SNOMED CT and SNOMED International Ian Green Customer

SNOMED CT and SNOMED International Ian Green Customer Relations Lead, Europe and Clinical Engagement Business Manager

Agenda ▪ ▪ ▪ ▪ Overview of the landscape SNOMED CT Subsets International view International release Collaboration Education Clinical Engagement

The interoperability challenge DIFFERENT DOCUMENTS Ambulance/ Emergency services Pharmacists Specialists Patient record “I have breathing problems sometimes” “I am an asthmatic” “I have asthma attacks” “I am diagnosed with respiratory disease” Diagnostic imaging DIFFERENT FORMATS DIFFERENT TERMINOLOGY General practice Hospitals Allied health professions Pathology DIFFERENT SYSTEMS

Putting the pieces together ▪ ▪ ▪ ▪ ▪ Terminology standard (SNOMED CT) Information models Data dictionary Clinical terminologies/classifications Messaging standard Enterprise architecture Information governance Drug terminology standard Classification (ICD-10)

SNOMED CT – what is it ? ▪ ▪ Most comprehensive multilingual clinical terminology Supports high quality clinical content in health records Global effort to reach improvement Increasing number of tools and implementations ▪ Used in more than 50 countries ▪ Deployment examples: http: //snomedinaction. org/ ▪ Features ▪ Concepts enable meaning-based queries ▪ Descriptions assist searching for concepts and provide multi-lingual support ▪ Relationships support aggregation and queries

SNOMED CT Re ad ason mi ss for ion ry Family histo Allergies t Surgery tes Thera b py La ults res lan Medication are p C Diagnosis Health Records Terminology SNOMED CT Concept Body structure (body structure) Clinical finding (finding) Environment or geographical location Event (event) Observable entity (observable entity) Organism (organism) Pharmaceutical / biologic product (product) Physical force (physical force) Physical object (physical object) Procedure (procedure) Qualifier value (qualifier value) Record artifact (record artifact) Situation with explicit context (situation) SNOMED CT Model Component (metadata) Social context (social concept) Special concept (special concept) Specimen (specimen) Stages and scales (staging scale) Substance (substance) https: //browser. ihtsdotools. org/ 6

Hierarchical Structure example Procedure ▪ Subtype／supertype relationship Imaging procedure MRI procedure ▪ Poly-hierarchical structure Biopsy MRI guided biopsy ▪ A concept can have multiple parents ‘MRI guided biopsy’ has two parents 7

Clinical subsets (Refsets) ▪ What we have in place ? ▪ Dentistry ▪ Nursing ▪ General Practice/Family Practice ▪ Developing new subsets ▪ ▪ ▪ Criteria – international usage Use case requirements driven Clinical Reference Group input Maintenance considerations Governance processes

SNOMED CT - International view ▪ SNOMED International publishes a biannual release of SNOMED CT ▪ SNOMED International as an organisation, continues to grow (33 members currently) ▪ All content meets the requirement of international validity/usage ▪ All additional products (maps and reference sets) meet the requirement of clearly specified and documented use cases ▪ The product set associated with the release is continually under review, both from the point of view of new products and also reviewing the continued support for existing products based on usage

SNOMED CT International Release ▪ SNOMED CT International Release, published twice yearly (January and July) ▪ Includes additional products ▪ SNOMED CT maps to classifications ▪ E. g. SNOMED CT to ICD-10 ▪ Clinical reference sets (refsets) ▪ E. g. Nursing issues ▪ SNOMED CT editorial guidance ▪ Each release will be updated with new/changed content, based on user requests, and systematic content development ▪ The maps and reference sets are updated/aligned to the each release

Collaborations Purpose • To enable users to utilise SNOMED CT interoperably with other information standards, all have agreed joint deliverables ▪ WHO (ICD-11 MMS) ▪ Content alignment, where clinically relevant ▪ Map to ICD-11 MMS (pilot) ▪ DICOM ▪ Availability of an agreed SNOMED CT set internationally ▪ LOINC ▪ Agreement in place – provides guidance on the usage and management of both standards together ▪ HL 7 ▪ Member-led work on developing and sharing SNOMED CT bindings in FHIR ▪ ICN ▪ Focus is one way linkage table between ICNP and SNOMED CT

Education ▪ On-line learning ▪ ▪ Foundation course Implementation course Authoring course Developers pathway ▪ E-Learning Advisory Group (ELAG) ▪ Facilitates delivery of E-Learning products and services that address requirements of Members and other stakeholders. ▪ https: //www. snomed. org/participate/join-an-advisory-group/elearning-advisory-group ▪ Website ▪ https: //www. snomed. org/snomed-ct/learn-more ▪ Open Access – Availability of a number of open access educational materials ▪ https: //www. snomed. org/snomed-ct/learn-more/open-access-and-other-educational-materials ▪ Document library ▪ https: //confluence. ihtsdotools. org/display/DOC

Engaging the clinical workforces ▪ Why should we change ? ▪ Making the case for change ▪ Will it improve the quality of the care ? ▪ Will it save me time ? ▪ Will it save me money ? ▪ Clear statement of the perceived benefits of SNOMED CT and the larger move to electronic processes ▪ Empowerment - engaging with clinical communities to shape the solutions

Clinical Engagement ▪ The team ▪ ▪ ▪ Ian Green (Business Manager) Jane Miller (Collaboration Lead/Clinical Reference Groups) Dr. Charles Gutteridge (EMEA) Dr. Mike Bainbridge (Asia. Pac) Dr. Peter Hendler (Americas) ▪ Clinical Reference Groups (CRG’s) ▪ Confluence based specialty groups, facilitating discussion and development of specialty focused use case requirements ▪ Clinical Use cases ▪ Library of clinical use cases for SNOMED CT, to assist in the engagement of clinicians globally ▪ Clinical education items ▪ Development of specific educational materials aimed at clinicians and clinical groups

SNOMED CT and SNOMED International Ian Green Customer Relations Lead, Europe and Clinical Engagement Business Manager