2025-04-08 - CMAG Meeting

Welcome

@Monica Harry 

5 mins

• Attendees list

• Introductions 

• Note:

  • The meeting will be recorded for the purpose of creating minutes. The recording of meeting will be available online until minutes approved. Once approved the recording will be deleted.

  • Joining the meeting by accepting the Zoom prompt declares that you have no objection to your comments being recorded

Administration

 @Monica Harry  

• Apologies - noted

• Declarations of Interest 

• February meeting minutes - no comments

• Briefing notes

  • Inactivation impact of initial and follow-up assessments

    • Germany - no concerns

    • Australia: Only use as a high level concept, don't use the child concepts. 

  • Planned Deprecation of the SNOMED CT - ICD-O version 3.1 Morphological and Topography Maps

    • No comments provided in meeting.

High Usage Procedures

Group

• Page for capturing information by country: High Usage Procedures

• Still time to comments on areas that are priorities for your country.

National content development activities

Group

• Denmark

  • Created a reference set - pregnancy and delivery concepts.

  • Approximately 400 concepts. Have sent about 80 for promotion. Please contact the NRC for further information.

  • Concept creation regarding the elderly and health.

  • Translating ICNP and IPS refsets. 

    • Have been submitting a number of CRS tickets in relation to these where clarification is required. 

• Norway

  • Starting work in May for fetal diagnostics for birth registry.

    • EHR's do not accept fetal codes so diagnoses will be recorded in the mothers record. This is problem for implementers.

    • Needs to be fetal, not congenital

      • Have around 270 identified existing congenital disorders that are being considered in relation to the need to create a fetal version. Not sure on number that will created as yet. There is an ICD-10 extension for fetal disorders which is being used as the basis for what they need to record. 

    • Will potentially consider promotion of these. The field is growing and changing fast. 

      • Will send SNOMED International a list when ready.

  • Contributing to the NPU work. 

    • May have a separate code set as Norwegian labs register techniques and they are not part of NPU. Looking at creating a refset for these as well as anatomical locations. Will be submitting CRS requests where new content is needed given the international significance. 

  • Very happy with the NCPT refset - planning to use as soon as possible. Will need to translate. Eager for second refset - interventions.

• India

  • Have multiple national extensions released for public use, including common drug codes:

    • Generics which are not in the international edition and those that align with the national program

    • Branded medication - nearly 80,000.

    • Close to 120,000 concepts in this extension.

  • Have 30 refsets based on national programs -maintained with new releases of the international

  • Patient friendly terms language refset - translation of international concepts

    • Many languages are spoken in India.

    • This enables patients to have instructions about prescriptions in their local language. 

  • Geographical location extension: State, major cities, districts, subdistricts - mapped to the local development code. 

• Sweden

  • Some gaps in ICNP - working on with nursing experts.

    • Could look to pull together a list and do an overlap comparison (with other NRC represented at the meeting) and submit together the content that is overlapping.  

  • Microbiology

    • Viral content - from regions in about August.

    • Have reached out to France re microbiology with plans for a call. Others with content -please reach out and we can work on overlaps. 

• Australia

  • New pathology make up 40 % of requests

    • New genetic tests are a big gap - naming these can be a challenge - gene codes, disease they represent. Requesters don't always know the acronym. Adding autoantibodies tests as well as other antibody tests. 

  • National E - requesting for both pathology and radiology. Working with both colleges.

    • Radiologists have developed a catalogue -just over 2,500 tests. That has been mapped to SNOMED and now looking at the gaps -about half is missing from SNOMED - a lot of that relates to lateralisation. Don't  need all the bilateral concepts, but there are some left/right concepts missing. Have reached out to Canada and the UK and will see what they have first. Where that exists could request promotion of that content, rather than create new. 

  • Recent unusual recent topic relating to content for exploding lithium batteries - injuries (burns, inhalations), also wanted to differentiate cars or e-scooters.

