The need for change

The code system called Read Codes Version 2 has been used since the 1990s in New Zealand primary care to code for medical conditions in patient records. Read Codes have featured in clinical performance indicator reporting, injury claims, medical certificates and reimbursement processes.
Read Codes came from the United Kingdom, where they were used for many years until withdrawal in 2020 in favour of SNOMED CT.
SNOMED CT dates from the early 2000s when created as a blend of Clinical Terms Version 3 (successor to Read Codes V2) with an earlier version of SNOMED from the College of American Pathologists.
Now known as SNOMED International, the International Health Terminology Standards Development Organisation was formed in 2007 to lead the global adoption of SNOMED CT, with New Zealand as a founder member.
The Ministry of Health and now Health New Zealand have established SNOMED CT as a requirement for our health system and we operate the SNOMED National Release Centre to support its implementation in all clinical information systems by health providers and their industry partners.
Many New Zealanders now have a SNOMED-coded primary care record but work remains to complete the migration from Read Codes.

Using SNOMED CT

As our principal standard for terminology, SNOMED CT is the required source of codes and terms for many data elements in the NZ Patient Summary (NZPS) and NZ Core Data for Interoperability (NZCDI) data set. SNOMED CT is also an important standard for CVD risk assessment.

Using SNOMED CT-enabled software at point of care makes for health records that can be reliably communicated between clinicians, patients and whānau, and linked machine-readably to health pathways, health education resources and other digital tools.  

Amid its versatile applications, the central requirement is to use SNOMED CT to record problems and medical conditions in all health records.  

For example, this means using SNOMED CT to code a diagnosed health issue, an indication for a medicine, a medical condition addressed by a care plan.  

The Ministry of Health and Health NZ have worked actively with the Accident Compensation Corporation (ACC) and Ministry of Social Development (MSD) since 2016 to modernise forms and interfaces so that health providers can use SNOMED CT natively in place of Read Codes.  

Our membership of SNOMED International makes SNOMED CT freely available in New Zealand. We publish a mapping table in our standard product the SNOMED CT NZ Edition to enable health providers and their industry partners to complete this change.  

In the context of the health targets, the five pathologies including cardiovascular disease need to be properly represented in the patient record using a modern clinical terminology that is up-to-date with medical science and healthcare practice.

SNOMED is a required standard for any new investment in Health NZ information systems and also as one of the principal standards for interoperability that we regulate in the sector through HISO processes and contracting and commissioning.  

Advice to implementers

  • Register with the SNOMED National Release Centre for access to the SNOMED NZ Edition
  • Keep your systems current with our six-monthly updates of the SNOMED NZ Edition, released in April and October
  • Get an API key to download code systems, value sets and maps from the NZ Health Terminology Service (NZHTS)
  • Use our Read Codes V2 to SNOMED CT map distributed with the SNOMED NZ Edition and available from NZHTS

 

Supporting tools