1. Key Collaboration updates
Jane Millar – Collaboration Lead

2. 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

3. 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

4. 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.

5. 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

6. SNOMED International WHO related work
Maps SNOMED CT to ICD (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

7. 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

8. 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

9. 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

10. 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

11. 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!!!!

12. 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.

13. 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

14. 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

15. 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

16. 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

17. 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
Questions?