SNOMED Questionnaire

QUESTIONNAIRE FOR TRUSTS TO UNDERSTAND THE CURRENT BURDEN OF USING SNOMED CT ACROSS ENGLAND

NHS England has commissioned a study to identify the current burden of using and maintaining the SNOMED CT terminology and its related value sets across secondary care settings in England. To complete this work, there is a requirement to engage with as many of the current users as possible to understand different experiences of using and maintaining SNOMED CT and value sets within Trusts across England.

Please complete this questionnaire based on your individual experience of SNOMED CT to help us understand how the system is currently working within your organisation. Questions such as Trust name and job role / title have been required so that we can assess the size of the organisation to give context to the responses received and build a picture of the potential costs associated with the maintenance of SNOMED CT.

We are particularly interested in establishing the resource implications in terms of staffing and costs of maintaining SNOMED CT in individual organisations and any rough estimates of staff time and costs would be very much welcomed to support our analysis.

Should you wish to discuss your experiences further, the team can be contacted via email necsu.projectsupportoffice@nhs.net

Initial Questions

1. Please detail the organisation for which you are responding on behalf of:(Required)

2. How many clinical specialties does your trust provide?

<10

11-20

21-30

31-40

41-50

>50

3. Which EPR system does your organisation use?

Allscripts Healthcare (IT) UK Ltd.

Cerner Ltd.

Dedalus (formerly DXC)

MEDITECH UK

EPIC

TPP SystmOne

EMISWeb

IMS MAXIMS

Nervecentre

Other

4. Does your organisation use SNOMED CT Codes, lists or subsets?

Yes

4a. Roughly how many departments / specialties within your Trust currently use SNOMED CT?

5. Which type of role to you hold?

Clinician / CIO

Clinical Coder

IT Specialist / Developer / EPR System Specialist

No to SNOMED

NoQ1. Is there an ambition or plans in place for your organisation to move to SNOMED CT coding?

Yes

NoQ1a. As you answered Yes to the previous question, please specify timeframe and plans if known

NoQ2. Are there any barriers preventing your organisation from using SNOMED CT?

Yes

NoQ2a. As you answered Yes to the previous question, please outline the barriers as you understand them

Clinician

ClinQ1. What is your current role / Job title?

ClinQ2. To what extend does your organisation use SNOMED CT lists and subsets?

In full use across the organisation, including the integration of subsets and forms

Currently being implemented across the organisation

Variable use across the organisation – it is not mandated but some departments and specialties are using SNOMED CT list and subset

Not used at all

ClinQ3. Within your clinical role do you regularly code or input patient level data using SNOMED CT codes?

Yes

ClinQ4. Is SNOMED CT the main coding mechanism utilised within your organisation?

Yes

ClinQ5. For what purposes is SNOMED CT used within your organisation?

ClinQ6. Does your EPR System or organisation provide you with a limited subset of SNOMED CT codes for your department/speciality to assist with data entry?

Yes

ClinQ7. Do you generally use the defined subset(s) or do you find you need to search/browse for the codes you require?

Defined subsets are sufficient

Defined subsets are insufficient and often, there is a requirement to search for the relevant code(s)

ClinQ7a. As a clinician using SNOMED CT, how often do you meet with or contact the IT/technical team with routine queries or when SNOMED CT updates need to be incorporated or cause issues?

ClinQ8. Are you involved with the maintenance of the specialty subsets for your speciality /Clinical Service?

Yes

ClinQ9. How often are you required to contribute towards the maintenance and updating of SNOMED CT lists and subsets to ensure that codes are current and appropriate in your specialty/clinical service?

ClinQ9b. How often are you requested to create SNOMED CT subsets or incorporate SNOMED CT into forms/Clinical decision support tools? (Internal departmental/specialist requests)

ClinQ10. Over the course of a year, could you give an estimate of the number of days which you would need to dedicate to the maintenance and updating of the SNOMED CT lists and subsets?

ClinQ11. Do you know who in your organisation is involved with the maintenance of SNOMED CT lists and subsets? (Number of staff, roles or job titles if known. Otherwise please share details of the process as you understand it)

ClinQ12. As a clinician what do you see as the main burden of managing and maintaining SNOMED CT lists and subsets?

ClinQ13. Is the creation of subsets an area which your EPR System/Organisation intends to pursue?

Yes

NoQ2. Are there any barriers preventing your organisation from using SNOMED CT?

Yes

NoQ2a. As you answered Yes to the previous question, please outline the barriers as you understand them

Clinical Coding Staff

CoderQ1. What is your current role / Job title?

CoderQ2. Does your organisation use departmental/specialty SNOMED CT lists or subsets to assist with consistent data entry?

