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SNOMED CT IN LITHUANIA
Arvydas Laurinavičius
EuroRecTallinn, 20100618
VILNIUS UNIVERSITY NATIONAL CENTRE
OF PATHOLOGY
SNOMED CT in LT
• Why (we got it)?
• How (we got involved)?
• Plans and achievements
WHY?
Need for consistency and maintenance
Need for comprehensive medical terminology
Need for semantic interoperability of e-health systems
SNOMED CT
CostingGroups
Classifications
Exchange Formats
EHR
Structured Document
Data Group
Element
Folder
Element
Element Element
Element Element
Value Domain Terminologies
& Codesets
Data Group Data Specifications
Terminologies
Relevant information standards
Lithuanian E-Health Strategy:
Technical and Semantic Interoperability mainly based on:
• ICD-10
• SNOMED CT
• HL7 v.3
• DICOM
IT STARTED IN 2003…
US Secretary of Health Thompson on SNOMED CT…
“It will be free because we want you to use it.”
July 1, 2003
Vilnius, Oct 2003
© 2002 College of American Pathologists
SNOMED CTSystematizedNomenclature ofMedicineClinical Terms
Vilnius, Lithuania October 28, 2003
Frank Elevitch, MD, Chair, SNOMED International Authority Polius Raslavičius, MD, Past President,
College of American Pathologists
Vilnius, Oct 2003
New York, June 2006
2007-3
•IHTSDO
2007-6
• SNOMED CT National Release Centre
2008
•Pilot translation into Lithuanian 3,000 concepts
2009
•Translation into Lithuanian (50,000 concepts)
•Consult implementation in E.Health
X2011-2012
NATIONAL CENTRE OF PATHOLOGY
SNOMED CT National Release Centre
Our 3-years experience in the IHTSDO
• LT – small, non-English, modest resource• Does not feel like that
– Team spirit and democracy– Sensitive culture
• It is more than just SNOMED CT– Networking with national HIT organisations– Sharing resources– Joint harmonization effort
• We (can) get more than (can) contribute
From our perspective, IHTSDO:
• Pro-active with other organisations
• Clear priority for implementation
• IHTSDO Workbench 2009
• IHTSDO Translation Tool 2010
• Member Exchange Initiative 2010
TRANSLATION
Pilot translation timeline
• Approval for funding: 06 2008
• Tender for translation tool: 09 2008
• Tender for translation: 09 2008
• Training from CAP STS, CARECOM: 09 2008
• Translation methodology drafted: 11 2008
• Subset selection: 11 2008
• Translation accomplished: 12 2008
• Translation review: 02 2009
Pilot translation 2008
Pilot Translation – Subsets Selected
• 3 top levels of SNOMED CT hierarchy - 361 concepts
• CAP eCancer Checklists – 2,176 concepts
• Anatomic Pathology Procedures - 766 concepts
• Specimen unsatisfactory for evaluation - 21 concept
• Echocardiography - 28 concepts
Translation Workflow
SNOMET CT vertimo paslaugos teikėjas (UAB „Fotonija“)
SNOMED CT sąvokųpoaibio sukūrimas (atlieka VPC)
Verčiamų sąvokų paketų sudarymas(atlieka sąvokų tvarkytojas)
Sąvokų vertimas(atlieka vertėjas)
Vertimų peržvalga(atlieka vertimų vertintojas)
Dalykinė ekspertizė(atlieka specialistas-medikas)
Vidinė peržvalga(atlieka vertimų kokybės kontrolierius)
Publikuota sąvokaRedakcinė kolegija
(VPC+vertimo paslaugos teikėjas)
SNOMED CT LT, HealthTerm
Pilot Translation Outcomes
• DK, CA and SE experience studied
• Translation methodology developed
• Persons trained: 4+5
• Concepts translated: 3,352
IMPLEMENTATION
LIFE-CYCLE OF IMPLEMENTATION
SNOMED CT
Demand
Reference Set
Translate
Implement
QA
IMPLEMENTATION-DRIVEN TRANSLATION
IHTSDO
SNOMED CT for Pathology
IHTSDO
Unsatisactory Sample
PAP Test – Unsatisf Sample Rpt
LT
EN
Potential Implementation Priorities
• Problem list
• Procedures
• Pathology and Laboratory Medicine
• Pharmacy
• Patient Safety
• Cancer prevention programs
Cervical Cancer Prevention System – A Concept
NPFCR
PCC
25-60 yr womenPAP, HISTO
QueryPAP-
Woman
Invitation (A)
Confirm (B)
Invitation (B)
PATHOPAP
PAP
HISTO
GYN BIOPSY
PAP+
Query PAP+
PAP+
Public Info
80%
100%
LT Efforts and Issues
• E-Health Program being reviewed 2010
• Translation of 50,000 SNOMED CT 2011-2012
• Implementation-driven translation – think of ROI
• Need competence
• More resource
• Synergize with international implementation efforts
