The Science and Practice of SNOMED CT Implementation

The overall research question of this PhD research was: "How can the clinical value of the Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT) be demonstrated in the primary health care setting to enhance patient care?" The position taken in this research is that there is clinical value in using SNOMED CT.;To inform the current state of knowledge, a literature review of SNOMED CT papers catalogued by PubMed and Embase between 2001 and 2012 was carried out, and interviews were conducted with 14 individuals from 13 health care organisations across eight countries. The results showed there was a lack of understanding of how to craft post-coordinated expressions, how to fully utilise the semantics of SNOMED CT in data retrieval, and a lack of evidence on how SNOMED CT added value.;A proposed SNOMED CT Clinical Value Framework that organised the primary and secondary uses of SNOMED CT was created and a SNOMED CT design methodology was formalised that consisted of three components to aid in auditing, encoding and retrieval through a primary health care study.;In this PhD research, the potential clinical value of SNOMED CT was demonstrated by improving the completeness of clinical records and facilitating decision support features such as alerting clinicians to potential drug-allergy interactions, and reminding clinicians to order routine tests. The realisation of the potential clinical value was based upon the accurate and unambiguous manner in which clinical terms were encoded using the encoding method, the efficient and effective retrieval of relevant concepts using the retrieval method, and to a lesser extent, the ensuring that the concepts used were consistent using the auditing method.