We did a vast amount of work on this in the Clinical Terms Project
and got full sign-off from all the professional bodies.The "CT" of
SNOMED-CT is of course a reference to the products of the Clinical
Terms Project.
I work in a laboratory in the Southern Cluster, and don't know why
the catalogue of investigations is not based on SNOMED-CT.
Jonathan
On 11 Oct 2007, at 10:12, Paul Schmidt wrote:
> Re LOINC adoption in US vs READ codes: I can understand why, it is
> more
> logical/comprehensive/systematic...you name it...however LOINC is not
> perfect at all: eg it is not object oriented at present. But at
> risk of
> misrepresenting history, I understood that one of the influences the
> European/UK views brought to the SNOMED collaboration was the object
> orientation that SNOMED CT adopted. A similar influence may come
> about with
> more collaboration in this area....
>
> I'll check out OpenEHR
>
>
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of Richard Jones [Pathology]
> Sent: 11 October 2007 09:58
> To: [log in to unmask]
> Subject: Re: Conversion units
>
> Just a little clarification - my understanding was that the Read
> codes for
> tests were offered to SNOMED but the US insisted in going with
> LOINC and
> hence initially isolating Pathology.
>
> In the end there will be one global code scheme - complex I know but
> necessary. OpenEHR is worth a view as it's based on open
> architecture and is
> object orientated. Problems with early code systems were that they
> were too
> rigid and lacked the ability to deal with the rapidly changing
> world. It's
> noteworthy that SNOMED is beginning to emerge into the new world of
> open
> standards - see also Microsofts open source moves with the common user
> interface.
>
> In the new world it pays more to collaborate than compete - sadly
> we are
> still paying the price for previously mis-guided attempts to corner
> the
> market in codes.
>
> As to who's in charge of UK pathology coding - I'd love to find out.
>
> Rick
>
> Dr Rick Jones
> Assoc Clin Director, Yorks and Humber SHA NPfIT
> Sen Lect, Yorkshire Centre Health Informatics, Univ of Leeds
> [log in to unmask]
> http://www.ychi.leeds.ac.uk <http://www.ychi.leeds.ac.uk/>
> http://elipse.redirectme.net <http://elipse.redirectme.net/>
> http://www.pathology.leedsth.nhs.uk <http://
> www.pathology.leedsth.nhs.uk/>
> 0113 343 4961
>
>
> ________________________________
>
> From: IT working group of the Association of Clinical Biochemists
> on behalf
> of Paul Schmidt
> Sent: Thu 11/10/2007 09:40
> To: [log in to unmask]
> Subject: Re: Conversion units
>
>
>
> Hi Arden,
>
> I think this call for a collaborative effort is very commendable.
> There is
> just one problem with it: the US have decided a few years ago that
> they are
> adopting the LOINC database for the names/codes of laboratory tests
> and
> other clinical observations, and whoever in the UK is in charge of
> these
> things seem to view it with antipathy or at least indifference. As I
> understand it there is collaboration with SNOMED CT so that the
> domains will
> be complementary. Several other countries in Europe has also agreed
> to adopt
> the standard.
>
> http://www.clinchem.org/cgi/content/full/49/4/624
>
> Nobody is saying it is yet the complete package, but it is a damn
> sight more
> comprehensive and systematic with potential for improvement (eg in
> describing ordering panels) than anything else I have seen. The
> issue of
> developing a single framework for standard units of measurement is
> one which
> should also tie in to that (and in the US I guess it does??).
>
> For my part I have never understood why we in the UK cannot see the
> sense of
> joining the collaborative and influencing the changes one might
> want to see
> from the UK perspective, just like the situation was with READ
> codes (UK)
> and SNOMED RT (US). Then the NHS and College of American
> Pathologists joined
> hands and SNOMED CT hasn't looked back since. Instead there is
> constantly
> new little initiatives here in the UK bubbling up under various
> organizations uncluding the Southern cluster in NPfIT which seems
> keeps
> re-inventing the wheel (yawn!)
>
> The point I am making is: if the UK is not even part of the broader
> collaborative of agreeing names and codes for test results, then
> the issue
> of agreement on SI units is almost moot, as there is unlikely to be
> any
> universal exhange standard.
>
> I would be very interested if someone could enlighten me why this is
> happening (or not happening!)
>
> Paul Schmidt
>
> Queen Alexandra Hospital
> Portmsouth UK
>
>
>
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of A. Forrey
> Sent: 10 October 2007 18:24
> To: [log in to unmask]
> Subject: Re: Conversion units - PMIP[MESSAGE NOT SCANNED]
>
> I would like to urge that the UK clinical laboratorians dvelop a
> collaborative effort with those in the US with respect to the
> common units
> and their representations (whether in messages or in data structures
> such as the EHR). The IFCC/IUPAC SI represerntations are those
> recommended
> both by national and international groups. The educational
> challenge for
> the health professional (useers and producers of measurments/
> observations)
> has been a majo one over the 16 years that work of the US with
> the EU
> CEN TC 251 groups has been pursued. Much more could and should be done
> collbaoraively and synergistically. AACC LISMID Chair Al Jekelis is
> a key
> contact and he is working with LISMID memeber pam Banning on a
> terminology program for the AACC 2008 Annual meeting in July in
> Washington
> DC. There is still time to develop a joint effort with ACB to
> address this
> specific challenge and have useful information by the time of that
> presentation. I invite those interested to contact these
> individuals on
> this subject.
