scale)(assessment scale)
84741000220100Irish Paediatric Early Warning System (assessment scale)(assessment scale)
84901000220104Infective exacerbation of cystic fibrosis (disorder)(disorder)
74901000220105Columnar cell lesion of breast (finding)(finding)
74921000220101Antimicrobial stewardship Performance Indicator Measurement System (APIMS)Data Set for Ireland (foundation metadata concept)(foundation metadata concept)
41661000220104Breastcheck screening service reference set (foundation metadata concept)(foundation metadata concept)
74931000220103Dentistry refset Ireland (foundation metadata concept)(foundation metadata concept)
84731000220109Lymphodema reference set Ireland (foundation metadata concept)(foundation metadata concept)
61681000220104National ambulance service reference set (foundation metadata concept)(foundation metadata concept)
73041000220108Patient Flow Dataset Ireland (foundation metadata concept)(foundation metadata concept)
61671000220102Public health nurse clinical caseload dataset Ireland (foundation metadata concept)(foundation metadata concept)
62051000220105Janssen COVID-19 Vaccine 0.5 millilitre suspension injection Janssen Inc (medicinal product)(medicinal product)
62071000220101Personal public service number (observable entity)(observable entity)
84881000220101Bed rail risk assessment (procedure)(procedure)
11661000220109Care bundle (procedure)(procedure)
11671000220103Care bundle for medical device (procedure)(procedure)
84761000220101Face, legs, activity, cry, consolability pain assessment scale (procedure)(procedure)
11651000220107Introduction situation, background assessment recommendation (procedure)(procedure)
84871000220104Manual handling risk assessment (procedure)(procedure)
84891000220103Subcutaneous cannulation (procedure)(procedure)
84821000220100Frailty care plan (record artifact)(record artifact)
84861000220105Home support service care plan (record artifact)(record artifact)
84791000220108Incontinence associated dermatitis care plan (record artifact)(record artifact)
84841000220106Neurogenic bowel care plan (record artifact)(record artifact)
84781000220105Pressure ulcer prevention care plan (record artifact)(record artifact)
84851000220108Urinary catheter care plan (record artifact)(record artifact)
84951000220100Urinary incontinence care plan (record artifact)(record artifact)
84831000220102Wound care plan (record artifact)(record artifact)
84801000220109Care of incontinence sheath (regime/therapy)(regime/therapy)
84961000220103Care of neurogenic bowel (regime/therapy)(regime/therapy)
84811000220107Care of postnatal depression (regime/therapy)(regime/therapy)
11631000220101Cardiotochogram indicated (situation)(situation)
11641000220105Postnatal risk factors (situation)(situation)
62041000220108Janssen Inc. (supplier)(supplier)



Appendix 2

Table 1.2

These  are new incoming relationships.

273249006Assessment scales (assessment scale)(assessment scale)
76752008Breast structure (body structure)(body structure)
361713003Entire subcutaneous tissue (body structure)(body structure)
321667001Respiratory tract structure (body structure)(body structure)
195647007Acute respiratory infection (disorder)(disorder)
17097001Chronic disease of respiratory system (disorder)(disorder)
177010002Chronic infectious disease (disorder)(disorder)
116339002Breast finding (finding)(finding)
86569001Postpartum state (finding)(finding)
446609009Simple type reference set (foundation metadata concept)(foundation metadata concept)
787859002Vaccine product (medicinal product)(medicinal product)
55465005Columnar cell atypia (morphologic abnormality)(morphologic abnormality)
6920004Defect (morphologic abnormality)(morphologic abnormality)
423901009Identification code (observable entity)(observable entity)
410604004Subject of record (person)(person)
337636000Incontinence sheath (physical object)(physical object)
258620006Vascular cannula (physical object)(physical object)
223490009Appliance procedures (procedure)(procedure)
445536008Assessment using assessment scale (procedure)(procedure)
710955000Biomedical equipment procedure (procedure)(procedure)
42825003Cannulation (procedure)(procedure)
11661000220109Care bundle (procedure)(procedure)
225297008Care planning and problem solving actions (procedure)(procedure)
9718006Polymerase chain reaction analysis (procedure)(procedure)
399150003Polymerase chain reaction test for severe acute respiratory syndrome (procedure)(procedure)
118726005Procedure on subcutaneous tissue (procedure)(procedure)
408767007Procedure with a clinical finding focus (procedure)(procedure)
408766003Procedure with a procedure focus (procedure)(procedure)
225338004Risk assessment (procedure)(procedure)
416325004Vascular cannula procedure (procedure)(procedure)
255212004Acute-on-chronic (qualifier value)(qualifier value)
410512000Current or specified time (qualifier value)(qualifier value)
129265001Evaluation - action (qualifier value)(qualifier value)
410535002Indicated (qualifier value)(qualifier value)
441862004Infectious process (qualifier value)(qualifier value)
257867005Insertion - action (qualifier value)(qualifier value)
129271007Management - action (qualifier value)(qualifier value)
734163000Care plan (record artifact)(record artifact)
387672006Cardiotochogram (regime/therapy)(regime/therapy)
309637002Care of equipment categorized by device (regime/therapy)(regime/therapy)
225365006Care regime (regime/therapy)(regime/therapy)
133877004Therapeutic regimen (regime/therapy)(regime/therapy)
225219005Verbal communication interventions (regime/therapy)(regime/therapy)
318331000221102Active immunity stimulant role (role)(role)
708538000Procedure indicated (situation)(situation)
243796009Situation with explicit context (situation)(situation)
774164004Supplier (supplier)(supplier)



