The SNOMED-LOINC Collaboration: Advancing Interoperability

Episode 05: Show Notes

LOINC (which stands for Logical Observations, Identifiers, Names, and Codes) is an international standard for identifying health measurements, observations, and documents. Over the past few years, SNOMED International and Regenstrief Institute, which oversees LOINC, have been collaborating on an exciting interoperability solution that will be released in the coming weeks.

In this episode, Kelly Kuru, Chief Communications and Collaborations Officer at SNOMED International, is joined by Marjorie Rallins, Executive Director of Health Data Standards at LOINC, to discuss this collaboration. They delve into the importance of this joint effort in developing standards for digital health and interoperability. The conversation highlights the history and ongoing efforts to integrate SNOMED CT and LOINC. The episode also covers the technical aspects, challenges, and successes of this collaboration, emphasizing the mutual benefits for those involved and the positive impact it is likely to have on the global healthcare community. 

Key Points From This Episode:

• [01:29] An introduction to Marjorie Rallins and her role at LOINC.
• [03:44] The relationship between SNOMED and LOINC.
• [07:20] Working toward the shared goals of interoperable content. 
• [10:02] What we can expect from this interoperability solution. 
• [12:55] Examples of analytics use cases that will be enabled. 
• [15:02] Release dates and update schedule. 
• [17:51] The challenges and wins of this collaboration. 

Quotes:

“And I really look at our two organizations, our communities, as really one community or a Venn diagram that overlaps almost completely.” — Marjorie Rallins [0:09:08]

“We all gained from diversity of complementary skills and knowledge. We've talked about that in some of our joint discussions. And we've sort of experienced sustained and collective community interests.” — Marjorie Rallins [0:19:42]

“We got some value out of being able to transform the LOINC terminology into the concept model in a way that we hadn't anticipated and that actually saved resources.” — Marjorie Rallins [0:19:59]

Links Mentioned in Today’s Episode:

Marjorie Rallins

Regenstrief Institute

LOINC

The LOINC Ontology

Kelly Kuru

SNOMED International

SNOMED CT + the Bahmni Coalition: Open-source electronic medical record makes digital health tech available in low-resource settings globally

Episode 04: Show Notes

The mission of SNOMED International, the not-for-profit organization that owns, administers and develops SNOMED CT, the world’s most comprehensive clinical terminology, is to develop a global language for health -- uniting health systems from around the world and enabling them to communicate with and understand one another. As part of that goal, the organization also has a humanitarian mandate to develop tools and advance capabilities in digitally maturing countries with the goal of enabling more people around the globe to benefit from the use of SNOMED CT. To that end, in 2023 SNOMED International began a collaboration with the Bahmni Coalition, a group of organizations that have come together to steward the future of Bahmni, an open-source EMR specifically designed for use in low-resource healthcare settings. In 2024, SNOMED International official joined the Coalition.

In this episode, SNOMED International Chief Communications and Collaborations Officer Kelly Kuru is joined by Nick Egharos, SNOMED International's Global Vendor Engagement Lead and Customer Relations Executive for the Middle East and Africa; and Satish Viswanathan, Head of Social Change and Sustainability for ThoughtworksIndia & Middle East, and a member of the governing committee of the Bahmni Coalition. 

They discuss how SNOMED CT has been integrated into the Bahmni EMR, and what this means for the low-resource countries where it is being used. Through the Coalition, the ecosystem using Bahmni has grown, leading to its adoption in more than 50 countries around the world. Tune in to hear about the evolution of this partnership and the plans for it going forward. 

Key points from this episode:

• The formation of the Bahmni Coalition and what it aims to do.
• How SNOMED got involved with Bahmni and the objectives that brought them together.
• The alignment of this partnership with SNOMED International’s humanitarian mandate. 
• The phases of the project and what has already been achieved. 
• An introduction to the Bahmni EMR and how it was built with open source. 
• Insight into Bahmni’s use cases and global adoption. 
• SNOMED’s ongoing role in the Bahmni Coalition.
• What it means for Bahmni to have SNOMED in its coalition.
• The input and feedback that the coalition is seeking to shape the future of Bahmni. 
• Plans for the future of SNOMED and Bahmni’s continued work and areas of focus. 

