From ad-hoc terminology to using SNOMED CT_AU and the National Clinical Terminology Server

The Challenge: Renewal software and terminology to support MALT initiative

The Royal Australasian College of Surgeons (RACS) pursued a visionary e-health, future-proofed data environment for their members and stakeholders who contribute data to their Morbidity Audit and Logbook Tool (MALT). MALT collects data in order to track the surgeon’s experience and performance during training, as well as overseas qualified surgeons under assessment for equivalency with a RACS Fellow and consultant surgeons (FRACS).

MALT users keep a personal case log and/or undertake clinical audit. The MALT software that pre-dated SNOMED, was owned, developed and controlled by RACS themselves, but was due for re-engineering. RACS have taken this opportunity to renew both the software and the terminology that support the MALT initiative.

The Response: A digital platform to help patients manage their rehab

AEHRC mapped the existing MALT terms to SNOMED and then expanded the terminology content to enrich the data that could be captured by MALT users. This included the development and maintenance of aggregation maps to support ongoing reporting processes from the MALT data. During 2017 RACS migrated to an NCTS-based deployment of Ontoserver using FHIR-based valueset and map artifacts.

The Results: Bridging the communication gaps between clinicians and patients

Both the RACS RefSet (a subset of SNOMED CT content) and the RACS grouping layer have been deployed in off-the-shelf analytics tools (QlikView).

Over the past two years RACS has done a fantastic job of deploying SNOMED CT across desktop, iphone and tablet platforms. Users have quickly embraced the new RefSet content and have continued to request expansion of the content coverage from SNOMED CT.

RACS analysts and the RACS surgical specialty training boards continue to make regular use of the output data to support their business needs. Little change has been evident in the aggregation layer, and this provides data stability over time, allowing trend data analyses to proceed and to accurately report the length and breadth of the surgeons experiences (as their training periods cover three years or more).

Their experiences from design, development and deployment has allowed them to become almost entirely self-sufficient users of SNOMED CT.

Notably, RACS have also acted in the best interests of their clients and the surgeon community more generally, by releasing the RACS Surgical RefSet (via ADHA) for broad use within the Australian community.