Key Collaboration updates Jane Millar – Collaboration Lead

Background driving collaboration/partnerships Recognition of the need for ‘bundling’ or ‘packaging’ of standards to support an interoperable solution for specific Use Cases – e.g. ISO TC 215 RSP Digital Imaging, JIC Patient Summary Standard Set Meeting the needs of different stakeholders e.g. vendors, clinicians, government agencies, statisticians, researchers Addressing requirements of different Use Cases e.g. EHR, Clinical Registries, derived data for billing, Genomics Adaptability/flexibility for different economies and stages of implementation Recognition of the need to link clinical information to supply chain and regulation for medical devices and drugs ‘End to end’ solutions – incorporating data standards, messaging, security, identification, analytics etc Therefore essential that those responsible for standards work together to produce usable products and services to avoid duplication, excessive costs and wasted time

WHO collaboration principles (1) Commitment to linkages between SNOMED CT and WHO Classifications for the benefit of Member States and other stakeholder groups Working together in development of sustainable solutions Focused on solutions which are practical and implementable, and cost-effective Openness and transparency between the two organisations and to Member States and other stakeholder groups

WHO collaboration principles (2) Sharing of knowledge and skills where there is benefit to the content, quality and processes underpinning each organisations products and services Annual joint work plans agreed and resourced appropriately by both organisations A clear governance structure providing timely and appropriate guidance and oversight of all relevant activities.

WHO collaboration benefits Better data while reducing data capture and reporting costs Improved accuracy of clinical and administrative data by standardization Re-use of clinical data for other purposes including billing, statistical, epidemiology, research Exchange of standard information in health information systems Efficient submission and response to national reporting requirements Increased quality of products via feedback from linkage development and usage By working together, offer solutions that decrease costs for members states

SNOMED International WHO related work Maps SNOMED CT to ICD-10 2016 (International) Content alignment as relevant and maps to ICD-O Content alignment with ICD-11 Mortality and Morbidity Statistics ICD-11 (MMS) – March 2017 field trial content Mapping to ICD-11 to MMS for 2018 release by WHO - - in preparation

HL7 International – 2016 agreement SNOMED CT ‘Development’ License for HL7 Affiliates in SNOMED International non-member countries Issued to HL7 France Discussion with HL7 Brazil in May 2017 Application of licencing in Art Décor (Germany based) Input to HL7 Terminology Authority policy and guidance direction when referencing SNOMED CT HL7 International progress with identifying an agreed set of SNOMED CT that can be used free in HL7 International products regardless of country of usage. Development of joint work proposal focusing on SNOMED CT binding in FHIR and CIMI for international products – currently no resources available at HL7 Input to SNOMED CT references in TermInfo Monitoring HL7 International portal to access SNOMED CT

LOINC Content work as per Content update Evaluation of Agreement with recommendations on going forward – part of review of key collaborations Work with Members to agree how to collate requirements for non-LOINC countries External Organization: 3M Health Information

GMDNA Content work reported separately Monthly feeds of new/changed GMDN content Monthly operational calls established Agreement currently being evaluated as coming up for renewal – ready to information new SNOMED International MB in July

GS1 Principles/guidance for linking SNOMED CT and GTINs Draft version published for review and feedback based on usage – 1 year Use Cases also published Next piece of work - exploration of options for technical solutions to support such linkages Ongoing - joint communications about the work

DICOM License Agreement with DICOM Agreed SNOMED CT set for use in DICOM standards Updated 6 monthly as part of agreement in line with SNOMED CT International Release Free for use internationally Subject to license and fees apply if go beyond agreed set Not a SNOMRED International refset Note that DICOM is used in 95% of digital imaging systems globally – so SNOMED CT is in use!!!!

JIC Joint Initiative on SDO Global Health Informatics Standardization Membership - CEN, CDISC, DICOM, GS1, HL7, IHE, SNOMED International, ISO + observers SNOMED International current chair, IHE incoming 2018 Patient Summary Standards Set ‘End to end’ set of standards – based on existing standards Use case Standards set with options Conformance criteria Guidance on use Free for use and not normative Taking into account epSoS, HL7 IPS, Trillium Bridge, CEN work etc.

ISO TC215 Health Informatics SNOMED International Liaison ‘A’ – can comment but not vote Review of all standards going through balloting process to identify which are of relevance Different aspects: No relevance e.g. patient identification Of interest for potential future work areas e.g. Traditional Medicine specifications Likely impact and therefore review and potentially provide comments to the ballot Need to actively influence, therefore participate in actual development work Attendance on working group calls and face to face meetings Input to strategic direction of ISO TC215

Clinical Collaborations American Dental Association (ADA) Development of General Dentistry Diagnoses subset, through International Dentistry SIG – release March 2017 Development of a SNOMED CT subset equivalent to SNODENT Development of a SNOMED CT subset for Odontogram (based on work in Norway) – release September 2017 International Council of Nurses (ICN) Maintenance and updating of equivalence tables : ICNP to SNOMED CT Nursing Diagnoses ICNP to SNOMED CT Nursing Interventions Meeting with ICN CEO March 2017 to discuss future partnership opportunities – awaiting feedback Note – based on equivalence tables for first version, producing refsets for Nursing Diagnoses and Nursing Interventions – September 2017

Clinical Collaborations Wonca – World Organisation of General Practitioners Maintenance and updating: SNOMED CT GP/FP subset – Reasons for Encounter/Health Issues SNOMED CT subset map to ICPC-2 INSERM – owners of Orphanet – Rare Diseases Addition to SNOMED CT of Orphanet concepts and provision of a linkage table. Content being added to SNOMED CT approximately 500 per release ERA-EDTA – Renal Registry Draft proposal of SNOMED CT free set for Cause of Death data item to enable linkage between SNOMED CT encoded record to registry information requirements

Further activities openEHR CDISC Letter issued requiring a SNOMED CT licence statement in all artefacts published containing SNOMED CT and reinforcing this where they are aware of usage in non-member country Situation to be reviewed in 1 year openEHR has no mechanism for monitoring download/usage in SNOMED International non-member countries Current licence is issued by UK and no requirement to report usage CDISC Currently reference SNOMED CT as a terminology for use in a number of CDISC international data products linking clinical research and EHR content Discussions re need for licence statement as per openEHR – change in personnel at CDISC delaying but imminent

Other collaboration/partnership work Updating website content for collaborations and partnerships over 2017 Q2 under direction of Head of Communications Review of Member survey content to identify any gaps This presentation does not include all organisations we are working with – contact Jane Millar at jmi@snomed.org Questions?