Rodrigues and colleagues have published a paper ‘Sharing Ontology between ICD 11 and SNOMED CT will enable Seamless Re-use and Semantic Interoperability‘ which is open-access (Creative Commons Attribution Non-Commercial License). Amongst the authors is Kent Speckman, former chief terminologist at IHTSDO.
Kent Löfgren explains the concept of ontology. In this article it is the more restricted meaning that is being used.
This article is highly specialised but at the same time it addresses issues that are central to the future use of electronic health records and diagnostic coding. Thus while the article is specialised there are implications for clinical practice.
Where are we now?
Many countries are presently using ICD-9 or ICD-10. The World Health Organisation are developing ICD-11. Currently many electronic health records would enable the recording of ICD-9 or ICD-10 codings. SNOMED-CT® is already being used in electronic health records and is a standard for clinical descriptions. Having a standard is important for many reasons. One important reason is to enable electronic health records to ‘talk’ to each other and allow information to follow a patient from one clinical system to another.
In their paper, Rodrigues and colleagues point out the benefits of a shared ontology between ICD-11 and SNOMED-CT®. If both were widely used in clinical systems it would make it easier for clinical systems to be able to ‘talk’ to each other. If it is easier for clinical systems to ‘talk’ to each other it is easier for information to follow a patient between organisations.
Are there any challenges?
The authors have identified some issues that need to be addressed. This is to be expected. Complex problems usually need to be solved to achieve big goals. The authors in this paper note at that at the time of writing, SNOMED CT® does not allow negation. They refer to a joint advisory group that focused on developing a common ontology for SNOMED CT® and ICD-11 and which proposed that there should be a 1:1 mapping between core classes in ICD-11 and SNOMED CT®. The catch is that negation is used in ICD-11, as in previous versions of ICD in the form of exclusion criteria.
Are there ways forwards?
Yes. The authors also point out systematic ways to address these issues and include the development of a query language that allows negation.
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