Semantic Mapping of German Nursing Diagnoses in SNOMED CT: Risks and Challenges

Stud Health Technol Inform. 2026 May 7:335:147-152. doi: 10.3233/SHTI260073.

Abstract

Background: Nursing diagnoses and interventions are essential components of clinical documentation and patient-centered care, yet nursing data in German-speaking healthcare settings are commonly documented using local terminologies.

Objectives: This paper aims to analyze translation- and modeling-related challenges when mapping German nursing diagnoses to SNOMED CT.

Methods: Nursing diagnoses from the DiZiMa® catalog were translated and mapped to SNOMED CT using a structured semantic mapping approach. Two large language models (ChatGPT and Microsoft Copilot) were used in parallel to support translation, guided by established principles of scientific translation.

Results: While 98.6% of the diagnoses could be mapped to SNOMED CT, 27.2% showed semantic precision loss, particularly for risk diagnoses and context-dependent nursing concepts, often requiring postcoordination, or remaining unmapped (1.4%).

Conclusion: Semantic interoperability of nursing data requires more than direct translation or simple 1:1 mapping, highlighting the need for nursing-specific modeling strategies.

Keywords: Electronic health records; Nursing data; Nursing informatics; SNOMED CT; Semantic interoperability; Terminology mapping.

MeSH terms

  • Electronic Health Records*
  • Germany
  • Humans
  • Large Language Models
  • Nursing Diagnosis*
  • Nursing Records*
  • Semantics*
  • Standardized Nursing Terminology*
  • Systematized Nomenclature of Medicine*
  • Translating