Canadian SNOMED CT Strategy October 2012 Draft

Content 1 Background Approach Current State Future State Considerations Action Plan

Background Infoway – strategic investor of projects to contribute to the electronic health record initiatives across Canada Standards Collaborative – (national release centre for Canada), develops and maintains standards and provides support for implementers A stakeholder governance framework is in place “Knowing is Better” campaign Several SNOMED CT strategies have been developed – challenges included — Funding for the strategy unclear or not available — Lack of “buy in” — Got stuck on the barriers 2

Background Interest in SNOMED CT had increased dramatically; The following initiatives are using or planning for SNOMED CT Use: Diagnostic Imaging Project Wait Times Project e-referrals project Problem list Successfully delivering SNOMED CT education and training, including custom education sessions Over 3000 requests for changes received this year so far, mainly new concepts 3 Microorganisms Order Sets Cancer Synoptic Surgery Public Health Surveillance

Approach 4 Vision: Over the next three years Infoway will demonstrate the value of the SNOMED CT enabled, structured health record as a care and health system management tool.

Current State – High Level A Current State exercise was done for the following areas: Internal Scan Tools, Terminology Services, Operations, Engagement International Outreach Past Strategy Work Jurisdictional Interviews Value proposition is not well understood or articulated — It is unclear when to use SNOMED CT, why it should be used and what benefits can be achieved Products and services either do not exist or do not effectively meet client needs to facilitate adoption SNOMED CT is perceived as being difficult to adopt and overly complex 5

Future State* Clear understanding of the value proposition and business case for SNOMED CT for high priority stakeholders — Knowledge of when, where, how and why to use SNOMED CT — Converting today’s paper chart paradigm into electronic form is not sufficient to achieve currently targeted benefits. — a compelling value argument for the country to move to SNOMED CT. if we demonstrate that structured & coded data will not only move health care to be patient focussed but also allow for data driven patient care decisions, then this will re invigorate how health care is delivered. Client focused services to support SNOMED CT adoption and bring value to stakeholders — Suite of easily consumable SNOMED CT product (such as Ref Sets), tools, education products — Easy access to SNOMED CT experts (SC and jurisdictional/non-SC) — Operational model that effectively supports stakeholder needs — Increased capacity of resources to support adoption in Canada SNOMED CT adopted using various and pragmatic approaches in a cost effective and straightforward manner — Supporting health system driven projects is key to adoption and to realizing value. 6 * Assumes Future state is 3 years out.

Future State Objectives SNOMED CT Adoption plans in place by a minimum of two priority jurisdictions — Jurisdictional leverage is used to influence vendors to include SNOMED CT in their solutions — Benefits such as interoperability between solutions and ability to perform analytics can be realized in the future. A comprehensive suite of SNOMED CT adoption tools, products and services is being used by our clients — Benefits such as ease of implementation and increased understanding and awareness have been realized. 7

Future State Objectives The SNOMED CT value proposition is articulated by key influencers across domains and settings. — SNOMED CT Success Stories are published that include the benefits — SNOMED CT is adopted in solutions that demonstrate how it can be used to support interoperability and analytics Partnerships are realized with three organizations that further the adoption of SNOMED CT — align support activities to project needs Build capacity and increase knowledge of SNOMED CT through improved communication and education 8

Future State Tactics The following five tactics will enable the team to meet the future state objectives: 1.Develop a SNOMED CT adoption plan in partnership with priority jurisdictions 2.Define what a client service focused terminology service is and execute a plan to get there 3.Execute an end to end terminology tooling service, both internally and to support external stakeholders 4.Develop an engagement plan that focuses partnering with other organizations for success 5.Develop and execute a communications plan targeting priority stakeholders to aggressively market the value proposition of SNOMED CT 9

Future State Vision – SNOMED CT Support Service Achieving this vision will require the following to occur over the next 6 months: Operationalizing a new business model focusing on client service Renaming of terminology service to SNOMED CT Support Services Realizing seamless cross-business unit participation Ensuring appropriate resources are in place to deliver on the plan 10

Shift to Client Focused Approach 11 Committed Clients Products services and tools are developed to meet needs Determine what further value can be achieved Ease of adoption is realized Products, services and tools are available to meet client requirements Understand client requirements Understand who clients are Get clear understanding client needs Understand landscape and limitations Provide options for feedback Commit to responding and delivering Welcome critical comments Ensure that issues are resolved Measure performance Implement process and remove barriers to providing good service Keep up to date on the industry news

Future State – SNOMED CT Support Service SNOMED CT Support Services will provide the following services: 12 Implementation support Education and training Adoption planning Requests for change Client Services Core SNOMED CT terminology and pan-Canadian extension IHTSDO influence and liaison Licensing and agreements Product Support Implement, operate and ongoing management of internal and external SNOMED CT tools and tooling support Tooling Support Ref Set development support Access and support of tools Access to standards including existing Ref Sets

Future State – Action Plan 13 Implementation Support Education and Training RFCs Limited access and support of tools Access to Standards Core SNOMED CT IHTSDO Influence and liaison Licensing and Agreements Limited tooling available Pan-Canadian Extension Enhanced tooling available internally and externally Fully operational Suite of tools available internally and externally CurrentYear 1Year 2 Adoption Planning Ref set development support Enhanced education and training Access to Ref Sets Increased access to tools

Key Enablers for Success The following are key enablers for success: Commitment from external clients to further vision Internal and external financial resources to realize vision Communications planning and support Strong client engagement at all levels of internal and external organizations Buy-in and participation from all relevant business units Commitment ongoing operational support 14

Shifts in Priorities In order to realize the Future State; certain priorities of the terminology team will need to shift; the following is a list of activities that can potentially be deemed lower priority: — Development of net new Ref Sets – adoption and development of Ref Sets will be driven by implementers — In-house customization of tooling – as much as possible off the shelf and outsourced tools will be used — Participation of terminology team on committees with questionable value 15