SNOMED CT NZ Edition

The Ministry of Health works with health and disability agencies and their industry partners to publish SNOMED CT reference sets, mapping tables and other standard content for digital health solutions in New Zealand.

The SNOMED CT NZ Extension packages these local components for release every April and October, to be used with the latest SNOMED CT International Edition release. Together, the International Edition and the NZ Extension are called the SNOMED CT NZ Edition.

Use these materials for free in New Zealand and forty SNOMED International member countries. Register with us to download the current releases from the SNOMED member licensing and distribution service.

You can browse all New Zealand and overseas content using the SNOMED CT browser

Thank you to everyone contributing to this digital product.

April 2020 release

The April 2020 release of the SNOMED NZ Extension is the current release and should be used with the March 2020 international release, which includes the required new COVID-19 concepts and terms.

The new release updates the previous release in June 2019 with many new concepts and terms that fulfil content requests and support new standards, including HISO 10050.2:2020 Maternity Care Summary Standard and HISO 10071:2020 Cardiovascular Disease Risk Assessment Data Standard.

See the April 2020 release note for details.

Content

The SNOMED NZ Edition is a comprehensive source of concepts and terms for recording health information. The New Zealand National Release Centre creates SNOMED concepts, terms and refsets for individual health specialties and service types when this is useful for end users and implementers.

All local content is governed by a recognised national clinical network.

Refsets

SNOMED CT refsets are created whenever it is useful to narrow the selection of concepts for some purpose. For many purposes, refsets are not required and SNOMED CT hierarchies can be used to guide the user and enforce business rules.

The release includes following refsets and these can also be viewed online at the links.

Emergency care refsets

 

Three refsets provide emergency department clinicians with a standard set of concepts for chief presenting complaint, diagnosis and procedures.

We acknowledge the work by emergency medicine specialists at Nelson-Marlborough DHB to develop the refsets for chief presenting complaint and diagnosis. The emergency care procedure refset was also developed by NZ emergency medicine specialists. And we thank the Australian Digital Health Agency and NHS Digital for some of the original material.

The first DHBs are now submitting SNOMED-coded ED visit data to the National Non-Admitted Patient Collection (NNPAC).

A national ED clinical information reference group has been established and is meeting every six months to oversee the content of these refsets and their use.

National Patient Flow refsets

 

The seven refsets released so far include the most common presenting reason and diagnosis concepts used in cardiology, gynaecology, rheumatology, endocrinology, general surgery, general paediatric and child development outpatient services.

The refsets are defined at a suitable level of detail for outpatient services and may be extended in future for other purposes. These refsets use the standard terms of the SNOMED CT International Edition for the moment. New Zealand preferences for new or different terms per concept will be introduced in a later release.

The Ministry of Health is working with recognised sector groups to develop and maintain these refsets.

Gateway child health assessment refset

This refset includes needs and recommendations concepts used in Gateway child health assessments. There are plans to extend the refset to other parts of the assessment.

The Ministry of Health is working with Oranga Tamariki to develop this content.

Notifiable disease refset

The notifiable disease refset identifies all notifiable diseases in New Zealand. The refset may be extended for reporting disease subtypes.

The Ministry of Health works with ESR to manage this refset.

Disability refset

The disability refset identifies the types of disability that may be recorded about a person and their needs.

The Ministry of Health manages this refset.

Adverse reaction manifestation refset

The adverse reaction manifestation refset represents the most commonly encountered manifestations of allergic reactions and other adverse reactions at a level of detail for adverse reaction reporting and personal health records.

The refset is developed and maintained by the HISO adverse reaction reporting standard working group.

We acknowledge the Australian Digital Health Agency for some of the original material.

Further refsets supporting adverse reaction reporting are in development.

Microorganism refset

The microorganism refset is the agreed standard for microbiology and infection control and includes all microorganisms in the SNOMED International Edition.

HISO, the NZ Microbiology Network and the National Pathology and Laboratory Round Table are co-stewards of the refset and its adoption.

Ambulance clinical impression refset

The ambulance clinical impression refset includes the concepts paramedics use to represent clinical impressions in the national ePRF system.