Quotes:

“By providing SNOMED for free in an open source EMR product, I think we're really trying to show that we're committed to the broad distribution of SNOMED globally, and super keen to find ways to distribute it in ways that allow us to maintain our ability to support SNOMED and yet give that broad access.” — Nick Egharos [0:05:48]

“The credibility that having an organization like SNOMED as part of the Bahmni Coalition offers to countries and ministries of health worldwide can prove a real shot in the arm for adoption of open source technologies like Bahmni in digital healthcare settings worldwide.” — Satish Viswanathan [0:18:57]

“We've already benefited from collaborating with the SNOMED team to enhance our understanding of terminology, but we also hope that with SNOMED’s deep clinical and terminology expertise, we'll also be able to get more feedback about the product itself and help shape the future of the product as we go forward.” — Satish Viswanathan [0:19:24]

“In terms of additional enhancements, I think there's nothing but opportunity and there's a wide array of things we could do, but we want to make sure that as we move forward, we're building things that add value to the customers and to the Bahmni Coalition as a whole.” — Nick Egharos [0:22:51]

Links mentioned in today’s episode:

SNOMED International

The Bahmni Coalition

Satish Viswanathan

Kelly Kuru

Nick Egarhos

Bahmni + SNOMED CT

Bahmni roadmap consultation

Thoughtworks

Digital Public Goods Alliance

The International Patient Summary (or IPS) is an accessible standardized minimum health dataset for patients’ health information. In this episode, we delve into what it is, how it works, and the potential benefits it holds for patients, healthcare providers, and entire healthcare systems.

For this conversation, Kelly Kuru, Chief Communications and Collaborations Officer at SNOMED International, is joined by two health information standards, business, and IPS subject matter experts: Robert Hausam and Michael Nusbaum. Both are active contributors to the IPS and its related governance. They also both serve as representative members of the Joint Initiative Council for Global Health Informatics Standardization (JIC), an organization focused on furthering the important role that health information standards play in enabling interoperability. 

Rob and Mike shed light on the development of the IPS since its inception, the collaborative efforts behind the initiative, and the drivers shaping its development and use. You’ll learn about the type of information included in the IPS, real-world examples of how it can be used, the milestones attained to date, and the challenges to its widespread adoption. Tune in to gain valuable insights into this groundbreaking initiative and its potential to revolutionize healthcare information sharing globally.

Key Points from This Episode:

• An introduction to our guests, Rob Hausam and Mike Nusbaum, and their roles in the IPS.
• What the International Patient Summary (IPS) is and why it was created. 
• The required information and some of the other items that may be included in the IPS.
• Insight into the Joint Initiative Council for Global Health Informatics Standardization (JIC).
• Why the IPS has become a priority for healthcare.
• The role of the G7 and other entities that have highlighted the importance of the IPS.
• Specific examples of IPS use cases.
• The milestones that the IPS has already reached and the ones ahead.
• Challenges and obstacles to its widespread adoption.
• How to learn more about the IPS.

Quotes:

“TheInternational Patient Summary is a minimal and a non-exhaustive set of basic clinical data of a patient, especially agnostic and condition-independent, but it's intended to be readily usable by all clinicians for unscheduled cross-border patient care.” — @rhausam[0:04:45]

“What [the JIC has] resulted in now is a number of standards that are designed to work together, developed by different organizations but designed to be fully synchronized, which is really helpful to those who want to implement and use the IPS in their day-to-day activities.” — @mhnusbaum [0:07:25]

“… in June 2021, when the G7, at their meeting in the UK, they actually issued a statement that declared the importance of collaboration and the use of the International Patient Summary very specifically.” — @mhnusbaum[0:08:07]

“Everybody seems to be rallying around the IPS and the importance of the IPS because it’s one of the very first things that have ever been developed in the digital health world that is truly and uniquely international.” — @mhnusbaum[0:08:32]

Links Mentioned in Today’s Episode:

Robert Hausam

Michael Nusbaum

Kelly Kuru

SNOMED International

International Patient Summary

Joint Initiative Council for Global Health Informatics Standardization

G7 Health Ministers Declaration

Global Digital Health Partnership

HL7 International

Coded Conversations: The Entity Linking Challenge 

Episode 02: Show Notes

There are vast amounts of patient data captured in unstructured clinical data, making it challenging to analyze them and extract meaningful insights. However, by applying a standardized clinical terminology like SNOMED CT, healthcare organizations can convert this free-text data into a structured format that can be readily analyzed by computers, in turn stimulating the development of new medicines, treatment pathways and better patient outcomes. 

In this episode, SNOMED International Chief Digital Information Officer Rory Davidson is joined by Will Hardman, Artificial Intelligence (AI) specialist at UK-based AI consultancy Veratai, to discuss why SNOMED International has partnered with Veratai and PhysioNet, the research resource for complex physiologic signals that is managed by members of the MIT Laboratory for Computational Physiology, to launch the Entity Linking Challenge. 

You’ll learn what entity linking involves and why the challenge was launched, as well as a few of the challenges the partners faced in designing the competition. Will explains some of the difficulties faced by annotators in dealing with codes that are ambiguous and predicts some of the exciting outcomes that the challenge is expected to produce. He also shares his predictions for the future of entity linking beyond the competition. Tune in to find out more about the Entity Linking Challenge, how you can get involved, and what winners stand to gain – including a share of the $25,000 prize pool!

