SNOMED Cross-Walk Development Meeting July 12 - 13, 2016 National Harbor, MD

Background – What is SNOMED CT? Systematized Nomenclature of Medicine - Clinical Terms Provides for consistent information interchange and is fundamental to an interoperable EHR Becoming the gold standard for documenting diagnoses, procedures, and other clinical information to allow for the shift towards value Value Sets are a subset of SNOMED CT codes developed to help with implementation

Background – Why Now? SNOMED CT codes will be used for documentation in the Enhanced MTM Model Test (EMTM) CMS foreshadowed in the 2017 Final Call Letter that SNOMED CT codes will be forthcoming Success requires consensus on consistent and standardized definitions for the industry that describe pharmacists’ patient care process and recognition of Value Sets used to code for those services

Short Term Goals Elevate and engage individual organizations to finalize their own internal MTM services/interventions/ activities mapping to SNOMED CT Describe MTM Services and obtain consensus for clinical/MTM term definitions Reconcile where use of SNOMED CT codes: Align Do Not Align Gaps

Longer Term Goals Develop a consensus-based, standardized framework to report meaningful MTM data Promote interoperability and improved efficiencies in analyzing data pertaining to MTM Provide an ongoing process for refining the standardized framework as MTM services evolve over time

Participants – 33 Stakeholder Organizations

MTM Terms to Define Medication Therapy Management Medication Therapy Interventions Pharmaceutical Care Medication Therapy Problems Adverse Medication Reaction/Event Medication Care Plan Medication Goals Adherence/Compliance Medication Action Plan Targeted Medication Review (TMR) Medication Education/Counseling Medication Reconciliation Medication Synchronization Comprehensive Medication Review (CMR) Personal Medication Record Medication Therapy Recommendations

Value Set Gaps Participants identified 179 gaps in the draft Value Sets that were addressed by the PHIT Collaborative as follows: 17 SNOMED CT codes we added to existing Value Sets 42 SNOMED CT codes were added to new Value Sets that were created 44 SNOMED CT codes already existed in Value Sets and were duplicates 4 SNOMED CT code requests are considered “pre-coordinated” 20 SNOMED CT code requests do not exist and must be requested through the National Library of Medicine 49 SNOMED CT code requests require additional information or clarification prior to proceeding.

Draft Consensus Recommendations and Next Steps Consensus recommendations under review by participant organizations until August 5, 2016 Public comment period August 15 - September 16 Provide CMS with initial recommendations by October 2016

JCPP Organizations: The Ask Review and comment on draft proceedings Disseminate proceedings during public comment period to pertinent stakeholders Support recommendations when finalized Show support to CMS on the need to use consensus definitions Show support to CMS on accepting the PHIT Collaborative Value Sets Continue to support the process of refining definitions and Value Sets as the practice of pharmacy evolves