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Clinical practice as well as research and quality-assurance benefit from unambiguous clinical information resulting from the use of a common terminology like the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT). A common terminology is a necessity to enable consistent reuse of data, and supporting semantic interoperability. Managing use of terminology for large cross specialty Electronic Health Record systems (EHR systems) or just beyond the level of single EHR systems requires that mappings are kept consistent. The objective of this study is to provide a clear methodology for SNOMED CT mapping to enhance applicability of SNOMED CT despite incompleteness and redundancy. Such mapping guidelines are presented based on an in depth analysis of 14 different EHR templates retrieved from five Danish and Swedish EHR systems. Each mapping is assessed against defined quality criteria and mapping guidelines are specified. Future work will include guideline validation.

SummaryInconsistent use of SNOMED CT concepts may reduce comparability of information in health information systems. Terminology implementation should be approached by common strategies for navigating and selecting proper concepts. This study aims to explore ways of illustrating common pathways and ancestors of particular sets of concepts, to support consistent use of SNOMED CT and also assess potential applications for such visualizations. The open source prototype presented is an interactive web-based re-implementation of the terminology visualization tool TermViz that provides an overview of concepts and their hierarchical relations. It provides terminological features such as interactively rearranging graphs, fetching more concept nodes, highlighting least common parents and shared pathways in merged graphs etc. Four teams of three to four people used the prototype to complete a terminology mapping task and then, in focus group interviews, discussed the user experience and potential future tool usage. Potential purposes discussed included SNOMED CT search and training, consistent selection of concepts and content management. The evaluation indicated that the tool may be useful in many contexts especially if integrated with existing systems, and that the graph layout needs further tuning and development.