clinical data standards: the building blocks for sharing data dr lorna ramsay lee davies jamie gray/...
TRANSCRIPT
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Clinical Data Standards: The Building Blocks for Sharing Data
Dr Lorna Ramsay
Lee Davies
Jamie Gray/ Phil Dalgleish
National Clinical Dataset Development Programme
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• Progress in clinical data standards development
• Implementation – where’s it at?
• The next big thing – clinical data standards
modelling
• What’s happening with SNOMED CT?
National Clinical Dataset Development Programme
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The NCDDP will support clinicians
to develop interoperable national
clinical data standards to facilitate
the implementation of integrated
care records across NHS Scotland.
NCDDP Vision
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• Fit for clinical purposeMaking sure the clinical content of IT systems is fit for clinical purpose: Care, Share, Compare
• Clinically ledStandards developed & agreed by clinicians
• InteroperableData recorded by different clinicians in different care settings using different systems can be brought together in an integrated patient record.
NCDDP Aims
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Care: Support direct patient care, informed by best practice guidance
Purpose of national clinical data standards
Share: Facilitate effective communication between health care professionals
Compare: Support secondary uses including audit & clinical governance
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Development process
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Health & Social Care Data Dictionary
www.datadictionary.scot.nhs.uk
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HEIGHT
Definition: Height in metres - measured without shoes
Format: n.nn metres (to the nearest centimetre)
Codes and values: N/A
Sub data items:Verification level0 Unverified1 Verified
Further information:
If height cannot be measured, record recently documented or self-reported height (if reliable and realistic) as ‘unverified’.
In certain groups or diseases, measurement of height may not be straightforward, e.g. infants, wheel chair/ bed bound, scoliosis, kyphosis. Guidance for such specific circumstances will be included in specialist data standards as appropriate.
National Clinical Dataset Development Programme
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Achievements so far
• >300 clinicians actively participated
• >2500 unique items published
• 60 approved sets of data standards
• 5 sets completed consultation
• 7 sets in development
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What’s happening with
SNOMED Clinical Terms?
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•SCT tools procured from Health Language Incorporated (HLi) available free to NHS Scotland organisations
• Lexplore SnomedCt Browser
• www.isdscotland.org/isd/4048.html
SNOMED CT – NHS Scotland
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•Working with NCDDP to develop approach to ‘snomedisation’ of national clinical data standards as a key route to SCT implementation
•ISD Terminology Services
•www.isdscotland.org/isd/4426.html
NHS Scotland Terminology Service
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Clinical Data Standards, the building blocks for sharing data
Implementation – where’s it at?
National Clinical Dataset Development Programme
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June 2006 – July 2007 team of 3 put together
Produced Guidance Documents
Defined, Designed and enhanced Support Processes
Early engagement with systems developers
National Clinical Dataset Development Programme
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Accurate and Robust Implementation
Consistent use of Standards
Interoperability
(SEHD Health Department Letter (2005) 46).
National Clinical Dataset Development Programme
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Implementation activity
• Nationally procured systems
• Ongoing national procurements
• New nationally developed systems
• Existing national systems
• Others – local, regional and national
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Nationally procured systems:
• EDIS (Emergency Department Information
System)
• NaSH (National Sexual Health system)
Implementation activity
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Ongoing national procurements:
• IPACC (Integrated Primary and Community Care system)– Mental Health (CAHMS, adult/child)
– Nursing Care, Palliative Care)
– AHP
– Child Health
– Generic
– Long Term Condition
– eCare
– Single Shared Assessment
• PMS (Patient Management System)
Implementation activity
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New nationally developed systems:
SCI-DC (SCI Diabetes Clinical)
• SCI-CHD (SCI Coronary Heart Disease)
• GCS (Generic Clinical System)
– Cancers (breast, gynaecological, head &
neck, etc)
– Community Nursing Clinical System
Implementation activity
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Existing national systems:
• CHI Database (master patient index)
• SCI Store (national repository)
• SCI Gateway (referrals, discharges, lab results, etc)
Implementation activity
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Others – local, regional and national:
COPD - Lanarkshire Orthopaedic Surgery & Elective Admission System – Lothian
eSAY - Lanarkshire Paediatric Epilepsy Network – NISG
Face (Mental Health System) – Ayrshire & Arran
Rheumatology - Glasgow
Hope Rehab System – Scottish Centre for Healthy Working Lives
Safer Today Safer Tomorrow - QIS
Marie Curie Cancer Care (EPR) - Tayside
SCCRS
MS Society Scotland SFHS- Scottish Family History Study
NCCIAS (Colposcopy)
Implementation activity
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Step 3Step 3: Support/ Guidance provided by NCDDP
Step 1Step 1: : Early engagement with all stakeholders
Step 2Step 2: Stakeholder provides proposed dataset
Step 4:Step 4: Suppliers implement NCDDP Standards
Step 5:Step 5: Post implementation Communication
Step 6:Step 6: Maintain & Improve compliance
Review and Communications
National Clinical Dataset Development Programme
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www.datadictionary.scot.nhs.uk
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Implementation resources
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National Clinical Dataset Development Programme
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Implementation – where’s it at?
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Lee DaviesProgramme Development Manager, NCDDP
Clinical Data Standards Modelling: Compound Clinical Concepts
National Clinical Dataset Development Programme
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Data DictionaryClinical InformationStandards
Continuous Review
National Clinical Dataset Development Programme
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Development and implementation of new clinically intuitive headings assisting structure and navigation through the data dictionary Data Dictionary software changes e.g. Tagging
Data Dictionary
National Clinical Dataset Development Programme
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Direct access to required standards through the dictionary
Presents less opportunity to overlook standards Reduces the risk of duplication
Benefits
National Clinical Dataset Development Programme
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Clinical Information Standards
Structure of Information Standards
Development Model
Extensibility and Future Proofing
National Clinical Dataset Development Programme
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Splits the clinical knowledge domain from:Technical Terminology
Which are complimentary and interoperable at implementation
Groupings of clinically relevant and/or related information based on existing approved data standards and focus on reuse
Concept of maximal information which can be constrained to support clinical specificity at a later stage - supports changes in Best Practice
Compound Clinical Concepts
National Clinical Dataset Development Programme
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Benefits
Extended value sets refined for reuse Groups of related standards (inclusive not
exclusive and are optional) Enhanced quality
National Clinical Dataset Development Programme
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Specific Constraint Layer
Archetype
Clinical Knowledge Layer
(Compound Clinical Concepts)
Terminology Layer
(SNOMED CT)
Technical Layer
(XML, HL7, 13606)
National Clinical Dataset Development Programme
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National Clinical Dataset Development Programme
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Connecting for Health
NEHTA
OpenEHR
National Clinical Dataset Development Programme
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Next Steps Approach developed Specific Development – Focus on
Adverse Reactions
National Clinical Dataset Development Programme
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Contact UsTeam e-mail:
Website: www.clinicaldatasets.scot.nhs.uk
eLibrary: www.elib.scot.nhs.uk/SharedSpace/ncddp
Data Dictionary: www.datadictionary.scot.nhs.uk
National Clinical Dataset Development Programme
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Thank You
National Clinical Dataset Development Programme