please read and contribute to peer discussion  

Peer 1: SNOMED CT is the global clinical terminology that adds processable meaning to an Electronic Health Record. Enabling effective, meaningful representation of clinical information plays a pivotal role in worldwide endeavors to deliver cost-effective, high-quality healthcare. SNOMED CT is a valuable component of the EHR. It has been developed and validated by clinical, technical, and terminological experts. Realization of its potential benefits depends on the implementation, deployment, and practical use. Throughout the world dedicated health professionals work hard to provide high-quality care to a growing population with an ever-wider range of health needs. Despite these best efforts, avoidable deaths and injuries occur, as busy practitioners miss key information about their patients or overlook evolving standards of best practice. The use of an Electronic Health Record (EHR) is a significant step forward. It improves communication and increases the availability of relevant information. Moving from paper to electronic documents is only part of the solution. The remaining challenge is to identify and link key facts in oceans of relevant data. A clinically validated, semantically rich, controlled terminology, like SNOMED CT, helps to make an EHR meaningful. Using SNOMED CT to represent clinical information allows meaning-based retrieval of information. A SNOMED CT-enabled EHR can be used to identify key facts, presenting opportunities to reduce the risks of errors of omission or commission. As a global enterprise, maintained by an international collaborative effort, SNOMED CT offers a vendor-neutral resource. As the clinical terminology of choice for EHR systems throughout the world, SNOMED CT is increasingly being used to link clinical knowledge in ways that contribute to the quality, consistency, and safety of healthcare delivery. (SNOMED CT – Adding Value to Electronic Health Records, 2014).  SNOMED CT is superior to ICD-10 for clinical representations due to its controlled focus on clinical concepts and multi-axial structure. While ICD-10 is designed as a hierarchical statistical classification system, SNOMED CT is represented by multiple levels of granularity. Some of these levels include:

Body Structure

Clinical Finding


Peer 2: SNOMED-CT (Systematized Nomenclature of Medicine – Clinical Terms) is utilized in electronic healthcare records to create accessible, high-quality clinical content. It provides a systematic approach to representing clinical terminology that doctors capture and also supports automated interpretation. The major goal of SNOMED-CT is to encode meanings that are used in health information to supplement meaningful clinical data recording to improve care (Miarro-Giménez et al., 2017). The appropriate use of SNOMED-CT can benefit individual patients and doctors, the public, and enhance evidence-based healthcare.

In a clinical session, SNOMED-CT allows essential clinical information to be collected using consistent and recognizable visuals. It also promotes the sharing of relevant content among those involved in the delivery of treatment to patients via recorded data, allowing conventional comprehension and analysis of clinical evidence by all clinicians (Gaudet-Blavignac et al., 2018). The method allows for accurate and comprehensive searches that identify patients who require follow-up therapy changes based on the studied guidelines.

SNOMED-CT eliminates linguistic obstacles. SNOMED-CT also allows for the early detection of emergent issues, the monitoring of a population’s health, and the response to changes in clinical practices. It also allows for targeted and accurate access to essential data, as well as a reduction in costly duplications and errors. SNOMED-CT provides for the provision of relevant data to enable research and the addition of evidence to improve future services.

Finally, this technique improves care audit by providing the option for a detailed review of clinical records in order to investigate exceptions and outliers.

SNOMED-CT improves the quality of care that individuals receive and allows for the linking of clinical information. It also improves clinical protocols and standards. SNOMED-CT also minimizes the expenses associated with duplicative and ineffective therapy and testing, as well as the frequency and severity of adverse health occurrences (Agrawal et al., 2016). Finally, SNOMED-CT improves cost-effectiveness and quality of care delivery.

In conclusion, SNOMED – CT is effective for clinicians in delivering care to patients and the population as a whole and produces cost-effective quality care.


Agrawal, A., Perl, Y., Ochs, C., & Elhanan, G. (2016). A contextual auditing method for

SNOMED CT concepts. International Journal of Data Mining and Bioinformatics, 15(4),


Gaudet-Blavignac, C., Foufi, V., Wehrli, E., & Lovis, C. (2018). Automatic annotation of French 

HCAD 640 – Discussion: Activity-Based Costing ( answer in 100 words minimum with at least 2-3 references)

Peer 3: 

