1. SNOMED CT implementation, the national picture Royal College of Paediatrics and Child Health April 14 th 2016 1 Presented by Ian Arrowsmith (ian.arrowsmith@hscic.gov.uk)

2. NHS Informatics Strategy (England) National Information Board (NIB) Published Personalised Health and Care 2020 - A Framework for Action Endorses the move to adopt a single clinical terminology – SNOMED CT – to support direct management of care. Actively collaborate to ensure that all primary care systems adopt SNOMED CT by the end of December 2016. And the entire health system should adopt SNOMED CT by April 2020. During this time, we must also work with local authorities to understand and address the implications of this for social care.

3. Drivers for SNOMED CT Single terminology for the precise, unambiguous representation of clinical information in patient records Enables effective interchange of clinical data across all healthcare sectors supporting shared care Supports improved functionality of clinical systems including decision support, care pathways, outcome comparisons ‘Richer’ data available for analysis from information captured by clinicians at source in the patient record

4. Historical perspective For many years the only currencies for national analysis from secondary care (and mental health) has been classification or dataset codes Most coding was within the PAS system or dedicated bespoke departmental systems Local analysis may have also made use of ‘local’ codes In primary and community care the various versions of the Read codes have been in use for many years Other than for mandatory reporting there has been no national standardisation of coding – certainly with regard to patient clinical records/notes There was little coded communication across sectors

5. Evolution Electronic health records are becoming more prevalent in more sectors (especially secondary care) Inter-organisational information flows are becoming more important Growing recognition that coding of the direct care clinical process will allow greater opportunities for analysis or other machine driven processes (e.g. decision support) Recognition that coded content should be more useful in describing care and in driving the clinical process The requirements for reporting/secondary uses remain as compelling as ever

6. SNOMED CT adoption Live in: Cerner Millennium Lorenzo Rio MediTech Allscripts EPIC (and others) Summary Care Record e-Referral Electronic Prescription Service

7. SNOMED CT implementation support Support care provider organisations in their adoption of SNOMED CT  Requirements for system procurements  Providing guidance on local configuration options and support tools  Assisting analysis of SNOMED CT coded data  Provide hands-on consultancy for first of type/best of breed systems Support system suppliers in their adoption of SNOMED CT  Provide design guidance and clear specifications for common use cases  Identify problem areas of adoption and devising scalable solutions  Assist with migration issues from legacy or bespoke coding systems

8. SNOMED CT implementation support Provide guidance for developers of national interoperability standards on the optimal use of SNOMED CT  Contribute to multiple cross-cutting standards design decisions  Provide guidance on use in archetypes and information models  Provide guidance on use for associated Academy of Medical Royal Colleges approved headings Provide guidance for developers of statutory national reporting on the optimal use of SNOMED CT  Provide guidance on what fields to code with SNOMED CT  Provide guidance on the use of mapping tables to national classifications, particularly in outpatients departments

9. ‘Transfer of Care’ Programme All GP systems to be using SNOMED. GP payments through HSCIC SNOMED driven Primary Care SNOMED CT Project Parallel Projects ITK DTS/MESH GPSoC – CDA Reciept ITK TMS CDA Send Q3 2017 Q2 2017 Q1 2017 Q4 2016 Q3 2016 Q2 2016 Q4 2015 Q3 2015 Q2 2015 Q1 2016 eDischarge No paper, no fax eDischarge – AoMRC Headings NHS Standard Contract Structured Message delivered over MESH / TMS or Document Repository Nationwide delivery eDischarge – AoMRC Headings + **SNOMED Diagnosis, Procedures, Allergies, Meds eDischarge – Long View

10. SNOMED CT implementation support Provide support for specifications for the development of new outcome-based commissioning and payment mechanisms in care  Feeding into design phase to make maximum use of existing patient level data on for interventions and outcomes. Provide comprehensive range of education and training resources for all communities of interest Other Activities :  Content development (Request Portal available)  Benefits realisation – extend range of case studies  Engagement with national care professional bodies  Guide Standardisation Committee for Care Information (SCCI) on use of SNOMED CT in all information standards, data collections and data extractions

11. Why SNOMED CT An overview Brochure Finding out more… Leeds A&E Department Moorfields Eye Hospital Rotherham Foundation Trust University Hospitals Morecambe Bay Barts Health Case Studies from someone using it for real Introduction to SNOMED CT Finding Content in SNOMED CT Clinical Data Analysis SNOMED CT Webinars Browsers for SNOMED CT data On-line Browser How do I view SNOMED CT content? Email: snomedtraining@nhs.netsnomedtraining@nhs.net Discussion Groups: NHS NetworksNHS Networks Where Can I ask questions? ON HSCIC TRUD UKTC Education and Training Resources eLearning Resources to help develop an understanding of SNOMED CT UKTC website: http://systems.hscic.gov.uk/data/uktc/traininghttp://systems.hscic.gov.uk/data/uktc/training NHS Networks: SNOMED CT NHS NetworkSNOMED CT NHS Network

12. Any Questions