I’ve been reading up on where other countries have gone with the integration of SNOMED and ICD-11. I’m surmising we too will go with both for 10+ years. Any thoughts on this?
SNOMED-CT will probably (and hopefully) be with us for decades. I’m not so sure about ICD-11. NZ current uses ICD10-AM, but ICD-11 is very different and I’m not sure if it’s used by any clinical systems here at the moment. Linearization of ICD-11 on my FHIR Terminology Server (Terminz) as a candidate for discussion in the HL7 FHIR community as there doesn’t seem to be an obvious way to implement it (i.e., many of the concept properties such as descriptions, synonyms, parent & child concept links are only contained in the underlying Foundation Code System).
By the time we get going, we will be on ICD-11! I’m just looking at Australia and Europe to see how likely the two will run alongside each other, how it will work, etc.
We move to version 11 FY23, it must be a nightmare for data scientists and analysts, so many different versions. I hate seeing that Aotearoa is so behind other countries in these areas. Apparently they’ll be less need for country-modifications as time goes by.
My understanding is that the WHO aren’t planning to create country-specific versions of ICD-11. I always ask about ICD-11 implementations at the HL7 International Meetings and am not aware of any national implementations or any FHIR Servers (other than mine) that support it. Will pose the question again to the terminology folks at next week’s meeting.
We don’t have a firm timetable yet to implement ICD-11, but most likely it will be closely in step with Australia, working with AIHW as part of the Australasian WHO FIC. While ICD-11 will be contained to its core purpose of statistical reporting, SNOMED CT will be the coding standard for digital health records, clinical decision support and so forth. NZ is working with other nations to get ICD-11 and SNOMED CT better integrated because it’s true the maps at present are not good enough.
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Thanks @Alistairk. I am trying to consider what having SNOMED CT integrated into EHRs will look like long-term but certainly how it will interact with ACHI&AR-DRG, & clinical coding. As you may know my speciality lies here, and I am looking for reassurance that we aren’t missing an opportunity to address ‘documentation gaps’ and ‘areas of poor quality’ that our team has uncovered. Our team works on the ward with clinicians, to improve the record, before it gets to clinical coding. However, we’ve also gained great insights in doing so.
There is, in my opinion, a real gap in the understanding and appreciation for the full potential of clinical documentation from the perspectives of quality, patient safety, and most simply communication. In turn the data that is derived through clinical coding. Just ranting!
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SNOMED can certainly be your friend in addressing this. It would be handy to know some more about your investigation so that we can look at how using SNOMED can help to fill the gaps. Getting from SNOMED-coded clinical documentation to ICD-coded data is an issue right now because genuine efforts have been lacking to make the two systems work together. But I expect to see something fairly seamless emerge in the next few years now that the problem’s recognised (to be raised at World Health Assembly this month)
Alastair, my kōrero is passionate and full of ideas and findings but I haven’t found the audience yet 
. I’ve contacted @Alistair too, as they are far ahead with Cortex and EHR development.
Im going to the Clinical Digital Academy and hoping I met get 5 minutes with Lara Hopley in a few weeks.
If you have the right forum for this work or suggestion please let me know.
Truly appreciate your comms with a little fish in a big pond!
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