Enabling connected care: Mapping aged care clinical concepts to snomed ct

Health information systems for acute, primary and aged care have evolved separately. Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) is the dominant clinical terminology in acute and primary care, while interRAI assessment systems are widely used in aged care. This creates barriers for seamless sharing of health information when older people transition between settings. We answer the research question "Is it feasible to map aged care clinical concepts to a standardised clinical vocabulary?", to support interoperability.

Using existing guidelines and open-source tools, we mapped a representative sample of aged care assessments from the interRAI suite of systems to SNOMED CT. The sample consisted of 50 mappable elements covering physical health, cognitive and functional status domains. Each mapping was characterised as 'equivalent', 'broader', 'inexact', or 'narrower' and the mappings were validated with clinical experts through discussion to reach consensus.

All interRAI elements had a feasible mapping to SNOMED CT. 68% were an equivalent match, 26% were broader, 4% were inexact and 2% were narrower. SNOMED CT qualifier values were used in 46% of maps to replicate the granularity in the interRAI assessments. In most maps (86%), one-to-one mappings were used.

This study demonstrates the feasibility of mapping interRAI elements to SNOMED CT, however not all maps were equivalent. Future work should attempt mapping an entire interRAI assessment system. This will advance efforts towards interoperability among aged care and other clinical settings, which will improve consumer experience, safety and continuity of care for older people.