Transcript National Clinical Dataset Development Programme Clinical Data Standards: The Building Blocks for Sharing Data Dr Lorna Ramsay Lee Davies Jamie Gray/ Phil Dalgleish National Clinical Dataset Development Programme •

National Clinical Dataset
Development Programme
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?
NCDDP Vision
The NCDDP will support clinicians
to develop interoperable national
clinical data standards to facilitate
the implementation of integrated
care records across NHS Scotland.
NCDDP Aims
•
Fit for clinical purpose
Making sure the clinical content of IT systems is
fit for clinical purpose: Care, Share, Compare
•
Clinically led
Standards developed & agreed by clinicians
•
Interoperable
Data recorded by different clinicians in different
care settings using different systems can be
brought together in an integrated patient record.
Purpose of national
clinical data standards
Care: Support direct patient care,
informed by best practice guidance
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
National Clinical Dataset
Development Programme
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 level
0
Unverified
1
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.
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?
SNOMED CT – NHS
Scotland
•SCT tools procured from Health Language Incorporated (HLi)
available free to NHS Scotland organisations
• Lexplore SnomedCt Browser
• www.isdscotland.org/isd/4048.html
NHS Scotland
Terminology Service
•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
National Clinical Dataset
Development Programme
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).
Implementation activity
• Nationally procured systems
• Ongoing national procurements
• New nationally developed systems
• Existing national systems
• Others – local, regional and national
Implementation activity
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)
National Clinical Dataset
Development Programme
P
P
Step 6:
Step 5:
Suppliers implement NCDDP Standards
Step 3:
Support/ Guidance provided by NCDDP
P
P
Step 2:
Step 1:
Post implementation Communication
P
P
Step 4:
Review and
Communications
Maintain & Improve compliance
Stakeholder provides proposed dataset
Early engagement with all stakeholders
www.datadictionary.scot.nhs.uk
Implementation
resources
National Clinical Dataset
Development Programme
Implementation –
where’s it at?
National Clinical Dataset
Development Programme
Clinical Data Standards Modelling:
Compound Clinical Concepts
Lee Davies
Programme Development Manager, NCDDP
National Clinical Dataset
Development Programme
Continuous Review
Clinical Information
Standards
Data Dictionary
National Clinical Dataset
Development Programme
Data Dictionary

Development and implementation of new clinically
intuitive headings assisting structure and
navigation through the data dictionary

Data Dictionary software changes e.g. Tagging
National Clinical Dataset
Development Programme
Benefits



Direct access to required standards through
the dictionary
Presents less opportunity to overlook standards
Reduces the risk of duplication
National Clinical Dataset
Development Programme
Clinical Information Standards

Structure of Information Standards

Development Model

Extensibility and Future Proofing
National Clinical Dataset
Development Programme
Compound Clinical Concepts

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

Splits the clinical knowledge domain from:
Technical
Terminology
Which are complimentary and interoperable at implementation
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
Terminology Layer
Technical Layer
(Compound Clinical
Concepts)
(SNOMED CT)
(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 Us
Team e-mail: [email protected]
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