1. Management Report
Quarter 4
31st December 2016

2. Table of Contents The Management Report for Quarter 4 includes:
Executive Summary
KPI Scorecard
SNOMED CT Reach, Usage and Composition

3. Executive Summary Introduction Summary of Q4 Activities
Quarter four of 2016 was as busy as the previous three quarters and the team was able to successfully complete 56 (89%) of the planned work items. A number of highlights are included in the Executive Summary but this list is by no means exhaustive. The updates by the lines of business and the Work Plan update included in this report provide further details of the progress that has been made by the IHTSDO team. The KPI Scorecard, SNOMED CT information and Risk sections of the report provide additional information to complete the picture.
Summary of Q4 Activities
The Content and Mapping team concluded Q4 with 100% remediation of all assigned KPI’s which included 4 different pattern reconciliations and well as 5 metrics for the Content Request Service Level Agreement. The CT program also added a graduate and 2 re-certifications in Q4. The October conference also concluded with successful presentations of the IHTSDO and UKTC Map collaboration as well as various meetings which progressed initiatives.
The CSRM team has been active on a number of fronts including planning for the on-boarding of Norway and Ireland as our newest Members. Planning also has been ongoing for a significant presence at HIMSS in the US this year. The presence will include a booth and a full program of presenters. A request for services went out to engage a Genomics expert to assist IHTSDO/SNOMED International with a strategy for the Genomics area. A proposal for a new framework for the SIGs has been developed and will go to the MB in January. The CSRM team has been working with the technical area to introduce Managed Service to Members and secure customers in this area. We have also had membership interest from the Ukraine, Sri Lanka and renewed interest from Brazil.

4. Executive Summary (continued)
The Education and Product Support team has increased course capacity to completely remove the application backlogs for the Implementation and Content courses. It has also completed the migration and restructuring of the TIG and other product support documents. Furthermore, it has published two new product support guides for review - the Practical Guide to Reference Sets and Decision Support with SNOMED CT.
The Technical Services team has now completed the Workbench Replacement Program with updates to the Authoring Platform transitioning to a scheduled maintenance releases. The first release of Template Based Batch Authoring (Iteration 1) was released on schedule on 15th December and work is underway for Iteration 2. The Content Request Service had a new deployment after user feedback, and the Refset & Translation tool has some new features which are currently being tested. The team has also updated the Disaster Recovery plan, implemented two factor authentication and conducted security penetration testing of our external facing web sites.
The Head Office functions of Communications, Corporate Services, Finance and HR have supported the organization throughout the quarter. As well as ensuring all the daily, weekly and monthly processes are operated to agreed schedules, these teams have been focused on ensuring that everything was organized for the October conference. One key area of focus has been the Relocation Project, and we are pleased to report that the General Assembly passed all the resolutions enabling the Danish entity to be liquidated and its assets to be transferred to the UK entity effective 31st December. Our Head of Human Resources has been working closely with lines of business to ensure staff development and training activities have been completed.

5. Executive Summary (continued)
Key Performance Indicators (KPIs) - we reported against 30 active KPIs this quarter for the Management Board. We achieved the specified target for 20 out of the 30 KPIs (67% success rate) compared to 19 in Q2 (63%). However, it must be highlighted that two of the Education and Product Support KPIs require further review as the targets for Course Fulfillment cannot be achieved due to the length of the application approval process and course intake dates. There are also two KPIs for Finance, Net Operating Position and Affiliate License Income, which are annual measures as they are dependent on the full year financial results. The quarterly results for these measures are distorted by time lags in expenditure and income. It is worth noting that the Work Plan RAG (Red/Amber/Green) status is currently showing 89% of work items are on track to be completed by 31st December.
SNOMED CT Reach - quarter 4 results show 48,390 SCT Browser sessions, an increase of 17% from the previous quarter. The highest hit rate originated in the US with 16,745 sessions.
SNOMED CT Licensed Use licenses have been issued directly by IHTSDO to Affiliates in non-Member countries. 367 of these licenses are from our relationships with Cerner and Phillips. The remaining 59 licenses have originated from requests via our licensing tool, MLDS. A number of our Members also use the MLDS tool to manage the Affiliates in their countries.
SNOMED CT Composition - no change to the Composition information until the next six-monthly release.

6. Executive Summary (continued)
Risk - The Management Team continues to review existing risks and identify and evaluate new risks on an ongoing basis. At the end of Quarter 4, 31 risks are active on the Risk Register, representing a 7% increase compared to the previous quarter. A mitigation strategy is in place for 30 out of the 31 risks. Four risks exist with a status of “very high” and 7 with a status of “high.” A total of 35 risks have been treated and closed since the JIRA risk system was introduced in 2014.
Looking ahead
Quarter 4 is the last trading period for the Danish entity. As of 31st December the entity has been liquidated and all its assets transferred to the newly incorporated UK entity. During 2017 legal counsel will work towards transferring all trademarks from the Danish entity to the UK entity. Once all of the trademarks have been transferred, the Danish entity will be fully dissolved. A liquidator has been appointed and will be responsible for ensuring all liquidation activities are completed in accordance with Danish law.

7. KPI Scorecard
2016 Q4

8. Key Performance Indicators
Quarter 1 (31st March 2017)
Member Satisfaction
Member Survey
Target: 90%
Actual:
Customer Service
Query Resolution
Target: 90%
Actual:
Education
Course Fulfillment
Target: 100%
Actual:
96%
94%
100%
Content
Avg. # of New Concepts Available for Release Quarterly
Target: 1,625
Actual:
Content
Content Requests Completed
Target: 90%
Actual:
Technical Services
Tooling Uptime
Target: 99.9%
Actual:
2,521
99%
99.4%
30 out of 31 Active KPIs met in Q4 (20 met in Q3 2016)

9. SNOMED CT Reach
Browser Sessions
Country
Sessions
United States
16,745
United Kingdom
5,777
India
3,082
Spain
2,664
Sweden
2,036
Canada
1,725
Belgium
1,455
Argentina
1,269
New Zealand
1,018
Australia
1,002
Netherlands
896
Germany
789
Denmark
676
China
640
Brazil
621
During the quarter there were 48,390 browser sessions compared to 41,330 the previous quarter, an increase of 17%. The highlighted countries are those who did not appeared in the previous iteration of this list.

10. SNOMED CT Licensed Use
(MLDS usage including some Members)
Country
Affiliates
India
180
Sweden
168
Belgium
148
New Zealand 94
Chile 90
Portugal 52
Switzerland 35
Denmark 26
Uruguay 23
United Kingdom 10
Germany 9
Australia 7
Ireland 6
Korea, South
United States 4
This shows licensed affiliates from non-member countries and those members using MLDS.
(map shows all the countries with registered affiliates)