Electronic Exchange of Clinical Laboratory Information: Issues and Opportunities. SYSTEMATIZED NOMENCLATURE OF MEDICINE (SNOMED)


SNOMED is a structured collection of clinical terms used in health and healthcare; from a lab perspective, it is used to code test results. It has been around since the late 1970s and has support from a number of the major standards initiatives including HL7, Digital Imaging and Communications in Medicine (DICOM), the Accredited Standards Committee (ACS) X12, and International Organization for Standardization (ISO). SNOMED has also been mapped to ICD 9 and there are efforts underway to map it to ICD10.

In 2003, HHS recommended that SNOMED Clinical Terms (CT) be part of a core set of patient medical information. The government also purchased a perpetual license for SNOMED to make it available to U.S. users at no cost through the National Library of Medicine (NLM).

The major issues encountered with SNOMED relate to its large scale: today, SNOMED consists of approximately 875,000 concepts and two million terms. Consequently, its ongoing development, use, and maintenance are very significant. In addition, SNOMED CT covers many precise areas of laboratory results, but other specialty areas may not be covered in sufficient depth, if at all.

Although SNOMED has been used since the 1970s, the current utilization of SNOMED remains low. Results from a survey conducted by the American Health Information Management Association (AHIMA) assessing uptake of SNOMED CT found that 60 percent of EHR vendors have or plan to obtain a SNOMED CT license and less than 20 percent of vendors indicate that SNOMED CT is currently operational in their applications.37

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