In this series of posts, I am assessing the SNOMED CT® terminology using the international browser. SNOMED CT® offers a description of environments both in terms of countries and in broader descriptions of types of environments.
Reflecting on this I can see that the country descriptors can be quite useful. For instance if people have visited another country or are visiting from another country this may play a role in the clinical history. In terms of the broader descriptions of types of environments I could see that describing healthcare settings is quite important.
With regards to other types of environments such as community settings these might be relevant in broadly describing the home environment of a patient (e.g urban versus rural). In a time pressured clinical environment, the challenge is for the clinician to record the essential information for care and it will be interesting to see whether in practice an address on the electronic patient record system will suffice or whether there will be a preference for adding this level of detail.
If this detail is coded then it allows for a more straightforward summary of population level data. This is in turn would be well suited to discussion around resource allocation. What becomes clearer to me on reflecting on this is that SNOMED CT® offers considerable flexibility and there are a lot of options for coding information. When information is coded it comes with a cost – the utilisation of time. At some level in the system there is a cost-benefit analysis in terms of resource allocation. It will be interesting to see how these calculations are applied in practice.
Appendix A – Other Posts in the Series on Health Information Exchanges
Appendix B – Definition of Health Information Exchange
This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)
‘Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘
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