National Clinical Dataset Development Programme Clinical Data Standards

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 Snomed. Ct 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) • Na. SH (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 e. Care 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 e. SAY - 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: Post implementation Communication P P Step 4: Review and Communications Step 3: 3 Suppliers implement NCDDP Standards Support/ Guidance provided by NCDDP P P Step 2: 2 Step 1: 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 q Development and implementation of new clinically intuitive headings assisting structure and navigation through the data dictionary q Data Dictionary software changes e. g. Tagging

National Clinical Dataset Development Programme Benefits q q q 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 q Structure of Information Standards q Development Model q Extensibility and Future Proofing

National Clinical Dataset Development Programme Compound Clinical Concepts q Groupings of clinically relevant and/or related information based on existing approved data standards and focus on reuse q Concept of maximal information which can be constrained to support clinical specificity at a later stage - supports changes in Best Practice q Splits the clinical knowledge domain from: Technical Terminology Which are complimentary and interoperable at implementation

National Clinical Dataset Development Programme Benefits q q q 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 Technical Layer (SNOMED CT) (XML, HL 7, 13606)

National Clinical Dataset Development Programme

National Clinical Dataset Development Programme Connecting for Health NEHTA Open. EHR

National Clinical Dataset Development Programme Next Steps q q Approach developed Specific Development – Focus on Adverse Reactions

National Clinical Dataset Development Programme Contact Us Team e-mail: NCDDPsupportteam@isd. csa. scot. nhs. uk Website: www. clinicaldatasets. scot. nhs. uk e. Library: www. elib. scot. nhs. uk/Shared. Space/ncddp Data Dictionary: www. datadictionary. scot. nhs. uk

National Clinical Dataset Development Programme Thank You