1. National Clinical Terminology & Information Service Terminology Update
Hi,
Quick update on what’s happening at the NCTIS
National Clinical Terminology & Information Service
Terminology Update
Margaret Prichard – Product Manager Terminology

2. Detailed Clinical Models SNOMED CT
Overview
Submission process
Detailed Clinical Models
SNOMED CT
ICD10
LOINC
Australian Medicines Terminology (AMT)
Resources
Touch briefly on the following

3. Within terminology scope? Overlap existing terminology?
Submission Process
Add, modify concepts, descriptions & relationships
Within terminology scope?
Overlap existing terminology?
National & International relevance?
Clinical relevance?
Should you be working on an implementation and there is a requirement of additions, modification, new concepts, or descriptions of either AMT or SNOMED CT-AU then you can submit a request
First part of the process our TAs go through is evaluation and they will ask these sorts of questions.
Following this if they feel it is more of international relevance for example, the request will be given up (in the case of SNOMED CT) to IHTSDO for consideration for inclusion
Otherwise it will be reviewed and if appropriate modelled here

4. NCTIS Secure Site – Request Submission (Licence holders)
Submission Process
Add, modify concepts, descriptions & relationships
NCTIS Secure Site – Request Submission (Licence holders)
NCTIS Service Desk
There are two ways that you can currently make a submission,

5. Detailed Clinical Models SNOMED CT
Overview
Submission process
Detailed Clinical Models
SNOMED CT
ICD10
LOINC
Australian Medicines Terminology (AMT)
Resources

6. Detailed Clinical Model (DCM)
Clinical information models + terminology integration enable semantic interoperability
Library of reusable “building blocks” from which specific solutions constructed
Discharge, referral, health summary
I just wanted to touch briefly DCMs as their development is currently our focus because of the requirements for the pcehr
Our current SNOMED CT-AU work is directly related to building the reference sets that support these clinical models.
Currently we have worked on discharge, referral and health summary

7. Detailed Clinical Model (DCM)
This is just a simple representation of a DCM.
The DCMs we are developing are maximal so that they will be able to be used in a diverse range of settings

8. Artefact Process Archetypes / Templates CDA Mappings DCM
Implementation
Archetypes / Templates
DCM
Structured Content Specifications (eHRs & DCMs)
Terminology Reference sets
CDA Mappings
Binding of the
Reference Sets
This is high level view of the artefacts that are part of the process of binding the SNOMED CT-AU reference sets that we created to the DCMs which then inturn are part of the Structured content specifications.
Robyn would be happy to explain this is greater details if anyone is interested?

9. DCM Development Process
NEHTA Detailed Clinical Models (DCM) Library
Constraints
Tools
Governance
Discharge
Medication
Adverse
Reactions
Problems/
Diagnosis
Pathology
Imaging
Family Hx
Social
Clinical
Synopsis
Requested
Services
Referral
Medications
Adverse Reactions
Problem/Diagnosis
Family History
Social History
Lifestyle/Risk Factors
Diagnostic Imaging
Clinical Synopsis
Requested Services
Recommendations
Health Summary
Specialist Letter
So as I mentioned before the DCMs are the building blocks or library components that we can now use to form the structured content specifications such as discharge, etc.

10. Scalable Approach to Generating Coded Data
Minimising the change
Stability of components
Reduce Standards Australia iterations & System Change
Scalability & reuse
Many use cases

11. Detailed Clinical Models SNOMED CT
Overview
Submission process
Detailed Clinical Models
SNOMED CT
ICD10
LOINC
Australian Medicines Terminology (AMT)
Resources

12. Classification maps
ICD10
Semi-automated coding of ICD -10 classification data from a clinical record which is clinically encoded in SNOMED CT
I just wanted to touch on briefly a couple of international work items that are underway.
Firstly the mapping of ICD10.
IHTSDO is working on this project with some assistance from member nations.
The current scope of this project is to be able to support a semi-automated coding of icd 10 from a clinical record which has been encoded with SNOMED Ct

13. Classification maps
ICD10
IHTSDO and WHO are developing a map from SNOMED CT to ICD-10
Map will support epidemiological, statistical and reporting requirements
Phase 1
9,500 SNOMED-CT concepts
based on the US National Library of Medicine core problem list

14. Classification maps Phase 2 Map an additional 110,000
ICD10
Phase 2
Map an additional 110,000
Plan for a preview release September 2011

15. Other code sets
LOINC
IHTSDO have consulted with member nations and have a positive response to moving ahead with a collaboration with LOINC

16. Detailed Clinical Models SNOMED CT
Overview
Submission process
Detailed Clinical Models
SNOMED CT
ICD10
LOINC
Australian Medicines Terminology (AMT)
Resources
I know today’s focus was around SNOMED but I wanted to give those who aren’t familiar with AMT a quick overview and also give you an update on the work plan

17. AMT 2007 - 2011 Dec 2007 – First national release
Apr 2009 – AMT Support Group formed
Nov 2009 – v3 model nationally agreed
Nov First state based implementation achieved

18. AMT 2007 - 2011 Feb 2011 – v3 alpha release to limited audience
Mar First reference sets released (RF2)
Aug 2011 – v3 (beta) in development
Dec 2007 – Jul 2011 – Monthly releases

19. AMT Strengths Unique identification Standardised representation
Model review – simplified v3
Persistent
National / across healthcare setting
Strong clinical development team
Interoperable
Possible links to other codes
Internationally aligned

20. AMT Plan Not achieved implementation expectations
Provide 3 Year plan and approach
Set expectations for Year 1
Collaboratively decide on Year plan

21. AMT Implementation Plan
Mapping
Compliance and Conformance
Governance and Support
AMT information Architecture
AMT Implementation Guide
AMT v2 to v3 Migration Plan
AMT v3 in RF2 Format
NCTIS Release Cycle and Versioning
AMP Technical Specification
Reference Implementations
AMT Mapping Policy
Guide to mapping of Terminology for Australian e-health
AMT Conformity Assessment – Mapping Implementations
AMT Conformity Assessment – Native Implementations
AMT Licensing Agreement
AMT Governance Model
AMT Service Level Agreement
NEHTA AMT Work plan 21

22. Phased Approach
Phase 1: Short-term future state resulting in single implementation date of July 2012
Long-term future state: delivering future releases of AMT for implementation from July 2013 (Phase 2) and July 2014 (Phase 3)

23. Phase 1 – July 2012 Mapping AMT Early adopters
PCEHR Wave 1 & 2 Implementations e-health sites
ETP specifications
e-Health Summaries

25. Phase 1 Implementation Plan

26. DRAFT AMT Implementation Maturity

27. What’s next Pause AMT releases until December 2011
Finalise & publish implementation plan
Release mapping guidelines
Release of v3 Beta & production
Escalate continued consultation for phase 2 & 3

28. Detailed Clinical Models SNOMED CT
Overview
Submission process
Detailed Clinical Models
SNOMED CT
ICD10
LOINC
Australian Medicines Terminology (AMT)
Resources

29. Resources SNOMED CT-AU and AMT release documentation
Tools –listed on eHealth Collaborate site
Education videos – YouTube
> Connecting Australia > Terminology & Information > Education Resources