Showcase how opensource Bahmni EMR integrates with SNOMED FHIR Terminology server, to leverage advantages of the SNOMED classification system, in areas of recording clinical data, reporting, CDSS, analysis, etc.
May 15, 2023 (Phase 1)
Integration with Snowstorm (opensource SNOMED Terminology server) for diagnosis search, form data entry, etc.
Showcase benefits of SNOMED hierarchical classification system in areas of: Reporting, CDSS, Analysis, etc.
This feature will allow customers to start using SNOMED terminology in their health facilities for recording diagnosis/clinical data, and also perform reporting & CDSS use-cases using this recorded data. The full implementation is opensource and SNOMED international is very happy to help support implementations/geographies that wish to adopt SNOMED.
Please contact @Angshuman Sarkar@Vijay Anand Shanmughadass@Gurpreet Luthra@Ketan Goenka@Kai Kewley (SNOMED Team) who can help you understand this integration better if you are interested in exploring SNOMED. Or come to our Slack channel to ask questions directly with the SNOMED team.
As part of Phase2 of this work (May-Dec 2023), the team is focusing on enhancing CDSS use-cases for Drug-Drug interactions, Allergies, Export of Bulk Patient Data as FHIR, Integration with SNOMED Analytics tool, WHO ICD-10 reports, Integration with micro FHIR Terminology server for on-pref/offline hospitals. We look forward for community inputs and contributions.
Create an open-source reference implementation that displays best practices regarding how EMRs can leverage and benefit from SNOMED CT coding system
SNOMED CT International is interested in incorporating SNOMED-CT codes with Bahmni to create an open-source reference implementation that displays best practices regarding how EMRs can leverage and benefit from SNOMED CT Coding systems. This is especially helpful when governments/countries adopt SNOMED CT, and need to better understand how to enhance and evolve their existing digital systems to realise the benefits of SNOMED CT.
Project Scope (1st Phase)
Record patient diagnosis in Bahmni using SNOMED CT with real time Terminology Search - DIAGNOSIS
Reports in Bahmni displaying the power of SNOMED CT- DIAGNOSIS REPORTS
CDSS alert in Bahmni based on recorded SNOMED diagnosis and drug interaction - CDSS
Support for recording chief complaints H&E forms using SNOMED CT & Support for designing Bahmni - FORM BUILDER
Phase 2 Scope
Generate ICD-10 reports based on SNOMED code mappings - ICD-10 Reporting
Export anonymised, FHIR based, patient data for SNOMED analytics tool - Bulk Export for Analytics Tool
CDSS alert in Bahmni based on drug-drug interaction (possibly with DrugBank) - CDSS
Implementation of micro FHIR terminology server for low resource settings (include Contract Tests) - Micro FHIR
Ability to setup and order procedures using SNOMED CT- PROCEDURES
Sync Procedures with SNOMED TS
Current Landscape of Bahmni-SNOMED Integration
Environments for Dev, QA & Demo
(Go to CLINICAL section. Default creds: superman/Admin123)
Users can try out the demo version of the Bahmni-SNOMED integration and provide the feedback here
Please note that the data will not be shared with any 3rd party. This data will only be used to contact you regarding clarifications on the feedback
Record patient diagnosis in Bahmni using SNOMED CT with real time Terminology Search
Clinicians can search for SNOMED terms for diagnosis or conditions
Upon providing keywords, Bahmni performs real time search in SNOMED CT and displays search results
Clinicians can also provide the SNOMED Code to search for a diagnosis in Bahmni
An advantage of SNOMED is that while searching for diagnosis, the descendants of the searched term are also displayed in search result, leveraging the hierarchical structure of SNOMED clinical terms
Once a term is selected from SNOMED TS, it is mapped and saved into Bahmni Concept Dictionary, and available for use in reports, CDSS, etc.
Reports in Bahmni displaying the power of SNOMED CT
Clinicians can generate diagnosis count reports based on SNOMED terms
Report feature can be accessed under the report module in Bahmni
Clinicians need to select the duration for the report and mode of display
Bahmni displays the patient count report based on gender
Advantage of using SNOMED CT TS
Bahmni leverages the hierarchical structure of Clinical Terms in SNOMED to also identify and report the descendants/children of the selected diagnosis for reporting
CDSS alert in Bahmni based on recorded SNOMED diagnosis and drug interaction
In this feature, the clinicians are notified with an alert when Drug-Diagnosis interaction is contraindicated
The hierarchical classification in SNOMED CT helps to identify all the descendants of a diagnosis and applies the CDSS rules to those as well. Meaning, if a drug is contraindicated to a diagnosis, then the drug will be contraindicated to all its descendants as well
Clinicians can accept the alert and make changes to medication or
Clinicians can choose to dismiss the alert by providing reason for dismissal (only in case of critical alerts)
Features of the Alert Notification implemented in the project
Three different severity (Critical, Warning, Info)
A drug-diagnosis interaction can have multiple alerts
Consists of summary (mandatory) and details (Optional)
Includes link to the source of information (like Wiki, etc.)
Clinician can choose to override critical alerts by providing justification
Support for recording chief complaints H&E forms using SNOMED CT & Support for designing Bahmni
Users can customise set of questions in Bahmni according to their requirements to record patient’s responses
They can customise the questionnaire under the form builder module
SNOMED CT is leveraged to provide the list of responses to a given question
Once saved and published, the form is used by clinicians to record patient responses
Clinicians can also generate a report on the patients’ responses under reports module
Currently, the form names that can be used for creating forms and reporting the same are: "Test Form", "SNOMED H&E Form", "SNOMED Malaria Form", "SNOMED Asthma Form", "SNOMED COVID Form", "SNOMED Accident Intake Form"
Advantage of using SNOMED
Using SNOMED terms helps in standardising the responses from the patient, so that it can be easily exchanged with other EHR systems, hence improving patient healthcare
Ability to setup and order procedures using SNOMED CT
Users can order SNOMED CT procedures from Bahmni which are grouped by body-sites
There are some pre-requisites to upload the procedures in Bahmni
For the pre-requisite, please follow steps mentioned here
User can view the procedures under the orders tab
User can choose the body-site, for which corresponding SNOMED CT procedures is displayed
User can select one or multiple procedures and save it for the patient
Generate ICD-10 reports based on SNOMED code mappings Phase 2
International Classification of Diseases (ICD) is a coding system developed by WHO.
The WHO requires its member countries to report health indicators and statistics to support its global health monitoring and surveillance activities.
Ensures accuracy and comparability of health data, which is essential for global health policy and decision-making.
Map from SNOMED to ICD-10 exists, hence, generating the ICD-10 report is of great value for both healthcare organisations, and the WHO.