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Source: New Zealand Ministry of Health

The Ministry of Health is moving towards improved recording of emergency department visits by district health boards. To support this, we have introduced standard SNOMED CT reference sets for chief presenting complaint, diagnosis and procedure concepts in emergency care.

The three reference sets are available as Excel spreadsheets from here or they can be downloaded from the SNOMED Member Licensing and Distribution Service as tab-delimited files in the SNOMED NZ Extension.

The same content can be downloaded from the SNOMED reference set tool as separate tab-delimited files:

We invite your comments and suggestions on the reference sets as they continue to develop. A clinical advisory group meets every six months to decide the content of each new release, working with the Ministry’s SNOMED National Release Centre.  

We acknowledge the work by emergency medicine specialists at Nelson-Marlborough DHB to develop the presenting complaint and diagnosis reference sets used since 2013. The procedure reference set was also developed by New Zealand emergency care specialists. 

This change is supported by the Australasian College of Emergency Medicine.

Adoption roadmap

Several DHBs have worked with the Ministry as early adopters of the reference sets, implementing them in their own ED information systems. The National Non-Admitted Patients Collection (NNPAC) has been extended to capture SNOMED-coded presenting complaint, diagnosis and procedure details for ED visits. The first DHBs began capturing and submitting ED visit information in this format to NNPAC in 2019. 

The National Collections Annual Maintenance Project (NCAMP) for 2019 introduced these changes for early adopters. For all other DHBs, the Annual Plan Guidelines for 2019/20 required a plan on how they will implement the change. An NCAMP 2020 change notification invites further DHBs to implement SNOMED in ED during the 2020/21 financial year, before implementation becomes mandatory on 1 July 2021.