clinical data standards: the building blocks for sharing data dr lorna ramsay lee davies jamie gray/...

Clinical Data Standards: The Building Blocks for Sharing Data

Dr Lorna Ramsay

Lee Davies

Jamie Gray/ Phil Dalgleish

National Clinical Dataset Development Programme

• 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

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

• 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

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

Development process

Health & Social Care Data Dictionary

www.datadictionary.scot.nhs.uk

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

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

What’s happening with

SNOMED Clinical Terms?

•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

•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

Clinical Data Standards, the building blocks for sharing data

Implementation – where’s it at?

National Clinical Dataset Development Programme

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

Accurate and Robust Implementation

Consistent use of Standards

Interoperability

(SEHD Health Department Letter (2005) 46).

National Clinical Dataset Development Programme

Implementation activity

• Nationally procured systems

• Ongoing national procurements

• New nationally developed systems

• Existing national systems

• Others – local, regional and national

Nationally procured systems:

• EDIS (Emergency Department Information

System)

• NaSH (National Sexual Health system)

Implementation activity

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

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

Existing national systems:

• CHI Database (master patient index)

• SCI Store (national repository)

• SCI Gateway (referrals, discharges, lab results, etc)

Implementation activity

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

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

www.datadictionary.scot.nhs.uk

Implementation resources

National Clinical Dataset Development Programme

Implementation – where’s it at?

Lee DaviesProgramme Development Manager, NCDDP

Clinical Data Standards Modelling: Compound Clinical Concepts

National Clinical Dataset Development Programme

Data DictionaryClinical InformationStandards

Continuous Review

National Clinical Dataset Development Programme

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

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

Clinical Information Standards

Structure of Information Standards

Development Model

Extensibility and Future Proofing

National Clinical Dataset Development Programme

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

Benefits

Extended value sets refined for reuse Groups of related standards (inclusive not

exclusive and are optional) Enhanced quality

National Clinical Dataset Development Programme

Specific Constraint Layer

Archetype

Clinical Knowledge Layer

(Compound Clinical Concepts)

Terminology Layer

(SNOMED CT)

Technical Layer

(XML, HL7, 13606)

National Clinical Dataset Development Programme

National Clinical Dataset Development Programme

Connecting for Health

NEHTA

OpenEHR

National Clinical Dataset Development Programme

Next Steps Approach developed Specific Development – Focus on

Adverse Reactions

National Clinical Dataset Development Programme

Contact UsTeam e-mail:

NCDDPsupportteam@isd.csa.scot.nhs.uk

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

Thank You

National Clinical Dataset Development Programme