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Mental Health Services Dataset SNOMED data quality dashboard

An interactive report allowing users to explore the SNOMED data recorded in Mental Health Services Data Set (MHSDS), and information on where improvements can be made. 

This dashboard has been designed to help providers improve their usage of SNOMED and thereby improve the submission of SNOMED to MHSDS.

Accessibility of this tool

This tool is in Microsoft PowerBI which does not fully support all accessibility needs. You can find the source data in our mental health services monthly statistics If you need further assistance, please contact us for help.


How to use this tool

You may find it useful to expand the power BI to full screen mode by using the diagonal arrows on the bottom right of the frame.

To navigate through the tool, use the contents tab at the bottom of the page. Or use the arrows in the bottom left and right corners of the screen. Each tab contains information on a specific topic or measure.

Select a region, organisation and where applicable month from the options available in each tab to view corresponding data.


Purpose of the tool

SNOMED is a clinical terminology used in electronic health records, SNOMED gives clinical IT systems a single shared language, which makes exchanging information between systems easier, safer and more accurate. It contains all the clinical terms needed for the whole NHS, from procedures and symptoms through to clinical measurements, diagnoses and medications.

Clinicians are advised to use SNOMED in such a way, that if another clinician were to review the care notes enough detail is there to allow that clinician understand the care that has been given.

The dashboard will help providers get a better understanding of SNOMED and how to improve usage. The dashboard assesses how much SNOMED is flowing to MHSDS, to which fields and tables, and by which providers, there is also a focus on procedures and assessments.


What you can find out

The data used within the dashboard is from the latest 12 months, up to the current reporting period displayed on the main page. Data can be filtered by region, provider, most recent system supplier and where appropriate by month. 

The three main areas covered by the dashboard are

  • which organisations have or have not submitted any SNOMED
  • counts of the number of different concepts submitted and values at national and organisational level
  • which organisations have submitted any data to the tables and fields in MHSDS that accept SNOMED

Procedures as part of direct patient care

Table MHS202 Care Activity should be used to record the procedures that have been undertaking as part of the direct care of the patient.

This dashboard shows: 

  • the appropriateness of some of the SNOMED concept submitted using the procedure categories below as a benchmark
  • the number of SNOMED procedure records submitted over time

Assessment scales

Assessment scales need to be recorded in 3 tables only.

The dashboard shows

  • the list of organisations who are submitting SNOMED assessment scales to an incorrect part of MHSDS

Children and Young People with Eating Disorders

MHSDS published measures on children and young people entering treatment and waiting for treatment in a 3 month period. Published statistics can be viewed here: Mental Health Services Monthly Statistics - NHS Digital.

SNOMED is used to show that a person has entered a NICE concordant treatment. The dashboard shows at provider level the number of referrals entering treatment in the current 3 months and the number still waiting at the end of the month. The waiting group are split into more detail on why a referral is showing as still waiting. Providers can also ask for record level data so they can improve data quality on this metric. Contact [email protected] for more information.


What the report cannot tell you

The report cannot tell you an exact list of which SNOMED concepts we expect to see submitted to MHSDS. 

It cannot tell you if every SNOMED concept submitted by an organisation is appropriate, as there is such a wide range on the SNOMED concepts that can be used as part of clinical care. We will not be able to assess all the individual SNOMED codes that flow to MSDS.


Procedure categories

Correct hierarchy: relevance not yet assessed

Description

This category contains concepts that are from the procedure and situation with explicit context hierarchies. However, no detailed assessment has yet been made of their appropriateness.

Suggested fix

Currently no action required. 

Post coordinated concept: relevance not yet assessed

Description

This category contains all post coordinated concepts submitted, however no assessment has been made of them yet.

Suggested fix

Currently no action required. 

Review: too generic

Description

We have identified 15 concepts that, although they are from the correct hierarchy, don't provide sufficient detail on the procedure done as part of the care contact with the patient.

Suggested fix

As a rule of thumb, ask: is the concept Description helpful to another clinician in the care of that patient; if not, it is unlikely to be appropriate for submission to MHSDS either.

Concepts deemed too generic and where each concept has a number of child concepts which would be more appropriate to use are:

386053000 |Evaluation procedure (procedure)|

277132007 |Therapeutic procedure (procedure)|

223458004 |Informing (procedure)|

390808007 |Mental health care (regime/therapy)|

392134007 |Care regimes management (procedure)|

243114000 |Support (regime/therapy)|

276239002 |Therapy (regime/therapy)|

182832007 |Procedure related to management of drug administration (procedure)|

Concepts deemed too generic, but which do not have many child concepts are listed below. It has been advised that a more appropriate concept with sufficient detail will likely exist elsewhere in the procedures. Concepts are:

185317003 |Telephone encounter (procedure)|

185318008 |Third party encounter (procedure)|

385893007 |Mental health treatment (regime/therapy)|

182991002 |Treatment given (situation)|

394656005 |Inpatient care (regime/therapy)|

9632001 |Nursing procedure (procedure|

7922000 |General treatment (procedure) |

We appreciate that the concepts in the above lists can hold value when used alongside other more detailed concepts, but if these are the only concepts listed during a are contact then they are not detailed enough to allow other clinicians to understand the interventions that have taken place with the patient.

Review: not a procedure concept

Description

This category contains concepts that are not from the procedure or situation with explicit context hierarchies which is the areas of SNOMED used for recording interventions. 

Suggested fix

It is recommended these are reviewed and more appropriate concepts identified. If using the Fully Specified Name, the semantic tag (words in brackets at the end) tell you which hierarchy the SNOMED concept belongs to. We would expect this to only be:

  • (procedure)
  • (regime/therapy) - a sub hierarchy of procedure
  • (situation)
Review: not a SNOMED concept

Description

This category contains all data items that are not SNOMED. It is no longer valid to send codes that are not SNOMED CT concepts ids.

Suggested fix

Do take care that legacy Read v2 or CTV3 codes are not to be submitted to this field as we expect only SNOMED here now.

If you are extracting data from a system that provides both sets of codes, you MUST ensure you extract content in SNOMED CT.

If you are using Excel, make sure the fields containing the SNOMED concept ids are set to text BEFORE entering any concept ids and NOT Number or General. Excel converts content that is all digits to exponential and can lose the last digit.

If manually entering a SNOMED concept, the SNOMED Term Browser is a good way to check the concept ID is correct, you can search descriptions to find the concept needed.

 


Notes and data sources

Only providers who are recorded as submitting to MHSDS as per the MHSDS submission update, are included in this dashboard. The data is from April 2020 onwards. 

The dashboard is updated on a monthly basis and uses data submitted via the multiple submission window model so may differ from published monthly metrics which do not use the multiple submission window model.


Contact us

Questions and feedback should be sent to [email protected]


Further information

internal SNOMED CT

SNOMED CT is a structured clinical vocabulary for use in an electronic health record. It is the most comprehensive and precise clinical health terminology product in the world.

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Last edited: 23 November 2023 11:21 am