1. Transforming Health together
SNOMED CT Workshop
Transforming Health together
Who am I? Practice, roles, gains, visions drs should be doctoring, pertinent about improving patient care and having a positive effect on the business. Inspiring and make you think how you do your daily work

2. Microtest’s Approach
SNOMED CT codes always start with either ‘=‘ or ‘+’ symbols
= is used for codes that belong to the GP Subset
+ is used for codes that are outside of the GP Subset
The rest of the code is essentially random 1
The descriptions are the full SNOMED CT terms
1 The first two characters of an ‘=‘ code are the first two of the corresponding Read 2 code
Having to find more improved ways of working. A good place to start is to review your internal processes and can these be streamlined and automated. Patient should remain the heart of any surgery – patient care is paramount but we have to be mindful of the business costs. Businesss cost often are well hidden in a surgery. General practice is changing rapidly than every before. The way practices are being funded are changing – Enhanced Services are key and getting these to work for the practice and not against processes

3. What does this mean for entries?
Historic entries are unchanged and will always represent Read 2 codes New entries will be coded with SNOMED CT mtcodes
H33..
Record of “Asthma” made in July 2017
=H30r
Record of “Asthma” made in July 2018

4. Dual Coding The Microtest system knows equivalences between codes
=H30r
Read 2 “Asthma”
Is equivalent to
SNOMED CT “Asthma”
The system therefore knows, when looking for ‘Asthma’, to look for both H33.. and =H30r

5. Finding the code you want?
Codes can be located using any of the following methods:
Text search on the Read 2 rubric or SNOMED CT description
Read 2 code – e.g. ‘H33’
Mtcode – e.g. ‘=H30r’ (technically this is the same as above)
SNOMED concept identifier – e.g. ‘ ’
SNOMED description identifier – e.g. ‘ ’
Preferred terms, frequently used terms, QOF terms etc. are highlighted to aid in selection.

6. How does this work for QOF etc?
The Microtest system also knows about code hierarchies Hence, it knows that ‘H33..%’ includes ‘H33..’, ‘H330.’, ‘H331.’ etc. and will look for those codes where the QOF rules specify ‘H33..%’. However, it also knows that ‘H33..’ is equivalent to ‘=H30r’ so it will also look for that code and all its descendants.
Currently:
H33..%
H33.., H330., H331., …
Future:
H33..%
H33.., H330., H331., =H30r, =H38t, =H3v2, +2hGt, …
Therefore all ‘Asthma’ entries will be found irrespective of when they were entered.

7. But other systems don’t know mtcodes?
The Microtest system knows the representation in Read2 and SNOMED CT for all combinations
Mtcode
Read2
SNOMED concept
SNOMED description
Rendering
H33..
Asthma
=H30r
Acute Asthma
+8Ht1
Cornish Pastie
When exporting data to other systems, the Read2 or SNOMED CT representations can be used as appropriate

8. Data Entry Screens in Evolution
SNOMED CT picker with velocity coding/read code frequency and QOF highlights.  Note QOF highlights all codes that are valid whether SNOMED CT or read code
Fire details
Introduction around the table

9. Data Entry Screens in Evolution
SNOMED CT picker, note the original read codes in brackets to help users find codes they are familiar with
Fire details
Introduction around the table

10. Data Entry Screens in Evolution
SNOMED CT picker drilled down a bit – note more matches offered now because there are more codes in SNOMED CT, and also note that Evolution is clever enough to know about SNOMED CT code relationships 'is a' even though there isn't a hierarchy like read
Fire details
Introduction around the table

11. Data Entry Screens in Evolution
SNOMED CT picker in band3 encounter screen, expanding out potential blood pressure codes
Fire details
Introduction around the table

12. Data Entry Screens in Evolution
SNOMED CT in the referrals module being used with a text search for long term care items – note the duplication is due to different SNOMED CT code families, and will be slimmed down before release
Fire details
Introduction around the table

13. Data Entry Screens in Evolution
Inline Read coding from consultation notes – behaves same as before but offers SNOMED CT codes
Fire details
Introduction around the table

14. Deployment Plans Pre Phase
October 2017 – Release of Snomed CT browser independent of clinical system
Phase 1
December 2017 – Release of Snomed CT browser within clinical system, but still recording in Read V2
Phase 2
1st April 2018 – Release of Snomed CT Subset and Snomed coding within the clinical system using dual coding
Phase 3
No set date as yet – Release of whole Snomed database
Fire details
Introduction around the table

15. Training and Comms Plans
Microtest is working closely with NHSD
NHS Digital have compiled excellent education package (which continues to grow)
Microtest is inputting into the process (monthly meetings)
Microtest is disseminating and tailoring the core package
Fire details
Introduction around the table

16. NHS Digital Education and comms package
This comprehensive package includes:
Videos
Webinar programme (live and recorded)
Query resolution database and other online resources
Publications, resources and links on the sharing website Delen
Fire details
Introduction around the table

17. Overall communication objectives
To build awareness of the transition to SNOMED CT
To create understanding and buy-in
To stimulate take up in education and training
To communicate key items such as timings
To help underpin an orderly transition
Fire details
Introduction around the table

18. Key Communication Challenge
To cut through the many other pressing issues surgeries face:
Limited time
Little perceived need for too much detail at this stage
This creates the need for:
Focus and clear, single-minded communications
Sensitivity to customer priorities
Phased communications, building over time
Fire details
Introduction around the table

19. Microtest Key Communication Channels
Evolution bulletins
Web-Ex
Social media
Topic Lead Local User Groups in Bodmin and Plymouth
Blog
Summarisation Training packages
Fast Visits
Optimisation Visits
Fire details
Introduction around the table

20. Specialist support within Microtest
Anita Truss – Clinical Systems Trainer & Lead SNOMED CT Trainer
Specialist Training and Customer Care Team
Fully trained Service Desk
Fire details
Introduction around the table