quality improvements based on detailed and precise terminology efmi on iceland june 2010 kirsten...
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Quality Improvements Based on Detailed and Precise Terminology
EFMI on Iceland June 2010
Kirsten Bredegaard, Senior ManagerConnected Digital Health in Denmark
kibr@sdsd.dk
Agenda• SNOMED CT in DK• Coding clinical data
using SNOMED CT• Advantages &
challenges using SNOMED CT
• Clinical documentation and reimbursement data at the same time?
SNOMED CT in Denmark
• National Release Center placed in National Board of Health
• Is translated into Danish• Is in very limited use• Smaller projects - ”pathfinder projects” –
conducted by Digital Health in cooperation with the National Board of Health
Quality Improvements based on detailed and precise Terminology
• Comparative study, carried out by – Digital Health– Intensive Care Units– Daintel, vendor of ”Critical Information System”
• Validated visualized subset of SNOMED CT– Concepts selected and qualified by clinicians
• Questions to be answered: Using SNOMED CT will we then achieve– increased possibilities for quality monitoring?– increased possibilities for quality benchmarking?– faster access to evidence for new ways of treatment?
Method – making relevant subsets’
XxxxXxxxXxxxXxxxXxxxXxxxXxxXxxxXxxxXxxxXxxxXxxxXxxxXxxx
’
Xxxx xxx xxx xxxXxxx xxx xxxXxxxx xxx xxxXxxxx xxx xxxXxxxx
Currentlyused codes
Relevant groupings
Identifying similargroupingsin SNOMED CT
Marking recommended concepts
Subset to be shown in theCIS system when doing clinical documentation
Ambiguous terms are given a full textual definition
Coding clinical data using SNOMED CT
What can we gain using SNOMED CT – in short terms
• Detailed data• Precise overview – also
graphical• Quality monitoring • Direct benchmarking• Efficiency of treatment • Faster access to results
of new treatments• Faster change in
treatment strategy
What can we gain using SNOMED CT – Long term
• Reuse of data for many purposes
• Information exchange between systems – semantic interoperability
• Better possibilities for decision support
• Different kind of warnings, ex– drug interactions – alerts information – allergy notifications
Challenges• Reimbursement
– ICD-10 is used in all DRG-algorithms• National statistics based on ICD-10
– How can we compare data across the years if we change registration strategy?
• New EHR-systems increase the need for official clinical terminology developed for clinical use– Can we handle national subsets?
• So - How do we overcome the challenges and bring SNOMED CT in daily clinical use?
Clinical documentation and reimbursement data at the same time?
• Purpose– Investigate and examine
possibilities for reimbursement using DRG on clinical documentation with SNOMED CT
• Possible to make a reliable mapping between ICD-10 and SNOMED CT when documenting?
• Compute and compare DRG on different registrations
SKS
Senile cataract XXXX
XXXX
SNOMED
Search cataract
SKS SNOMED
Senile cataract + Senile cataractSenile cataract + Senile cataract
Other cataract + CataractOther cataract + Cataract
XXX XXXXXX XXX
Conclusion• The clinicians (ICU) want very much to use
SNOMED CT• Focus on the challenges and find future
solutions using international terminologies– we need a different kind of clinical documentation
in the year of 2010• We need to accept
– Small problems find quick solutions while big problems take a little while longer …… but there is a solution to every problem
Questions?
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