The Health Information and Quality Authority has made recommendations to the Minister for Health regarding the adoption of a national standard for clinical terminology in Ireland, an essential building block for rolling out eHealth and for the introduction of electronic health records.

The national standard that HIQA recommends is SNOMED CT, an electronic dictionary of healthcare terms. It involves the clinical coding of information; translating medical terminology into a coded format which is nationally and internationally recognised.

Professor Jane Grimson, Acting Chief Executive and Director of Health Information at HIQA said: “We are recommending the introduction of SNOMED CT to improve the quality of clinical data in patient records and the overall quality of care received by patients. The introduction of the SNOMED CT system means that patients can potentially benefit by receiving improved quality and safety of care and healthcare providers can benefit through cost savings and improved efficiency.”

The adoption of a standard terminology system such as SNOMED CT is essential to the implementation of the eHealth strategy, including implementation of electronic health records and ePrescribing. It is also essential to the delivery of a health information infrastructure based on the principle ‘create once use many times’.

SNOMED CT plays a key role in eHealth and facilitates the effective exchange of meaningful information between healthcare systems. It supports the EU’s eHealth Action Plan 2012-2020 and the eHealth strategy for Ireland.

Professor Grimson continued: “SNOMED CT is an essential element of eHealth and electronic health records as it supports the sharing of clinical information between different healthcare practitioners and across organisational boundaries. It is critical to ensuring that accurate information can accompany the patient along the care pathway, thereby substantially reducing the amount of duplication and fragmentation, while at the same time improving data quality.”

SNOMED CT facilitates information interchange and is central to an interoperable electronic health record. It allows a consistent way to index, store, retrieve and aggregate clinical data across different specialties and healthcare sites.

HIQA recommends that the Department for Health purchases a national licence for SNOMED CT, rather than making it a requirement for individual organisations such as hospitals, academia, or general practices to purchase individual affiliate licences at significant greater cost.

As SNOMED CT is a complex system to implement, due to both its size and structure, HIQA is proposing that it be adopted gradually on a project-by-project basis, with a national release centre to support stakeholders with implementation. HIQA suggests that focusing on a phased approach based on incorporating SNOMED CT into new systems rather than trying to retrofit it within existing systems would be a more practical and cost-effective approach.
ENDS

Further Information: 

Sinead Whooley, Communications Manager, Health Information and Quality Authority
01 814 7488 / 087 922 1941 swhooley@hiqa.ie

Notes to the Editor: 

• The International Health Terminology Standards Development Organisation (IHTSDO) – an international not-for-profit organisation based in Denmark – owns and administers the rights to SNOMED CT and related terminology standards.
• The current cost of a SNOMED CT annual licence for Ireland is $61,432. There is also a one-off payment required on joining the International Health Terminology Standards Development Organisation equivalent to the annual licence.
• The Authority’s recommendations for the adoption of SNOMED CT as the National Clinical Terminology are as follows:
  • Recommendation 1: SNOMED CT should be adopted as a national clinical terminology for Ireland immediately.
  • Recommendation 2: A SNOMED CT national license should be purchased and the resourcing and functioning of a national release centre for Ireland should commence in 2015.
  • Recommendation 3: The feasibility of entering into an agreement with a SNOMED CT national release centre in another jurisdiction should be investigated in order to provide support in the short-term (early stages of operation of SNOMED CT in Ireland).
  • Recommendation 4: SNOMED CT should be introduced gradually on a project-by-project basis with the active support of the SNOMED CT National Release Centre.
  • Recommendation 5: In order to future-proof information communication technology (ICT) investment, the requirement to support SNOMED CT should be included in all relevant software procurements from now on.
  • Recommendation 6: A review should be undertaken to determine the most appropriate agency to establish and operate the SNOMED CT National Release Centre