B.C. Health Concerns and Diagnosis Value Set

The B.C. Health Concerns and Diagnosis Value Set was created to support collection within electronic medical records (EMRs) for primary and acute health care settings. This value set contains the most common clinical terms used in British Columbia from SNOMED CT^® (Systematized NOmenclature of MEDicine – Clinical Terms), ICD-10-CA (International Classification of Diseases - revision 10 - Canadian edition), ICD-9, and the CED-DxS (Canadian Emergency Department Short List).

When implemented within health information systems (HIS), the standardized value set and the maps to ICD-10-CA, ICD-9, and CED-DxS allow a consistent and standardized approach to clinical information that can be shared across multiple systems in machine and human-readable format.

The SNOMED CT^® vocabulary is used by clinicians to capture patient encounter information at the point of care and can enable re-use of the data when mapped to a classification. The mapping of SNOMED CT^® to ICD-9 supports:

• Physician billing to MSP/Teleplan
• Reporting of aggregated health concerns and diagnosis data,
• Interoperability between primary care EMRs and the wider health care system, and
• Ease of use and acceptance of SNOMED CT^® implementation into the electronic medical records.

Scope

The audience for the mapping and guidelines is clinicians, Electronic Medical Record (EMR), Clinical Information System (CIS), and Pharmacy Management System (PMS) vendors and developers of health information management solutions across B.C. and Canada.

The scope of this mapping is to provide a list of clinical terms that may be used to record a patient’s current diagnosis, clinical history, family history, adverse events, or the indication for the visit. The updated value set has over 10,000+ concepts mapped to ICD-10-CA, ICD-9 and CED-DxS.  

The implementation guides provide an understanding of SNOMED CT^® and its advantages to EMR, CIS, and PMS and guidance for implementing the mapping to HIS. Although the B.C. Health Concerns and Diagnosis Value Set was developed for use in British Columbia, it was derived from multiple sources - both nationally and internationally and can be adoptable in other jurisdictions that require mapping to ICD-10-CA, ICD-9, and CED-Dxs. 

Governance

This value set and its implementation guides were endorsed by the provincial Health Information Standards Standing Committee (HISSC) and is currently governed by the Digital Health Strategy Office (DHSO).

Current Status

Version 3.0 of this mapping is available for download. A constrained downloadable version consists of 1000 sample mapping codes. For the FULL value set or inquiries related to the published B.C. Health Concerns and Diagnosis Value Set, please email the Health Information Standards team at HLTH.HISSupport@gov.bc.ca.

For non-B.C. HIS vendors, a Pan-Canadian Health Concern Value Set (PHCVS) was developed, based on BC’s work, to provide a standardized approach for collecting primary care health concerns & diagnosis information and to support patient-level physician billing. For further information see:

• Pan-Canadian Health Concern Value Set (PHCVS) | CIHI

The use of the CIHI reference set maps requires licensing agreements for both ICD-10-CA (from CIHI) and SNOMED CT^® (from Canada Health Infoway).

• ICD-10-CA is available at no charge to Core Plan subscribers or for purchase by non–Core Plan clients. To request a user license for ICD-10-CA, contact the CIHI Order Desk at help@cihi.ca.
• For SNOMED CT^® use, an implementer must confirm acceptance, annually, of the Terms of Use and License Agreements at:  Register (infoway-inforoute.ca)

Maintenance

Significant analysis, review and validation processes were undertaken to make sure that the mapping developed would be applicable and attainable to the various stakeholder groups.

Wherever possible, content templates defined and reviewed by standards bodies were referenced, and appropriate constraints for the B.C. context applied.

The content of this mapping may require post-production edits, additions and/or maintenance to address issues identified by technical validation. Additional updates will be made over time to reflect current SNOMED CT^® and ICD-9 CA term requirements in B.C. or to align with emerging pan-Canadian standards developments.

Download

1. Download the sample: B.C. Health Concerns and Diagnosis SNOMED CT^® mapping 3.0 (XLSX, 126KB).
2. Download the B.C. EMR User Guide for SNOMED CT^® (PDF, 1.7MB).
3. Download the B.C. Implementation Guidance for SNOMED CT^® (PDF, 1.6MB).
4. To receive the complete mapping of this value set, please send an email with 'Subject: Request BCHC Value Set Download' along with your name, title, organization name, and use of value set.