> Sincerely,
>
> Arden W. Forrey PhD
> Dept of Restorative Dentistry
> University of Washington School of Dentistry
>
> On Wed, 10 Oct 2007, Jonathan Kay wrote:
>
>> On 10 Oct 2007, at 10:40, Gethin Roberts wrote:
>>> In Wales we are currently working towards procurement of an
>>> "integrated"
>>> LIMS. OJEU ? Feb 2008.
>>> I'm heading a project to standardize biochemistry test names, codes,
>>> units and (where possible!) reference intervals.
>>
>> I think the key question is whether that is going to give
>> transferable
>> results...
>>
>> Best wishes
>>
>> Jonathan
>>
>>
>>
>> On 10 Oct 2007, at 10:40, Gethin Roberts wrote:
>>
>>> In Wales we are currently working towards procurement of an
>>> "integrated"
>>> LIMS. OJEU ? Feb 2008.
>>> I'm heading a project to standardize biochemistry test names, codes,
>>> units and (where possible!) reference intervals. I've also
>>> represented
>>> Wales on Jonathan Berg's W Midlands Biochemistry Harmonisation
>>> group.
>>> Looking at the spreadsheet I can see how this can easily develop
>>> into a
>>> pig's breakfast!
>>> We hope to proceed in Wales by setting up a code list for tests with
>>> agreed names and (SI) units. Any translation necessary for the IHR
>>> and/or clinical portal in Wales would occur further down the line.
>>> Although we hope to agree some consensus reference ranges the
>>> reality is
>>> that most results transmitted will (hopefully) have a standard
>>> code and
>>> unit but different ref ranges depending on lab.
>>> I would be grateful for any advice on how likely this approach is to
>>> succeed and any other comment on the most effective way forward.
>>>
>>> Gethin Roberts
>>> Consultant Clinical Biochemist
>>> Bronglais Hospital
>>> Aberystwyth
>>> 01970 635784
>>>
>>> -----Original Message-----
>>> From: IT working group of the Association of Clinical Biochemists
>>> [mailto:[log in to unmask]] On Behalf Of Jonathan Kay
>>> Sent: 10 October 2007 08:32
>>> To: [log in to unmask]
>>> Subject: Re: Conversion units - PMIP[MESSAGE NOT SCANNED]
>>>
>>> I don't think its safe for receiving systems to change any
>>> components
>>> of reports unless it is known that results between the different
>>> methods are transferable.
>>>
>>> Some minor conversions of units are probably OK (eg mmol to
>>> micromol)
>>> and should be based on systems sending well formed ISO units (IFCC/
>>> IUPAC to us), and be limited to those cases.
>>>
>>> If this approach isn't taken it is likely that eg enzyme results
>>> from
>>> different laboratories will be merged when the results are not
>>> transferable. (Because system implementers will look at the units
>>> and
>>> see they are the same... )
>>>
>>> NB: This is a criticism of UK laboratories, not information
>>> system or
>>> projects.
>>>
>>> Jonathan
>>>
>>> On 9 Oct 2007, at 21:23, Richard Jones [Pathology] wrote:
>>>
>>>> TPP (and I assume other GP suppliers) are now receiving data from
>>>> multiple labs with a mixed range of units. Though they store the
>>>> original unit when they display tables or graphs they have a need
>>>> to convert to a common base unit.
>>>>
>>>> They have set up the following conversions. I would be grateful if
>>>> anyone with a little time could check these for me and comment on
>>>> whether you think they are valid. see spreadsheet.
>>>>
>>>> Incidentally they have also noticed a number of labs sending
>>>> messages with 'inappropriate' units and other message content. I
>>>> have contacted CfH (at a very high level) to try to get their help
>>>> desk to resolve it without any reply - clearly the potential safety
>>>> issue is not recognised / understood.
>>>>
>>>> How do you think we should proceed?
>>>>
>>>> I have attached an anonymised list (at least only with lab ID
>>>> codes). Should I share the uncoded version?
>>>>
>>>> My feeling is that CfH should be picking this up and following
>>>> through to the labs.
>>>>
>>>> Comments welcome.
>>>>
>>>> Rick
>>>>
>>>>
>>>>
>>>>
>>>> Dr Rick Jones
>>>> Assoc Clin Director, Yorks and Humber SHA NPfIT
>>>> Sen Lect, Yorkshire Centre Health Informatics, Univ of Leeds
>>>> [log in to unmask]
>>>> http://www.ychi.leeds.ac.uk <http://www.ychi.leeds.ac.uk/>
> <http://www.ychi.leeds.ac.uk/>
>>>> http://elipse.redirectme.net <http://elipse.redirectme.net/>
> <http://elipse.redirectme.net/>
>>>> http://www.pathology.leedsth.nhs.uk
> <http://www.pathology.leedsth.nhs.uk/> <http://
>>>> www.pathology.leedsth.nhs.uk/>
>>>> 0113 343 4961
>>>>
>>>> <Anonymous Copy of Invalid Units.xls>
>>>> <Copy of Invalid Units.xls>
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