Part of SNOMED CT PaLM Mapping Best Practice
Mapping requirements
The scope of pathology and laboratory medicine terminology mapping covers several requirements, detailed below. It is important to distinguish between them, because the process involved requires different levels of effort, the challenge of implementing each one into live use differs, and each returns a different level of value.
Requirement 1
Mapping of single reportables to SNOMED CT PaLM
This is the core requirement, returning the most value. Fortunately, it is also the most straightforward, and implementing maps into live use is realistic and achievable.
| Hospital A local code | Hospital A local description | Hospital A UoM | SNOMED PaLM concept ID | SNOMED PaLM FSN | SNOMED PaLM preferred term |
|---|---|---|---|---|---|
| CREA | Creatinine | umol/L | 1107001000000108 | Substance concentration of creatinine in serum (observable entity) |
Creatinine substance concentration in serum |
| NA | Sodium | mmol/L | 1107871000000107 |
Substance concentration of sodium in serum (observable entity) | Sodium substance concentration in serum |
| K | Potassium | mmol/L | 1107761000000109 | Substance concentration of potassium in serum (observable entity) | Potassium substance concentration in serum |
| HB | Haemoglobin | g/L | 1107511000000100 |
Mass concentration of haemoglobin in blood (observable entity) | Haemoglobin mass concentration in blood |
| ALB | Albumin | g/L | 1105861000000106 |
Mass concentration of albumin in serum (observable entity) | Albumin mass concentration in serum |
| PLT | Platelets | 10*9/L | 1108041000000107 | Platelet count in blood (observable entity) | Platelet count in blood |
| WBC | White cell count | 10*9/L |
1110441000000100 |
White blood cell count in blood (observable entity) | White blood cell count in blood |
Requirement 2
Mapping to other SNOMED CT concepts that populate supplemental data elements in the Pathology FHIR specification
This requirement supports the goal of having fully atomic, structured, coded pathology reports, valuable in terms of enhancing data quality. The process involved is simpler than mapping single reportables, but the implementation challenge is harder because there are several target value sets that require agreement and sign-off by the clinical profession.
| Hospital A specimen local code | Hospital A specimen local description | SNOMED specimen concept ID | SNOMED specimen FSN | SNOMED specimen synonym |
|---|---|---|---|---|
| CG12 |
Endocervical swab (STD PCR) | 444787003 | Swab of endocervix (specimen) | Swab of endocervix |
| CG13 | Eye swab (STD PCR) | 445160003 | Swab of eye (specimen) | Swab of eye |
| CG14 | First void urine | 698276005 | First stream urine specimen (specimen) | First void urine sample |
| CG15 | Rectal swab (STD PCR) | 258528007 | Rectal swab (specimen) | RS - Rectal swab |
| CG16 |
Throat swab (STD PCR) |
258529004 | Throat swab (specimen) |
TS - Throat swab |
| CG17 | Urethral swab (STD PCR) | 258530009 | Urethral swab (specimen) | US - Urethral swab |
| CG18 | Vaginal swab (STD PCR) | 258520000 | Vaginal swab (specimen) | VS - Vaginal swab |
| CG19 | Vulval swab (STD PCR) | 258523003 | Vulval swab (specimen) | Vulval swab |
Requirement 3
Identifying multiple SNOMED CT PaLM reportables for complex microbiology reports
Whilst a valid requirement, due to its singular nature, this delivers less overall value. The process involved is more difficult than for the above requirements and automated techniques are yet to be fully assured. Automation would require a specialist mapping tool, and there is an argument that the same output could be more easily achieved by building map tables manually. Implementing the change into live use will likewise be difficult, due to testing and assurance requirements. See diagram in Algorithmic mapping section.
Additional requirements 4, 5 and 6
Recording provenance, governance, and assurance information of concept maps (4)
Automatic map maintenance (5)
Automatic creation of new SNOMED CT PaLM content (6)
These requirements deliver value towards ongoing maintenance and development of SNOMED CT PaLM. 4 and 5 are straightforward to achieve and implement, using existing functionality and best practice. In contrast, 6 is considered a 'stretch' goal, as it is difficult to achieve and implement, requires technological solutions to be created, tested, and assured, and would impact existing best practice.
Last edited: 22 May 2025 3:38 pm