MTUG Meeting - 27th September 2022

Welcome and introductions

SNOMED International

Attendees presented their mapping use cases:

The Netherlands: Primary care (ICPC codes) to SNOMED CT. Using an ECL expression to represent the set of possible codes

Erin (Babylon): Mapping RxNorm medication codes. Receiving medications in treatment norms in RxNorm, and want to convert to SNOMED CT

Recent features and enhancements to Snap2Snomed

SNOMED International

https://snap.snomedtools.org

Key new features were introduced:

• Improved deletion functionality

  • Deleting a map in Snap2Snomed is now much easier. You can delete a Map using the 'trashcan' icon next to each map in the Maps list, and you can delete a specific version of a map from the 'edit map' page.

• Improved map import

  • Snap2Snomed will now allow the import of all columns that can be exported, including the 'No map flag' and 'Status'. The tool also now provides better handling of variation in column headers.

• Map creation and edit

  • Map Name, version and description can now be updated

  • The 'Target SNOMED CT edition' and the 'Target SNOMED CT version'  has been separated for easier selection

  • Terms in the ECL for the target scope are now displayed

• Other features

  • The list of maps can now be filtered, using the map title, description, and user role.

  • You can open a map from the list of maps by simply clicking anywhere in the corresponding row.

  • You can now swap between map versions from within the map view.

  • Notes on each map row can now be saved and deleted.

  • Various improvements have been made to the 'Map Task' (detailed) view, including renaming the Target Properties to align with SNOMED names.

  • Improved bulk edit feature with option to bulk edit the map target

Feedback from user group

All

We had a good discussion about the current features.

Overall, the group is happy with the tool, and have many ideas for improvements.

Priorities and next steps

All

Attendees submitted their requirements for future enhancements and we had a discussion about the identified categories.

• Dual independent map and review

  • It is a high priority to support multiple mappers and reviewers of the same map rows

  • Resolution could be assisted by interrater variability measures.

• Map to Postcoordination

  • Requested by multiple attendees (Netherlands, Canada, UK). Option to start with a very simple, string-based approach. Eventually, more advanced support for the creation of expressions may be added.

• Mapping from SNOMED CT

  • Use cases mentioned:

    • Mapping to Dutch medication codes for Allergens. If someone has an allergy to a medication.

    • Mapping to nursing classifications

    • Mapping from an epidemiology standard (very broad categories and subcategories).

    • Gathering data from clinical trials. 

    • To get different domains together, to annotate the data with SNOMED CT. 

    • From SNOMED CT to CPT for claims and billing

    • Every country has a need to map from clinical content to national billing coding.

• Better multi-language support

  • For non-native English speaking countries, it would be very useful to be able to see the source code in the native language

  • An idea was introduced to have a multi-purpose additional column that comes from the import source vocabulary with eg Korean expression of concept. Or, in the case of the EDQM mapping, to take the definition of EDQM, or additional properties, and for the use case of mapping from local vocabularies to SNOMED CT, will provide information about the local context of the expression

  • Automap is not as great in Swedish as in English. Would it be possible to add additional translation mechanisms, not requiring the applied SNOMED CT Edition to have been translated.

  • Request to have the target term from multiple Editions shown. E.g. when mapping a local code to both German, French and Dutch

• Import additional properties / Possibility to split source concepts into two or more

  • Source code has categories and subcategories. Need to know if it belongs to a category or subcategory.

  • Need to be able to indicate if something is a type of concept. Everything could be used (Map to simple ECL?)

• Map to latest international + country extension to include latest content OR possibility to manually add a target SCT code from outside scope (for example new international content)

  • If we have a local terminology, then would want to map to Canadian edition (or other target edition). For the stakeholders to not wait for the next international edition, but each month to be able to use new concepts in the international edition. Some users want to keep pace with SNOMED International

• Propose replacements for inactive concepts / When creating a new version of the map

  • Having a feature that shows what concepts are affected by the new version of the SNOMED CT edition used (concepts that have suffered modifications, that have new children,...)

  • Flag what mappings should be reviewed

  • Need to see what the replacements are, with a review process

  • Maintenance like editing or authoring. It would use the normal editing and review process

• Snowstorm integration

  • Enable Snowstorm to deploy the tool, and to be able to publish to Snowstorm

• Display cases where multiple narrower concepts are mapped to one broader concept

• Map code/values to FHIR resource and element; Export to FHIR concept map

  • It would be nice to have the maps come out of the tooling as a FHIR concept map.

Next meeting

SNOMED International

Next MTUG meeting

TBD