Use case 1: Structured reporting and coding of non-neoplastic kidney diseases in Norway

Every pathology department in Norway is using the NORPAT codes for pathology diagnoses. The coding system is integrated in the laboratory information system. Coding the diagnosis is mandatory for pathologists. NORPAT codes are a continuation and further development of an older SNOMED version (SNOMED II). The national professional group of pathologists for non-neoplastic kidney diseases is currently working with a template for a structured pathology report for kidney diseases. This template uses a value set of NORPAT codes for the pathology diagnosis. The group has finished most of the specifications. At the same time, the Norwegian directory of eHealth is translating SNOMED CT into Norwegian, establishing a terminology server (snowstorm) and mapping parts of the NORPAT codes into SNOMED CT (codes for topography and procedures).

The Norwegian Renal Registry is a national quality registry, collecting both clinical and biopsy data of non-neoplastic kidney biopsies since 1988. The registry is currently using a proprietary coding system and in addition the Primary Renal Disease codes of the European Renal Association (ERA PRD). The registry will use the KBC codes as an additional coding system once established. In fact, through these different initiatives, KBC (as a subset of SNOMED CT) might become the basic coding system other coding systems are mapped to, thus providing interoperability between systems in Norway but also setting the stage for international collaboration (figure 1) (Contact Sabine Leh)

Figure 1: Codes used in pathology reporting and the national quality registry