Key points
- Demand is growing for clinical information to be shared between individual clinicians, health care organisations and state/territory health departments.
- Patient data is often captured in separate electronic systems with varying formats and terminologies, complicating processing and integration.
- In 2016 the National Clinician Terminology Service was launched to enable standards-based interoperability in healthcare.
It’s 2014 and connected healthcare is still a thing of the future.
Zoom into a buzzing café in the heart of Amsterdam, where a team of software engineers and scientists is huddled in a dark corner. Each is focused on a seemingly insurmountable challenge. Their goal is to increase adoption of SNOMED CT. It is the world's most comprehensive multilingual clinical healthcare terminology, and they want to see it used more widely in Australia’s digital health solutions.
Everyone agrees that using the same terminology to capture Australia's health data would improve data sharing and lead to better outcomes. However, implementing SNOMED CT in clinical systems is seen as difficult.
The need for unified clinical terminology
One of the largest challenges our healthcare system faces is the increasing demand for clinical information to be shared between individual clinicians, health care organisations and state/territory health departments. Patient data is often captured in separate electronic systems in different formats and described using different clinical terminologies or “languages”. This makes it difficult for computers to process and combine the information.
But in that buzzing cafe, a solution was posed – what if Australia could implement a federated national clinical terminology service? The terminology could be based on an application programming interface (API) within the emerging Fast Healthcare Interoperability Resource (FHIR) standard.
Australia’s National Clinical Terminology Service launched
From that point it was only two years later, in 2016, that Australia’s National Clinical Terminology Service (NCTS) was (softly) launched. The NCTS is underpinned by CSIRO’s Ontoserver FHIR Terminology server and is led by the Australian Digital Health Agency ("The Agency").
Since going live, the project has gone from strength to strength, helping to implement standard terminologies in Australia’s digital health systems. It is also enabling standard-based interoperability in data exchange. And in just eight years we have grown to a total of 1528 licences worldwide.
There are now over 100 organisations who have taken advantage of the free Ontoserver license available from the Agency. This allows them to investigate how they can implement SNOMED CT – and other health terminologies – into their systems.
Australia’s leadership in healthcare terminology services
Excitingly, other countries are now watching and copying. There are eight SNOMED national release centres using our Ontoserver technology to implement national terminology services in their own countries.
Kate Ebrill is the Product and Programme Lead for Clinical Terminology and FHIR products at the Australian e-health Research Centre (AEHRC). She explains that the real success of this story is that a research-driven, FHIR native product is now at the core of the NCTS. This signifies a great achievement for Australia on the international stage.
“Perhaps more than this, our NCTS model has really changed the way terminologies are implemented in the international space. We’ve now paved a way forward for the world.
"We’re proud that our Ontoserver technology, developed at the AEHRC, is enabling healthcare data in Australia to be collected using standard terminology," Kate said.
Prior to the availability of Ontoserver which uses FHIR APIs to deliver on demand, health services needed to download files every six months or so to make sure their terminology was up-to-date. Now, the updates are automatically delivered via Ontoserver, saving time and money.
Recently the team hit another milestone. The Australian Medicines Terminology model has been revised and is now in its fourth version (AMT v4). The team has now integrated this version into SNOMED International’s managed service platform.
Overcoming challenges in data sharing
With AMT v4, terminology users can now use the NCTS to leverage SNOMED International’s terminology hierarchies. While this won’t directly affect Australians using the healthcare system, it will indirectly benefit individuals.
Here’s how:
Healthcare across borders
Access to data can help improve decision-making on how to allocate resources in hospitals and healthcare. During periods of crises like outbreaks and epidemics, the data can help guide emergency decision making. But if the data is not easily transferable between different healthcare systems and organisations, then it cannot be used optimally.
Improved clinical decision making
Informed decisions in a clinical setting rely on various types of information, such as imaging and clinical notes. Clinicians with detailed data can make more accurate diagnoses and treatment choices for patients.
A global healthcare language
A global healthcare language creates a common standard for data exchange across international health systems. This means that if you’re hospitalised abroad, your patient records can be easily accessed and used for your care.
Ontoserver licences are available for free for end use in Australia from the ADHA.