• Netherlands

  • Pathology, especially cancer synoptic. Have a list of proteins, immune antibodies, anything that can be screened that is not in the international as yet. Want to promote them but acknowledge that Australia may also have them.

    • Australian response: have a big backlog that needs promotion but some needs review as created years ago.  Also have priorities with medicines - substances etc in relation to promotion. Need to determine where to start.

  • Have a big backlog of procedures and diagnosis for promotion.

  • Working on nursing problem list. Looking at ICNP refset, Norwegian refset. 

• Belgium

  • Avoiding adding content

  • Searching for a way to do reimbursement for clinician hospital procedures. Based on national coding system. Want to do this based in SNOMED so expect to receive a lot of content requests related to procedures in near future. Trying link with ICHI.

• New Zealand

  • Adding patient friendly terms - health service type reference set

  • New gambling harm intervention refset. 

  • Maintenance of other refsets e.g. radiology, procedure - work with clinicians

  • A number of refsets supporting capture of cancer data. - Reach out if interested

  • Working on content to support a government telehealth initiative as well as systemic anticancer therapy regimens. 

• Germany

  • No national concepts at this point.

  • Have published a position paper with a proposal for the base coding system. Discussions underway.

  • Mapping projects - want to use SNOMED CT - labs, oncology and documents 

  • Undertaking translation - 21,000 surgical procedures - will map to national procedure classification

  • Submitting a lot of change requests - outdated content

• Malaysia

  • Engaged with obstetricians -development of a refset.

  • Revising cardiology refset

• Ireland

  • Death register refset  - will be including paediatric and neonatal mortality

  • Acute floor refset - working diagnosis (emergency departments, surgical/medical assessment units)- almost completed

  • Planning work on sepsis - seems to be content gaps in this area.

  • Now have about 20 refsets. 

• SI

  • Good to share - potential for collaboration, good for us to know what is happening, opportunity for the international team to think about where we focus our effort. 

  • We may look to ask if you have clinicians working in specific areas - SME access can be an issue for us outside of the CRGs.

  • Talking to the translation group about trackers- how to move them along - need SME input to assist with some of these.

National Content Modelling Forum

Group

• Reminder exists to help with modelling questions.

Submission of Content Issues and Questions

@Monica Harry 

• Freshdesk and CRS

  • See slides 8 and 9. 

  • Please feedback if the information isn't clear.

  • Flow chart: 

    • Denmark: More information as sometimes requests go to through different paths e.g. project, internal discussions etc. Need this as well.

      • SI: Will look to improve chart. Potential paths advised verbally for now. 

  • US: Please also provide specific information on CRS statuses in particular - awaiting agreement and in inception.

    • SI:

      • Awaiting agreement - Using this for permission from owners of trademarks and IP, while we await response. e.g. branded ophthalmology devices there at present

      • There is information in the CRS guide on both of these statuses but we will enhance that.

  • Denmark: The ability to prioritise CRS was raised (and had been previously - unsure where). Would be good to be able to do that as can be done in JIRA. 

  • SI: Has been discussed internally. Not included at this point given factors such as the size of a change, need to consult with others e.g. COP, SME's, potential for impact to others or within terminology etc but will be looked at given comments here. 

    •  

      •  

        • SLA's - aim is 90% processed with the 6 months. 

• SI: Reminder that the 150 request limit refers to requests of one type of request, not the total that could be submitted.

• SI: Evaluation procedures and observables: 

  • Decision - from now on we will be adding these. 

• Slides 10 - 13 discussed with links to sites shown

• Content trackers explained and the priority of these were discussed. 

  • Feedback from Denmark and Australia that trackers are a priority. 

  • Quality not just structural correctness is important. 

Other business

Next meeting

• June 2025 - date and time to be advised. 

Apr 14, 2025 

Review meeting minutes

@Cathy Richardson 

Please review the April CMAG draft minutes and advise of any changes required by May 5, 2025. Thank you.