School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria, Australia.
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
J Am Med Inform Assoc. 2023 Oct 19;30(11):1762-1772. doi: 10.1093/jamia/ocad153.
Climate change, an underlying risk driver of natural disasters, threatens the environmental sustainability, planetary health, and sustainable development goals. Incorporating disaster-related health impacts into electronic health records helps to comprehend their impact on populations, clinicians, and healthcare systems. This study aims to: (1) map the United Nations Office for Disaster Risk Reduction and International Science Council (UNDRR-ISC) Hazard Information Profiles to SNOMED CT International, a clinical terminology used by clinicians, to manage patients and provide healthcare services; and (2) to determine the extent of clinical terminologies available to capture disaster-related events.
Concepts related to disasters were extracted from the UNDRR-ISC's Hazard Information Profiles and mapped to a health terminology using a procedural framework for standardized clinical terminology mapping. The mapping process involved evaluating candidate matches and creating a final list of matches to determine concept coverage.
A total of 226 disaster hazard concepts were identified to adversely impact human health. Chemical and biological disaster hazard concepts had better representation than meteorological, hydrological, extraterrestrial, geohazards, environmental, technical, and societal hazard concepts in SNOMED CT. Heatwave, drought, and geographically unique disaster hazards were not found in SNOMED CT.
To enhance clinical reporting of disaster hazards and climate-sensitive health outcomes, the poorly represented and missing concepts in SNOMED CT must be included. Documenting the impacts of climate change on public health using standardized clinical terminology provides the necessary real time data to capture climate-sensitive outcomes. These data are crucial for building climate-resilient healthcare systems, enhanced public health disaster responses and workflows, tracking individual health outcomes, supporting disaster risk reduction modeling, and aiding in disaster preparedness, response, and recovery efforts.
气候变化是自然灾害的一个潜在风险驱动因素，它威胁着环境可持续性、地球健康和可持续发展目标。将与灾害相关的健康影响纳入电子健康记录有助于了解其对人群、临床医生和医疗保健系统的影响。本研究旨在：(1) 将联合国减少灾害风险办公室和国际科学理事会(UNDRR-ISC)的灾害信息档案映射到 SNOMED CT International，这是临床医生用于管理患者和提供医疗服务的临床术语；(2) 确定可用的临床术语来捕捉与灾害相关的事件的程度。
从 UNDRR-ISC 的灾害信息档案中提取与灾害相关的概念，并使用标准化临床术语映射的程序框架将其映射到健康术语。映射过程涉及评估候选匹配项，并创建最终匹配项列表，以确定概念的覆盖范围。
确定了 226 个对人类健康产生不利影响的灾害危害概念。在 SNOMED CT 中，化学和生物灾害危害概念的代表性优于气象、水文、天体、地质灾害、环境、技术和社会灾害概念。热浪、干旱和具有地理独特性的灾害危害在 SNOMED CT 中没有找到。
为了增强对灾害危害和气候敏感型健康结果的临床报告，必须纳入 SNOMED CT 中代表性差和缺失的概念。使用标准化临床术语记录气候变化对公共卫生的影响提供了捕获气候敏感型结果所需的实时数据。这些数据对于构建具有气候弹性的医疗保健系统、增强公共卫生灾害应对和工作流程、跟踪个人健康结果、支持灾害风险降低建模以及帮助灾害准备、应对和恢复工作至关重要。