Yes

Don’t Know

CoderQ2a. Does the use of departmental / specialty SNOMED CT lists and subsets cause additional complications when coding? If so please specify

CoderQ3. Where records are primarily coded in SNOMED CT using lists or subsets, does your organisation have a local mapping tool to assist with matching those SNOMED CT codes to ICD-10 and OPCS Coding?

Yes

Don’t Know

CoderQ4. Do you know how often the departmental / specialty SNOMED CT lists and subsets are maintained/updated?

Weekly

Monthly

Quarterly

Half Yearly

Annually

I don’t know

Other

CoderQ5. Are you involved with the maintenance of these SNOMED CT lists and subsets?

Yes

CoderQ6. Over the course of a year, could you give an estimate of the number of days which you would need to dedicate to the maintenance and updating of the SNOMED CT lists and subsets?

CoderQ7. Do you know who in your organisation is involved with the maintenance of SNOMED CT lists and subsets? (Number of staff, roles or job titles if known. Otherwise please share details of the process as you understand it)

CoderQ8. As a clinical coder what do you see as the main burden of managing and maintaining SNOMED CT lists and subsets?

Technical Staff

TechQ1. What is your current role / Job title?

TechQ2. What control do you have over your EPR system to update and maintain SNOMED CT Lists and subsets / how is it supported and managed?

Managed service provided by the clinical system provider – limited control

Managed service provided by the clinical system provider – Full control

In house management – Full control of the system and update/developments

Other

TechQ3. To what extend does your organisation use SNOMED CT lists and subsets?

In full use across the organisation, including the integration of subsets and forms

Currently being implemented across the organisation

Variable use across the organisation – it is not mandated but some departments and specialties are using SNOMED CT list and subset

Not used at all

TechQ4. Are you/Your team responsible for the support or maintenance and updating of SNOMED CT and associated subsets?

Yes

TechQ5. How many staff within your team are responsible for supporting or maintaining and updating SNOMED CT and what are their roles?

TechQ6. If maintaining SNOMED CT is not the main job focus of members of your team, please give an estimate of staffing resources dedicated to the support or maintenance and updates of SNOMED CT and associated subsets

TechQ7. How often is SNOMED CT updated/maintained?

Weekly

Monthly

Quarterly

Half Yearly

Annually

I don’t know

Other

TechQ8. How often do you receive requests from departments/clinical specialties regarding creation of SNOMED CT subsets or new codes being generated, changed, or removed?

Daily

Weekly

Monthly

Annually

TechQ8a. Please estimate how much of your/team time this requires based on frequency indicated

TechQ9. If possible, please could you describe, at a high level, the process of maintaining and updating changes required as a result of requests from clinicians or SNOMED CT updates.

Note: please contact the team if you’ve a detailed process map that you’re able to share

TechQ10. As part of updating the SNOMED CT lists, does your system provide you with an automated list of potential erroneous/removed codes which have been used within the system (in subsets, forms or clinical decision-making tools)?

Clinical system/provider automatically highlights any codes used that have been removed

There is a support tool/script that is run as part of the update to identify codes which may be erroneous

There is no automated tool identifying potential erroneous codes and local intervention is required

TechQ10a. Please share high level details of your experience of chosen option

TechQ11. As a result of updating SNOMED CT, please quantify the time taken to complete data quality checks to ensure removed codes do not cause issues with your subsets/forms/clinical decision support tools

Please provide an estimate of amount of staffing resource utilised and time input i.e., Job role, grade and number of hours per week/month/year required to undertake this work

TechQ12. It is recognised that clinical input is often required to update / maintain SNOMED CT lists and value sets. Is advice given by a dedicated clinician(s) across all specialties or is there a need to consult with clinicians from each individual specialty?

How often is this / these clinician(s) consulted on updates/maintenance?

TechQ13. How often are you requested to create or update SNOMED subsets or incorporate SNOMED into forms/Clinical decision support tools? (Internal departmental/specialist requests)?

TechQ14a. Please could you indicate an estimate of staffing resource(s) required to complete the creation of Value sets / Subsets

TechQ14b. Please could you indicate an estimate of staffing resource(s) required to complete the creation of Forms / Templates

TechQ14c. Please could you indicate an estimate of staffing resource(s) required to complete the creation of Clinical decision support tools

TechQ15. What do you see as the main burden of managing and maintaining SNOMED CT lists and subsets within your organisation?

TechQ16. If your team is not responsible for the maintenance of SNOMED CT does this responsibility lie with:

Another team within the organisation (please specify)?

The clinical system provider?

Another outsourced company who provides this service (please specify)?

Another internal department or service (please specify)?

TechQ16a. Please specify, as per previous question

TechQ15. (DUPLICATE) What do you see as the main burden of managing and maintaining SNOMED CT lists and subsets within your organisation?

Phone

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