Table 1.4 

Text definitions

Id FSN SemTag Lang Term
84741000220100Irish Paediatric Early Warning System (assessment scale)(assessment scale)enIrish Paediatric early warning system (child (< 16 years) in-patient in the acute setting) IPEWS is a system which involves the anticipation, recognition, escalation, response and evaluation of the management of clinical deterioration
11661000220109Care bundle (procedure)(procedure)enA care bundle is a collection of interventions that may be applied to the management of a particular condition.
11651000220107Introduction situation, background assessment recommendation (procedure)(procedure)enISBAR (Introduction, Situation, Background Assessment, Recommendation) is such a tool. ISBAR organises a conversation into the essential elements in the transfer of information from one source to another.


Table 1.5

Product containing precisely belatacept 250 mg powder for concentrate for solution for infusion (clinical drug)
Product containing precisely clarithromycin (as clarithromycin lactobionate) 500 mg/ 1vial powder for concentrate solution for infusion
Product containing precisely dacarbazine (as dacarbazine citrate) 1000 mg powder for conventional release solution for infusion (clinical drug)
Product containing precisely dacarbazine (as dacarbazine citrate) 500 mg powder for conventional release solution for infusion (clinical drug)
Product containing precisely decitabine 50 mg/1 vial powder for concentrate for solution for infusion (clinical drug)
Product containing precisely dexrazoxane (as dexrazoxane hydrochloride) 500 mg/ 1 vial powder for concentrate for solution for infusion
Product containing precisely efmoroctocog alfa 1000 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely efmoroctocog alfa 1500 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely efmoroctocog alfa 2000 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely efmoroctocog alfa 250 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely efmoroctocog alfa 3000 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely efmoroctocog alfa 500 units/ 1 vial powder for solution for injection (clinical drug)
Product containing precisely epoprostenol (as epoprostenol sodium) 0.5 mg/1 vial powder for conventional release solution for infusion
Product containing precisely epoprostenol (as epoprostenol sodium) 1.5 mg/1 vial powder for conventional release solution for infusion
Product containing precisely esomeprazole (as esomeprazole sodium) 40 mg/1 vial powder for conventional release solution for injection
Product containing precisely etanercept 10 mg/1 vial powder for conventional release solution for injection (clinical drug)
Patisiran sodium (substance)
Product containing only alemtuzumab in parenteral dose form (medicinal product form)
Product containing only clofarabine in parenteral dose form (medicinal product form)
Product containing precisely alemtuzumab 10 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely clofarabine 1 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely mitoxantrone (as mitoxantrone hydrochloride) 2 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing only mitoxantrone in parenteral dose form (medicinal product form)
Product containing precisely botulinum toxin type A 100 units powder for conventional release solution for injection (clinical drug)
Product containing precisely botulinum toxin type A 50 units powder for conventional release solution for injection (clinical drug)
Product containing precisely botulinum toxin type A 125 units powder for conventional release solution for injection (clinical drug)
Product containing precisely carfilzomib 10 mg powder for solution for infusion (clinical drug)
Product containing precisely carfilzomib 30 mg powder for solution for infusion (clinical drug)
Product containing precisely carfilzomib 60 mg powder for solution for infusion (clinical drug)
Product containing precisely cefuroxime (as cefuroxime sodium) 50 mg/1 each powder for conventional release solution for injection
Product containing precisely migalastat (as migalastat hydrochloride) 123 mg/1 each conventional release oral capsule
Product containing precisely niraparib (as niraparib tosilate monohydrate) 100 mg/1 each conventional release oral capsule
Product containing precisely talazoparib (as talazoparib tosylate) 250 mcg/1 each conventional release oral capsule
