What is SNOMED CT?
Used in electronic health records, SNOMED CT is the most comprehensive and precise terminology product in the world, with extensive adoption across the globe. SNOMED-CT stands for the 'Systematized Nomenclature of Medicine Clinical Terms' and is a “common clinical language” consisting of sets of clinical phrases or terms, that can be grouped together with relationships between terms. Essentially it is used to provide a mapping to the existing sets of symptoms, treatments and procedures that you currently use. The aim of this is to create a uniform and consistent way of recording the treatment of patients. SNOMED CT is designed in such a way that a particular code always means the same thing no matter who wrote the notes, or who is reading them.
For instance, the following are some examples of SNOMED CT codes:
22891007Radiography of teeth (procedure)
234713009Fissure seal tooth (procedure)
234787002Insertion of amalgam restoration into tooth (procedure)
You can view further information here: www.snomed.org
Do the SNOMED CT codes relate to dentistry?
The Systematized Nomenclature of Dentistry (SNODENT) is an official subset of SNOMED CT, produced by the American Dental Association (ADA).
I would like to see a copy of the SNODENT CT codes. Where can I find them?
Unfortunately, they are not available. They were published on the NHS Business Services website in 2019 but have since been removed.
So, is this SNODENT CT the set of codes that we will use?
We are assuming so. Unfortunately, despite many efforts to seek clarification from NHS England, by the Dental Suppliers Association (DSSA), of which Dentsys are a member, we have not received any response. Without any further guidance we, and the rest of the dental software suppliers, will be using the SNODENT CT set of codes. However, they haven’t been publicly available from NHS England for nearly a year and a half.
Wasn’t this supposed to come in to effect back in April 2020?
Due to the Dental Software Suppliers association and other bodies such as the BDA, raising serious concerns about the way SNOMED had been implemented by NHS England and related bodies, coupled with the COVID pandemic, NHS England postponed the go live date to April 2021.
Wasn’t this supposed to then start in April 2021?
The same as in 2020, due to the Dental Software Suppliers association and other bodies such as the BDA, raising serious concerns about the way SNOMED had been implemented, and still coupled with the COVID pandemic, NHS England postponed the go live date to August 2021.
So then, I take it everything has been clarified in the time being?
At the time of the initial postponement, it was said by NHS England that NHS X (NHS Digital) will be holding discussions with the practice management systems supplier community in parallel with NHS E, DHSC, NHSBSA and the representative dental professional bodies. Unfortunately, this has not materialised and, as is the case for all software suppliers, we have had no further clarification, discussion or collaboration since April 2020. The Dental Software Suppliers Association has on many occasions attempted to engage with NHS England and the various bodies, but nothing has been forthcoming. Coupled with this, the SNOMED/SNODENT codes that that were available on the NHS Business Services, along with a SNOMED developer information forum for use by the software suppliers, were removed without notice back in 2019.
I have seen some other suppliers have released the SNOMED features already. Why haven’t you?
Due to the live date being postponed and the lack of information, collaboration and information from NHS England and related bodies, we decided to only put this live once it is required. We decided this was best so as to provide the most accurate system for you, and not to add to the burden on practices. We also spoke to many practices and the general response was split between not having really heard about SNOMED and not wanting the extra workload at that point.
What will I need to do to use SNOMED CT?
There are two main items; Configuring SNOMED and Using SNOMED.
You will need to map all your relevant treatment items to a SNOMED code. As all practices have many codes that are bespoke to them, and there is no standard set of treatment codes throughout dentistry, no matter which software is used, this is not something we can automate for you. However, we will be providing a set of mappings for our standard set of codes that we provide with the software. These will be pre-mapped, but you will still need to check them to make sure you are satisfied they are correct for you.
When applying a treatment item to a treatment plan, if the item has been mapped / associated with a SNOMED code, it will automatically enter the SNOMED code for you. Otherwise, you will need to select a relevant SNOMED code from the list. We will provide guidance once the SNOMED features are made available.
Who is responsible for the accuracy of the SNOMED mappings and their usage?
The mapping and usage of the SNOMED codes will always remain the responsibility of the clinician, as this is down to clinical judgement.
I saw it mentioned a while ago that the usage of SNOMED would be invisible to the clinician and they wouldn’t notice a thing. Is this the case?
No. Whereas the system will automatically enter SNOMED codes for you if they are mapped, the clinician will always remain responsible so will want to check what has been entered. Any treatment items that are not mapped will result in the clinician having to select the appropriate code from the overall list.
I work as a private clinician. Do I need to bother with this?
We currently understand that this is for NHS dentistry, but as the Dental Suppliers Associated have still not had any clarification despite multiple attempts, this is still unclear.