Information Systems HIMS

by | Feb 20, 2025 | Essays

Analyze and interpret processed health data and other evidence for the decision-making process in different healthcare settings.

SNOMED-CT (explore the coding system) is recommended for use in EHR (Electronic Health Record) and HIE (Health Information Exchange) for interoperability and has been widely adopted, except in the US where ICD-10-CM and CPT (4.0) are still used.

Write a Research Paper that addresses the following:

Assess the benefits and shortcomings of using SNOMED-CT in EHR and HIE. Why are ICD-10-CM and CPT (4.0) still used in the US?
What are the prospects of using SNOMED-CT in EHR systems in the US?
What needs to be done on the federal and state level for SNOMED-CT to replace CPT used in the USA?

 

 

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

The Prospects of SNOMED-CT in US Healthcare: Overcoming Barriers to Interoperability

Abstract:

This research paper analyzes the benefits and shortcomings of using SNOMED-CT in Electronic Health Records (EHRs) and Health Information Exchange (HIE), examining the reasons for its limited adoption in the US despite its widespread use elsewhere. It explores the continued use of ICD-10-CM and CPT (4.0) in the US, assesses the prospects of SNOMED-CT adoption, and outlines the necessary steps at federal and state levels for SNOMED-CT to potentially replace CPT in the US.

Introduction:

Interoperability, the ability of different health information systems to exchange and use information, is crucial for efficient and effective healthcare. Standardized terminologies and coding systems play a vital role in achieving interoperability. SNOMED-CT (Systematized

The Prospects of SNOMED-CT in US Healthcare: Overcoming Barriers to Interoperability

Abstract:

This research paper analyzes the benefits and shortcomings of using SNOMED-CT in Electronic Health Records (EHRs) and Health Information Exchange (HIE), examining the reasons for its limited adoption in the US despite its widespread use elsewhere. It explores the continued use of ICD-10-CM and CPT (4.0) in the US, assesses the prospects of SNOMED-CT adoption, and outlines the necessary steps at federal and state levels for SNOMED-CT to potentially replace CPT in the US.

Introduction:

Interoperability, the ability of different health information systems to exchange and use information, is crucial for efficient and effective healthcare. Standardized terminologies and coding systems play a vital role in achieving interoperability. SNOMED-CT (Systematized

Nomenclature of Medicine – Clinical Terms) is a comprehensive, standardized, and computer-processable clinical healthcare terminology. While widely adopted globally for EHRs and HIE, the US continues to primarily use ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) for diagnoses and CPT (Current Procedural Terminology) for procedures. This paper explores the reasons behind this divergence, the potential benefits and challenges of SNOMED-CT adoption in the US, and the necessary steps for its implementation.

Benefits and Shortcomings of SNOMED-CT:

Benefits:

  • Granularity and Specificity: SNOMED-CT offers a much more granular and specific representation of clinical concepts compared to ICD-10-CM and CPT. This allows for more accurate documentation, improved clinical decision support, and better data analysis.
  • Comprehensiveness: SNOMED-CT covers a wider range of clinical concepts, including diagnoses, procedures, findings, symptoms, and social circumstances.
  • Interoperability: SNOMED-CT’s global adoption facilitates seamless exchange of health information across different healthcare systems and countries.
  • Computer Processability: SNOMED-CT’s structured format makes it easier for computers to process and interpret clinical data, enabling advanced analytics and decision support.
  • Improved Research: The standardized terminology facilitates clinical research by enabling the aggregation and analysis of data from diverse sources.

Shortcomings:

  • Complexity: SNOMED-CT’s vastness and complexity can make it challenging to learn and implement. The steep learning curve can be a barrier for healthcare professionals.
  • Maintenance: Maintaining and updating SNOMED-CT requires significant resources to ensure its accuracy and relevance.
  • Implementation Costs: Implementing SNOMED-CT can be expensive, requiring investment in software, training, and infrastructure.
  • Resistance to Change: Healthcare professionals may be resistant to adopting a new coding system, especially if they are already familiar with ICD-10-CM and CPT.
  • Lack of Direct CPT Mapping: While mappings exist, SNOMED-CT does not have a one-to-one mapping with CPT, making the transition for billing and coding complex.

Why ICD-10-CM and CPT are Still Used in the US:

Several factors contribute to the continued use of ICD-10-CM and CPT in the US:

  • Established Infrastructure: Significant investments have already been made in systems and training for ICD-10-CM and CPT. Changing to SNOMED-CT would require substantial additional investment.
  • Billing and Reimbursement: CPT codes are deeply embedded in the US healthcare billing and reimbursement system. Switching to SNOMED-CT would require significant changes to this system.
  • Physician Familiarity: Healthcare providers are accustomed to using ICD-10-CM and CPT. Changing to a new system would require extensive retraining.
  • Lack of Mandate: While there have been discussions about adopting SNOMED-CT, there has not been a strong enough mandate at the federal level to drive widespread adoption.

Prospects of SNOMED-CT in US EHR Systems:

Despite the challenges, the long-term prospects for SNOMED-CT in US EHR systems are promising. The increasing emphasis on interoperability, data analytics, and personalized medicine is driving the need for more standardized and comprehensive clinical terminologies. As healthcare systems increasingly recognize the benefits of SNOMED-CT, adoption is likely to grow, albeit gradually.

Federal and State Level Actions for SNOMED-CT Adoption:

For SNOMED-CT to replace CPT in the US, significant action is required at both federal and state levels:

  • Federal Level:

    • Mandate: A clear mandate from the federal government, perhaps through the Office of the National Coordinator for Health Information Technology (ONC), would be crucial to drive adoption.
    • Incentives: Financial incentives, such as meaningful use criteria or reimbursement adjustments, could encourage healthcare providers to adopt SNOMED-CT.
    • Standards Development: Developing clear standards and guidelines for SNOMED-CT implementation would be essential.
    • Mapping and Translation Tools: Investing in tools to map between SNOMED-CT, ICD-10-CM, and CPT would facilitate the transition.
    • Training Programs: Funding and developing comprehensive training programs for healthcare professionals on SNOMED-CT usage.

  • State Level:

    • Regulation: States could align their healthcare regulations with federal mandates to promote consistent adoption.
    • Support: State-level HIEs can play a role in supporting the implementation of SNOMED-CT within their jurisdictions.
    • Collaboration: Collaboration between states can help share best practices and resources for SNOMED-CT implementation.

  • Addressing Billing Challenges: A phased approach to integrating SNOMED-CT into billing processes is necessary. This may involve developing crosswalks between SNOMED-CT and CPT codes for reimbursement purposes during a transition period. Eventually, a transition to SNOMED-CT-based billing could be considered.

Conclusion:

While the adoption of SNOMED-CT in the US faces significant hurdles, its potential benefits for interoperability, data analytics, and patient care are substantial. A coordinated effort at both federal and state levels, including clear mandates, financial incentives, standardized implementation guidelines, and robust training programs, is essential for overcoming the barriers and realizing the full potential of SNOMED-CT in US healthcare. A phased approach, addressing billing and coding complexities, will be key to a successful transition. The long-term goal should be a unified, globally interoperable system that leverages the power of SNOMED-CT to improve healthcare quality and efficiency.

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