Column: ‘Data crucial tool for healthcare’
Column: ‘Data crucial tool for healthcare’

Gabrielle Speijer, MD

Column Zorghelden, 02/2020

Column: ‘Data crucial tool for healthcare’

Gabriëlle Speijer and Pim Volkert: Effectively using data in healthcare is the shared mission of Gabriëlle Speijer, a radiation oncologist at HagaZiekenhuis, and Pim Volkert, coordinator of the Terminology Center & SNOMED1 NRC at Nictiz. They discussed the challenges and opportunities for the use of medical data and the added value that SNOMED brings to that data.

Gabriëlle, you are a data-driven doctor. What drives you?

“I want to take care of others, that’s why I became a doctor. But today, technology plays an important role. At the moment, we are not using it optimally. Technology is being used as we were used to working when we still carried a pager. That means pumping epistles back and forth to each other. I foresee the consequence: no more overview of the patient’s health situation. And yet it can already be done differently!”

Pim, what challenges do you see when it comes to the proper and safe use of medical data?

“Americans call registration at the source ‘Capturing Clinical Intent at Point of Care’. The challenge is to get that intention of the healthcare provider into the EHR in such a way that the computer and thereby other healthcare providers understand it well or unambiguously. So, no confusion for the general practitioner or nurse about what that medical specialist means in the discharge letter.”

And where do you see bottlenecks as well as opportunities for SNOMED in a doctor’s practice?

“A major bottleneck is the way healthcare providers can keep their records. I hear and see that people have difficulty recording structured and therefore coded reports. A lot of valuable data is hidden in free text fields. SNOMED offers possibilities for layering, so the level of detail with which the healthcare provider wants to express their intentions. And SNOMED can use the context in which the healthcare provider works with a patient. As a result, suppliers can make user interfaces much smarter and easier to use. This will yield much better health information.”

Gabriëlle, how can we accelerate and strengthen the interpretation from the heart of healthcare?

“I envision technology that makes such use of SNOMED that our contribution from our specialty is captured in the correct underlying SNOMED codes. That gives doctors freedom. At the same time, this is also the ultimate challenge: we have to agree on the interpretation with each other. This is also evident in the COVID-19 crisis, where I see many positive things happening, but there is still a lot to be gained in terms of coordination between professionals.”

I am in favor of linking a patient-friendly term to a SNOMED code. Pim, how do you feel about this?
“Record keeping is done in technical jargon, but the doctor explains as comprehensibly as possible to the patient what is going on. Now we link that technical jargon to patient-friendly terms and assign them a code. Patients can then read the conversation with the doctor in understandable words (or in technical jargon) in a portal or personal health environment (PHE).”

We are in the midst of a health crisis. Gabriëlle, how can data support you and your colleagues in this health crisis?

“Better data I would describe as better interpreted, but also immediately more findable, accessible, exchangeable and reusable. Mapping the infection with the coronavirus and its relationships with various other factors could provide us with more insight. Think of the relationship with weather conditions, with other diseases, with behavior, etc. But better data could also help us much more easily in earlier detection of symptoms, screening, and adjusting behavior at the population level.”

Pim, how can SNOMED help in a crisis like this?

“SNOMED is the language of and for healthcare providers. They are now asking for new COVID-19 related terms. Naturally, the medical terminologists at Nictiz immediately got to work and within a day, we added new codes. This results in uniform data that physicians and research institutions use for analysis to prevent further spread.”

Gabriëlle, what would you like to convey to your colleagues about handling data in healthcare?

“Doctors, realize that information technology has become our most important instrument for any form of communication that takes place outside of the examination room. This starts with receiving information and being able to oversee the situation smoothly and seamlessly to make the right decisions. And it continues with being able to further improve healthcare, whether through insight into quality or through the use of applications such as artificial intelligence. Valuable treatment of healthcare information is our core task today, with SNOMED as a foundation.”

About the author

Gabriëlle Speijer is a Radiation Oncologist at the Haga Hospital, founder of the healthcare innovation company CatalyzIT, HIMSS Future50 International HealthIT leader and member of the ICT&health editorial board.