Key points from this episode:

• How the idea for the Entity Linking Challenge came about.
• The barriers to using available technology to extract valuable information from clinical data.
• What entity linking involves.
• Unexpected challenges participants may encounter in the building of entity linking models.
• The role of each of the partners in the competition.
• Three exciting outcomes from the Entity Linking Challenge that Will foresees.
• The challenge of finding a dataset and how the partners came to use MIMIC-IV.
• How annotators deal with ambiguous codes.
• How participants can access the MIMIC-IV dataset and details on the training required.
• Will’s predictions for the future of entity linking beyond the competition.
• How to find out more about the competition.

Quotes:

“And really, the reason to do this Entity Linking Challenge was to show some of the things we talk about in SNOMED CT, about how do we use new technologies that fall under the AI banner and umbrella to benefit healthcare, improve healthcare data, and get SNOMED into the vast ocean of unstructured healthcare data records that are out there.” — Rory Davidson  [0:01:48]

“The question is, ‘Can you actually use the computer to figure out where the mentions of specific well-defined clinical concepts are in this data and extract them automatically?’” — Will Hardman [0:03:18]

“There's an awful lot of knowledge about health conditions and human health that's locked up in these records that's currently not available for analysis. So that's at the root of this [Entity Linking] challenge.” — Will Hardman [0:03:41]

“I think the linking part is easier. I think it's the entity recognition part that's hard.” — Will Hardman [0:23:03]

“And right now we're focusing on how do we get that structure into the data? Because once we've got that structure, that's when you can apply some of these technologies in even cooler things about the analytics and the clinical pathways and how do you improve patient healthcare and patient outcomes and that’s where we get into the really exciting stuff.” — Rory Davidson [0:23:56]

Links mentioned in this episode:

Will Hardman

Veratai

PhysioNet: MIMIC-IV

DrivenData

Blog post about entity linking 101 (Mentioned at 17:01)

SNOMED CT Entity Linking Challenge - Benchmark

Rory Davidson

Rory Davidson on X

SNOMED International

Interoperability: Developments and Challenges in the Pursuit of the Holy Grail of Digital Health

Episode 01: Show Notes

Achieving interoperability in digital health presents significant challenges, but the rewards are immense. In the inaugural episode of SNOMED International’s podcast Coded Conversations, we delve into the intricacies of interoperability, unpacking developments in this field and the challenges faced. Joining us are two leading experts: hematologist Dr. Charles Gutteridge,  clinical advisor to SNOMED International, and Chief Clinical Information Officer at Barts Health NHS Trust in London; and Rory Davidson, SNOMED International’s Chief Information Officer. Kelly Kuru, Chief Communications Officer for SNOMED International, moderates this conversation.

Tuning in you'll gain insights into what interoperability means in healthcare, the challenges inherent in achieving it, the vital role of a clinical terminology like SNOMED CT in enabling it, and where we currently stand in terms of its development. You’ll also hear about its benefits for medical professionals and patients, the global significance of comprehensible and shareable healthcare data, and the value of being able to use reliable medical data for research purposes. Join us in exploring the latest advancements moving the healthcare world closer to making interoperability a reality.

Key Points From This Episode:

• An introduction to interoperability in healthcare.
• Challenges of achieving interoperability: the human factor.
• The technical side of interoperability and the importance of establishing standards.
• How the COVID-19 pandemic contributed to the realization of interoperability.
• The role of clinical terminologies like SNOMED CT in enabling interoperability.
• What we are doing well in terms of achieving meaningful interoperability.
• The decision support built into this system.
• Some of the benefits of structured systems like this for patients.
• The value of interoperability in a world lacking sufficient healthcare resources and capacity.
• Parting comments about the importance of the global nature of interoperability for healthcare data.
• The value of being able to share data for research purposes.

Quotes:

“The technology will do what we want; it’s the human angle that’s the most important part of any discussion on interoperability.” — @rd_work [0:06:57]

“Terminology brings unambiguity into the message [of interoperability]. It means that [the message] is completely understood; you’re not having to interpret somebody else’s pretext or handwriting or anything like that.” — @rd_work [0:18:08]

“That magic bit of connecting data about people to research ideas that generate new knowledge is partly driven by making sure the data is interoperable.” — @GutteridgeC [0:27:06]

“Making it possible to share [data] for research purposes is one of the things that drives modern healthcare systems.” — @GutteridgeC [0:27:23]

Links Mentioned in Today’s Episode:

Dr. Charles Gutteridge on X

Rory Davidson

Rory Davidson on X

Kelly Kuru on X

Kelly Kuru

SNOMED International