This refset is maintained by the ambulance sector.

Health service type, occupation, clinical specialty and site of care refsets

The health service type, occupation, clinical specialty and site of care refsets have been created for consistency in recording health workforce and service delivery information, including clinical document metadata.

These refsets enumerate health service types (eg clinical pharmacology service, endoscopy service), professional occupations (eg obstetrician, clinical pharmacist, dietitian, audiologist), clinical specialties (eg obstetrics and gynaecology, dietetics and nutrition, general practice) and sites of care (eg general practice premises, nursing home, hospital department).

HealthShare has led the development of these refsets, in collaboration with DHBs, for the Midland clinical portal project.

Surgical complications

 

The surgical complications refset includes clinical findings and disorders related to general surgery.

Thanks to Canterbury DHB and their industry partners for the content and their commitment to this work.

A clinical governance group meets regularly to further develop this refset and others for surgical information.

Smoking refset

The smoking refset of concepts relating to smoking status and cessation is under review and will be updated in a future release. Vaping concepts will be added and the set of smoking concepts rationalised.

The Ministry of Health maintains this refset.

Laboratory order refsets

To support laboratory test ordering, the pathology test request refset developed by the Royal College of Pathologists of Australasia (RCPA) is included in this release.

Maps

The release includes the following maps between SNOMED CT and other terminologies and code systems.

READ v2 to SNOMED CT map

This unidirectional map from READ v2 to SNOMED CT is provided to aid migration to SNOMED CT in primary care.

We acknowledge NHS Digital for the source material, made available to us under an Open Government Licence. We have sourced content from NHS Digital data migration releases dated October 2016, August 2017 and October 2017. There have been some updates since in response to local requests.

NZMT medicinal product to SNOMED CT map

This map associates NZ Medicines Terminology medicinal product concepts to SNOMED CT concepts. There one-to-one mappings from NZMT concepts to equivalent SNOMED CT concepts where they exist, and many-to-one mappings from NZMT concepts to somewhat less specific SNOMED CT concepts otherwise.

This map is an RF2 version of the equivalent map maintained and documented in NZ Universal List of Medicines releases.

The version of the map included here comes from the NZULM February 2020 release.

ACC SNOMED CT to READ v2 translation table

This unidirectional map from SNOMED CT to READ v2 is used and maintained by ACC to help process SNOMED-coded personal injury claims. The table includes some content from the NHS Digital primary care refset equivalence tables.

MSD SNOMED CT to READ v2 translation table

This unidirectional map from SNOMED CT to READ v2 is used by the Ministry of Social Development to help process SNOMED-coded work capacity medical certificates. The table includes content from the NHS Digital primary care refset equivalence tables and the ACC translation table.

Language refsets

Language refsets are created to define the preferred terms and synonyms associated with each concept in some context. This release includes the following language refsets.

NZ English language refset

This language refset has preferred terms, synonyms and correct spellings for all concepts in the SNOMED CT NZ Edition. It is derived from the GB English language refset included with the SNOMED International Edition, and covers the terms included in the SNOMED NZ Extension.

NZ English patient friendly terms language refset

This language refset has patient and consumer friendly terms covering the most common health conditions and interventions. Some of the terms are chosen from the SNOMED International Edition while others have been added to the NZ Extension for this purpose. The refset is intended for use in consumer-facing applications, including patient portals and personal health apps.

Think Hauora has led the development of this content, working with the Ministry of Health.

Te Reo Māori patient and consumer friendly terms language refset

Work is underway with Think Hauora and Te Tihi on an equivalent te reo Māori patient and consumer friendly terms language refset.

Work in progress

The following refsets are in development:

  • Cardiothoracic surgery
  • Mapping of Fast Cancer Treatment CANDC codes
  • Ophthalmology
  • Orthopaedic surgery
  • Radiology
  • Renal

Future development

The following reference sets are planned for future development:

  • Dermatology
  • ENT
  • Gastroenterology
  • General medicine (excluding endocrine and diabetes)
  • Neurology
  • Neurosurgery
  • Oncology
  • Plastics
  • Respiratory
  • Urology
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