Developments
in The Netherlands focussed
on the IHTSDO Workbench
Jos Baptist, senior advisor
standardisation processes
IHTSDO, Stockholm, October, 2012
Nictiz in one sheet
• dec 2001: one platform for ICT in Healthcare
• 2002 - 2006 make an EHR possible in NL
– choice for national index registry and HL7v3
– problems with identifiers, privacy, safety, …
• 2007 - 2011 legislation for use of identifiers
– EHR rejected in parliament on April 5th 2011
(supposed privacy issues: politicians have 'cold feet')
• 2012 - … split up of Nictiz
– funded by the Government Nictiz continues the
standards and developments to improve Healthcare IT
– denationalization of the national index registry and
continuation in a private service centre for healthcare
Stockholm, October 2012, sheet 2
Nictiz support for
terminology use
Make terminology available via
portal and as a web service :
Create routines and make the
source code available as open
source to be built in in applications
Develop divers search routines to
support intelligent search, find,
select and use of terms and register
the code(s) in the system chosen.
Terminology services:
availability of codeand terminology
systems, tables,
classifications and
mappings, etc..
Maintenance and
management conform SNOMED CT
LOINC
NEN 7522
Declarations
Stockholm, October 2012, sheet 3
Website Nictiz
SAAS, webservice, …
Soundex NL
hierarchy
and ClaML
Soundex UK
search by
domain
string
partial terms
combination
use semantic web technology
thesauri:
diagnoses, CPT,
treatment, etc.
ICD
ICPC
ISO-9999
Central functions made
available to ICT vendors
and self programming
institutions in order that
care professionals will
always and everywhere be
able to use terminology
and coding systems in an
uniform way.
mappings
sub sets
value sets
code systems
reference sets
coordination
terminology support
Use existing developments on a national level and
include SNOMED CT as essential terminology
Find and support new implementations and domains for
SNOMED CT (those people really want it !)
Explain that Dutch terms are guaranteed for maximum
connectivity to the terms and concepts of the
International Release
Create that bridge between their needs and SNOMED CT
Make maximum use of the IHTSDO Workbench
Support them with software and Terminology Explorers
Support a NL extension for Dutch terms and synonyms
Stockholm, October 2012, sheet 4
what we really do …
DHD (Dutch Hospital Data)
We mapped > 6000 diagnoses in Dutch language to their SNOMED CT
concepts (one-to-one) and imported that as a batch through the
Workbench into the NL Extension 1000146
* We still have to reshape it as a language reference set for the DHD
We started to work out more Dutch language diagnoses that do not fit in a
1-1 mapping but need post coordination
We integrated the Dutch terms into our SNOMED CT Terminology Explorer
so you will always find the Dutch term + the concept in the International
Release
Optometrists
Using the SNOMED CT Terminology Explorer the optometrists association
Netherlands (OVN) selected diagnoses, anatomy, examinations and
treatments related to their domain
We create software to support the maintenance of their reference sets and
the Dutch translations of the English terms (+ 60%)
* We still have to import the reference sets as well as the translated terms
Stockholm, October 2012, sheet 5
what we really want …
Real clinical /medical registration with SNOMED CT !
- mappings from SNOMED CT to diagnosis declaration codes
+ mappings to ICD-10 either direct or via the NL codes
+ solutions for existing Dutch diagnoses terms in use that need post
coordination
- mappings from SNOMED CT to procedure codes for reimbursement
- organise domains and manage their reference sets
+ integration of language reference sets
+ Question: one Dutch language reference set plus one Belgian Dutch ?
- full integration in our SNOMED CT Terminology Explorers
+ make that available as open source software
+ organise the download support for registered users
- combination of 'request submission system' with the NL extension and
bring new concepts to the International Release
Stockholm, October 2012, sheet 6