NRCeS involves in development and customization of health informatics standards in form of subsets, refsets, user guide on using standards or parts of standards for complying with nationally defined standard treatment guidelines for various domains, national program specific usage, etc. to meet national requirements. Under this service, NRCeS offers -
- SNOMED CT Geographical Location Extension.
- SNOMED CT national refsets.
- SNOMED CT national drug extension.
- SNOMED CT Patient Instructions Language Extension.
- Country specific customizations to EHR standards.
- National release processes and guidelines.
- Manage and maintain national releases.
- Assists in development of vendor / implementer specific subsets / refsets.
Drugs (medicinal products) are one of the key data point captured and referred for continuity of care of an individual. In order for the drugs information to be identified, stored, referred, and exchanged between different clinical, reporting, stock, supply chain, dispensation systems, it is important to have common drug codes across those systems.
Lack of common drug codes across different systems and healthcare setups invariably introduce local maps, formats and naming conventions leading to input errors, missing information, incorrect identification and other problems that surface due to lack of unique identities and diverging naming methodologies. This makes exchange of health data a difficult and error-prone activity.
For a country rapidly digitizing its information systems and especially adopting digital systems in healthcare information management, it is important that this key piece of information is codified and made available for use across all system. Different system should be able to use the same codes with slightly different additional information to meet its purposes.
National Resource Centre for EHR Standards (NRCeS), a program of Ministry of Health and Family Welfare (MoHFW), Government of India is providing these Common Drug Codes for India for use across healthcare records, supply and pharmacy systems.
Common Drug Codes for India (Terminology Integrated Package) includes generic (clinical drug), supplier, and branded medicine concepts which when used along with SNOMET CT International Release covers all medicines, except devices, surgical implants, and combi packs, from:
- National List of Essential Medicines (NLEM) 2015
- Pradhan Mantri Jan-Aushadhi Yojana
- Affordable Medicines and Reliable Implants for Treatment (AMRIT) programme
- Medicines referred in Telemedicine Practice Guidelines
- HIV Drug list referred by National AIDS Control Organisation
- COVID-19 drug list referred in CLINICAL MANAGEMENT PROTOCOL: COVID-19 by MoHFW
The Common Drug Codes for India are distributed in two different formats for ease of use and adoption:
- Common Drug Codes for India (Terminology Integrated Package)
- Common Drug Codes for India (Flat Files Package)
1. Common Drug Codes for India (Terminology Integrated Package)
Common Drug Codes for India (Terminology Integrated Package) is a set of files that integrate with SNOMED CT Global Medical Terminology files and content for use in any data entry, analysis, or record exchange systems that adhere to MoH&FW notified Electronic Health Record Standards for India 2016 guidelines.
The Extensions are a mechanism to extend SNOMED CT for specialized terminology needs such as medicine to match requirements of different clinical specialties / domains. The purpose of this Extension includes:
- Enable standardized coding of medicinal products for clinical care
- Enable linkages to terminology and use in application/system for:
- Clinical Documentation
- Data Retrieval
- Data Analytics
- Stock Management
- Supply Chain Management
This is a Developer Preview release containing additional concepts covering Suppliers, Brand and Supplier combination, Clinical Drug, and Branded Medicines to familiarize affiliates and health IT implementors with the format and model of the national drug extension.
The Common Drug Codes for India (Terminology Integrated Package) is available as India Drug Extension for SNOMED CT to Affiliate Licensees to download through Member Licensing and Distribution Service (MLDS).
2. Common Drug Codes for India (Flat Files Package)
Common Drug Codes for India (Flat Files Package) is introduced to support standardized coding and sharing of drug codes without need of integrating the complete terminology. It is usable in following applications:
- Clinical Documentation
- ePrescription Dispensing
- Stock Management
- Supply Chain Management
Such systems / software can use the Flat Files Package for creating Masters for active ingredients, dose forms, generic medicines, branded medicines, suppliers, etc., and provide their own data such as batch code, price, data of purchase/sale, package form, patient, etc. to create their own solutions with common drug codes to interoperate with other applications in the digital ecosystem.
The package provides a Tab Separated Values in text files and covers codes for Substances, Trade or Brand Name, Supplier, Drug Forms, Generic Medicines and Branded Medicines.
Common Drug Codes for India (Flat Files Package) is available for use under terms provided in License.txt file included in the Package
3. Drug Information Service Bundle (DISB)
Drug Information Service Bundle (DISB) is a software providing a set of restful services to receive information about substances, generics, and branded medicines present in the Common Drug Codes for India released by National Resource Centre for EHR Standards (NRCeS) at Centre for Development of Advanced Computing (C-DAC), Pune.
The software can be useful in receiving additional reference / knowledge about the drugs in various usage scenarios.
The DISB enables clinicians, pharmacists and researchers to find out relevant information about the medicines and substances. It can also help health IT implementors in building decision support systems that can generate alerts about adverse reactions and allergies of medication. DISB will be distributed in synchronization with Common Drug Codes for India.
Drug Information Service Bundle is available for use under terms provided in License.txt file included in the Package.
On March 11, 2020, the World Health Organization declared the Coronavirus disease (COVID-19) outbreak, as a public health emergency of international concern. The health systems globally are continuing their efforts to manage the outbreak.
Pandemic outbreak such as Coronavirus outbreak can create huge challenges for the Government and Public Health Officials to capture, store, refer, exchange of clinical information at different location and analyze collected information.
India COVID-19 Extension for SNOMED CT enables standardized coding of essential clinical information for managing COVID-19, enable linkages to terminology and use in application/system for Clinical Documentation, Data Retrieval, Data Exchange, Data Analytics, Reporting, etc. in India.
The extension contains total 50 terms covering finding, procedure and physical object directly related to COVID-19 plus core concept for COVID-19 module.Release Note (986KB)
Geographical location being one of the essential element of demographic information, it is important to record the location of patients, practitioners, organizations, and healthcare services in a standardized way to ensure interoperability.
India Geographical Location Extension for SNOMED CT, available as part of Clinical Terminology, facilitates standardized coding of regions of India including states/UTs, districts, and sub-districts.
This extension contains 7628 concepts for geographical location in India and 4 core concept modules along with the simple map reference set to the Local Government Directory (LGD) codes.
Release Note (927KB)
Country like India where most of the population speak and understand their local languages, it is required to convey some of the medical information from the health records such as directions on prescription, consultation notes, and discharge summary to the patients in the language understood by them. SNOMED CT being the multilingual clinical terminology, can be extended to support multiple synonyms in multiple languages for use in Electronic Health Record (EHR).
This release provides the patient instruction terms in Hindi and covers frequency of dose, route of administration, does units, and dose instructions that are generally given in the Prescriptions.
Release Note (210KB)
India Reference Sets for SNOMED CT includes following 30 Simple Refsets covering common diseases under National Public Health Programs and Medical Specialty / Department-wise refsets. Administrative procedures are not included in the refsets.
| Refsets for National Programs
for Disease Control
|Refsets for Specialty or Department|
2. Cervical Cancer
3. Childhood Diarrhea
5. Iodine deficiency
7. Lymphatic filariasis
9. Oral Cancer
10. Pregnancy related Anemia
2. Cardiothoracic and Vascular Surgery
5. Fetal Medicine
7. General Surgery
12. Obstetrics and Gynecology
The Reference Sets can be used effectively by both public and the private sectors in health information systems.
The India Reference Sets for SNOMED CT are available to Affiliate Licensees to download through Member Licensing and Distribution Service (MLDS).Release Note (764KB)