A Methodology for Encoding Problem Lists with SNOMED CT in General Practice

This paper describes a methodology for encoding problem lists used in general practice with SNOMED CT. Our intent is to help general practitioners to incorporate SNOMED CT into their existing Electronic Medical Record (EMR) systems with minimal disruption as a first step, thus allowing them to assess its impact prior to full-scale conversion. We started with 1,713 original unique terms that made up the problem lists from the general practice EMR used in the study. We ended with 1,468 unique concepts after two cycles of matching and revisions that led to 1,347 or ~92% successful matches. The remaining terms were revised to tease out modifiers or secondary concepts that could be used to provide equivalency through post-coordination. While skeptics of reference terminology systems often balk at their unwieldy size and complexity for local adoption, this study has demonstrated that, using our methodology, it is possible to create a manageable subset of SNOMED concepts for problem lists used in general practice with immediate tangible value.