Product containing precisely talazoparib (as talazoparib tosylate) 1mg/1 each conventional release oral capsule
Product containing precisely dexamethasone phosphate (as dexamethasone sodium phosphate) 1 mg/1 ml conventional release eye drops, solution
Product containing precisely hydrocortisone sodium phosphate 3.35 mg/1 ml conventional release eye drops, solution (clinical drug)
Product containing precisely proxymetacaine hydrochloride 5 mg/1ml conventional release eye drops, solution (clinical drug)
Product containing precisely apraclonidine (as apraclonidine hydrochloride) 10 mg/1 ml conventional release eye drops, solution
Product containing precisely bromfenac (as bromfenac sodium) 900 mcg/1 ml conventional release eye drops, solution
Product containing precisely carmellose sodium 10 mg/1 ml conventional release eye drops, solution (clinical drug)
Product containing precisely carmellose sodium 5 mg/1 ml conventional release solution for eye drops (clinical drug)
Product containing precisely diclofenac sodium 1 mg/1 ml conventional release solution for eye drops (clinical drug)
Product containing precisely nepafenac 1 mg/1 ml conventional release suspension for eye drops (clinical drug)
Product containing precisely ketorolac trometamol 5 mg/1 ml conventional release solution for eye drops (clinical drug)
Product containing precisely hypromellose 3.2 mg/1 ml conventional release solution for eye drops (clinical drug)
Product containing precisely hexylresorcinol 2.4 mg/1 each lozenge (clinical drug)
Product containing precisely aciclovir (as aciclovir sodium) 250 mg/1 vial powder for conventional release solution for infusion
Product containing precisely alglucosidase alfa 50 mg/1 vial powder for concentrate for conventional release solution for infusion (clinical drug)
Product containing precisely aminolevulinic acid hydrochloride (as 5-aminolevulinic acid) 30 mg/1 ml powder for conventional release oral solution )
Product containing precisely anidulafungin 100 mg/1 vial powder for concentrate for solution for infusion (clinical drug)
Product containing precisely antithymocyte immunoglobulin rabbit 25 mg/1 each powder for conventional release solution for infusion (clinical drug)
Product containing precisely bendamustine hydrochloride 25 mg powder for concentrate for solution for infusion. (clinical drug)
Product containing precisely blinatumomab 38.5 mcg powder for concentrate for solution for infusion (clinical drug)
Product containing precisely ammonia 350mg/1g conventional release cutaneous emulsion (clinical drug)
Product containing precisely betamethasone (as betamethasone valerate) 1 mg/1g cutaneous foam
Product containing precisely paclitaxel (as albumin bound paclitaxel) 5 mg/1 ml powder for dispersion for infusion (clinical drug)
Product containing precisely colistimethate sodium 1 MIU/1 vial powder for solution for injection/infusion (clinical drug)
Product containing precisely colistimethate sodium 2 MIU/1 vial powder for solution for injection/infusion (clinical drug)
Product containing precisely cetuximab 5 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely fludarabine phosphate 25 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely gemcitabine (as gemcitabine hydrochloride) 100 milligram /1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely gemcitabine (as gemcitabine hydrochloride) 38 milligram /1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely gemcitabine (as gemcitabine hydrochloride) 40 milligram /1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely obinutuzumab 25 milligram/1 milliliter conventional release solution for infusion (clinical drug)
Product containing precisely patisiran (as patisiran sodium) 2 milligram/1 milliliter conventional release solution for infusion (clinical drug)




Table 1.6

Content promoted from other extensions to International

1106021000000101 |Insertion of magnetic marker into breast using stereotactic mammography guidance (procedure)| has ben added to the International release. This response is subject to change until the time of release.

1111791000000108 |Insertion of magnetic marker into breast using X-ray guidance (procedure)| has been added to the International release. This response is subject to change until the time of release.

1106671000000108 |Insertion of magnetic marker into breast using ultrasonographic guidance (procedure)| has been added to the International release. This response is subject to change until the time of release.