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The dm+d is a dictionary containing unique identifiers and associated textual descriptions for medicines and medical devices.

It has been developed for use throughout the NHS (in hospitals, primary care and the community) as a means of uniquely identifying the specific medicines or devices used in the diagnosis or treatment of patients.

The dm+d will become the NHS standard for medicines and device identification, enabling clinical system interoperability between diverse clinical systems by ensuring safe and reliable exchange of information on medicines and devices and allow effective decision support through linkage of data.

Improving Patient Safety is at the heart of all of the NHS IT initiatives being driven forward by Government. It is estimated that medication errors cost the NHS about £500 million per year in additional days spent in hospital. The National Patient Safety Agency (NPSA) has emphasised the importance of 'designing solutions that prevent harm'. Electronic prescribing and improved computer prescribing and dispensing systems have a vital part to play in reducing medication errors and transcription errors by providing clear, unambiguous, timely information.

These technical developments underpin the overall NHS Quality and Safety Agenda. The dm+d will contribute to the wider benefits to patients and healthcare professionals through the provision of consistent textual descriptors and codes for prescribing and dispensing leading to safer systems (less prescribing and dispensing errors). Further benefits will follow as links with the coding and bar coding systems used in the Supply Chain are developed.

Until now there has been no common, standardised vocabulary for clinical products. This situation does not allow interoperability between diverse clinical systems, or allow effective decision support through linkage of data. The case for change is driven at a strategic level by the need to underpin and support key national initiatives by providing a unique and unambiguous identifier.

Links to Snomed CT

The history of the development of the NHS Dictionary of Medicines and Devices (dm+d) required that a stand alone entity be produced to allow implementation in systems independent of the strategic clinical terminology solution the NHS was committed to – SNOMED Clinical Terms (SCT). However, even in taking this decision the importance of seamless integration with the SCT strategic solution was recognised and the decision to use SCT content and identifiers was made. (All unique identifiers used in dm+d are SCT codes)

Developers of clinical systems that do not need to provide users with access to clinical terms may consider the stand-alone implementation of dm+d to provide users with access to standard codes and terms for medicines and devices. It should however be recognised that proposals for increased involvement of clinicians in patient care (e.g. through access to centrally held clinical records) and the plans for widening clinical roles for users (e.g. supplementary prescriber status for nurses, pharmacists etc) may result in the need for their clinical systems to be able to receive clinical information from external sources (e.g. NCRS) and to provide clinical information to fully record the detail of their clinical interactions with patients. Where this is the case, provision of SCT may be required.

Feedback from Local Service Providers (LSP’s) and the Independent System Vendors (ISV’s) sub-contracted to the LSP’s has consistently shown that implementation of a single terminological structure would simplify the task when both dm+d and SCT are required. In response to this NHS Connecting for Health has undertaken to deliver dm+d in a SCT-like format.

At its simplest SCT is a three table terminology (Concepts, Descriptions and Relationships) designed to comply with all the principles of good terminology practice; at its simplest dm+d is a nine table dictionary designed to support the business processes of the NHS and comply with good vocabulary practice wherever possible. Translation of dm+d into SCT format (or SNOMEDisation as it may be informally called) would involve representing these nine tables in the three table SCT format.

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Last Updated ( Thursday, 12 April 2007 21:44 )  

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