Developed by Kaplan in the mid-1980s, activity based costing (ABC) is a system that has been adopted in public and private, service and managerial organizations. It is used to serve as a planning mechanism that shows the relationship between goal achievement and resource intensity when preparing budgets. (Carroll, & Lord, 2016) Activity-based costing can be used to mitigate rising costs by producing accurate and rational financial management information, and to provide information that could help managers make accurate product mix decisions. As well as product price calculations, and consumer profitability analyses.  (Carroll, & Lord, 2016) Activity-based costing can make a significant difference for the change in patient perception. For instance, gestational diabetes mellitus affects up to 10 percent pregnancies in the U.S. every year, which health systems worked on detecting as early as possible. If an organization utilizes the ABC system and apply it to a specific service line, they are able to identify patients who are at risk early, improve patient outcomes, and decrease cost overtime. (Health Catalyst Editors, 2019)

At UPMC, activity-based costing allowed their organization to better managed their population health and valued-based care systems by organizing and expanding their service lines. UPMC formed four services lines, Women’s Health, Orthopedics, Heart and Vascular, Neurology and Neurosurgery as well as other service lines. Their goal was to break down the virtual walls between the separate care locations, which helped them discover that relationship-building among service line providers from different care locations was the main objective. In order to expand their service lines and get providers to think in the same terms, each service line includes a formal structure with three specific components. 

The service team (clinicians and administrators)

The executive team ( execution operational leader and a physician leader)

The financial lead (primary contact for all financial matter) (Health Catalyst, 2016)

Incorporating the different service lines brought together practitioners across their system, which allowed them to remove the institutional barriers to effective collaboration and decision-making. When applying ABC organizations have to consider the size, clinical complexity, reimbursement models, and access to complete information. Each influences the ability for a service line to drive improvement being that every service line is not the same. After making those considerations, each decision is based on clinical indications and outcomes, and further informed by cost. With applying activity-based costing, UPMC was able to save millions within their targeted service lines. (Health Catalyst, 2016)


Carroll, N., & Lord. J. C. (2016). The Growing Importance of Cost Accounting for Hospitals. Retrieved from 

Health Catalyst Editors. (2019). Activity-Based Costing: Healthcare’s Secret to Doing More with Less. Retrieved from

Health Catalyst. (2016). Service Lines and Activity-Based Costing Reveal True Cost of Care for UPMC. Retrieved from 

Peer 4:

UPMC implemented a new activity based cost (ABC) system to aggregate clinical, operational and financial information from multiple systems within their organization in order to match supplies like blood products, equipment usage and a myriad of other clinical activities to specific patients (HealthLeaders, 2014).  The reasoning behind them adopting a new method of cost accounting was so that their data on cost and outcomes would be more transparent and precise in what they highlight as the new volume-to-value world and the new accountable care world.  UPMC chose to adopt an ABC system because these systems help health care organizations better understand their operations than conventional accounting systems, they provide more much more useful costing information than conventional systems, they provide for insightful information for process improvement, and they are better suited to controlling costs, which helps buffer against rising healthcare costs today (Lawson, 2017).

ABC has all these advantages over conventional accounting systems because ABC directly connects the actions and decisions of clinical staff to their respective costs, allowing for the accurate measurement and assessment of 100% of clinical costs (Beckers Hospital Review, 2021). This is beneficial to patients because users can exactly where and how resources are being used. For example, the use of ABC accounting lets us break costs down to their smallest units, i.e. the cost of a single minute in the operating room. This is typically a widely variable cost across different facilities because no real benchmarks are in place for the contributors to operating room costs. Using ABC, we can breakdown costs to the smallest unit, allowing us to see the percentages of direct and indirect costs and why exactly those costs are incurred. In 2014, Childers & Maggard-Gibbons (2018) broke down the average direct costs of California OR’s to wages and benefits as well as non-billable surgical supplies and indirect costs of security and parking. Using time driven ABC, Childers & Maggard-Gibbons mapped each step of a patient’s care, and the cost of each step in the smallest units possible, deriving an average OR cost per minute of $36-37. They write that data broken down in this manner is both more actionable and accurate.

In summary, ABC helps to control rising costs by accounting for 100% of clinical activity, and is beneficial to patients because they can trace the costs to each clinical activity and decision made during their care, should they request a breakdown of their healthcare costs. This alters their perception of inflated costs by allowing them to see the direct link to services they received and exactly what they were charged for. While costs are admittedly still exponentially high, this is one way to rationalize expenses incurred during treatments. Hospitals being forthcoming about cost breakdowns without being requested to however, is another issue entirely.


Beckers Hospital Review. (2021). How activity-based costing can boost hospital finances.

Childers, C. P., & Maggard-Gibbons, M. (2018). Understanding costs of care in the operating room. JAMA Surgery, 153(4), e176233.

Do you have a similar assignment and would want someone to complete it for you? Click on the ORDER NOW option to get instant services at We assure you of a well written and plagiarism free papers delivered within your specified deadline.