1. SNOMED CT IN LITHUANIA Arvydas Laurinavičius EuroRecTallinn, 20100618 VILNIUS UNIVERSITYNATIONAL CENTRE OF PATHOLOGY

2. SNOMED CT in LT Why (we got it)? How (we got involved)? Plans and achievements

3. WHY? Need for consistency and maintenance Need for comprehensive medical terminology Need for semantic interoperability of e-health systems SNOMED CT

4. Costing Groups Classifications Exchange Formats Data Specifications Terminologies Relevant information standards

5. Lithuanian E-Health Strategy: Technical and Semantic Interoperability mainly based on: ICD-10 SNOMED CT HL7 v.3 DICOM

6. IT STARTED IN 2003…

7. US Secretary of Health Thompson on SNOMED CT… “It will be free because we want you to use it.” July 1, 2003

8. Vilnius, Oct 2003

9. © 2002 College of American Pathologists SNOMED CT Systematized Nomenclature of Medicine Clinical Terms Vilnius, Lithuania October 28, 2003 Frank Elevitch, MD, Chair, SNOMED International Authority Frank Elevitch, MD, Chair, SNOMED International Authority Polius Raslavičius, MD, Past President, College of American Pathologists Polius Raslavičius, MD, Past President, College of American Pathologists

10. Vilnius, Oct 2003

11. New York, June 2006

12. http://www.ihtsdo.org/ IHTSDO established, March 2007

13. X 2011-2012

14. NATIONAL CENTRE OF PATHOLOGY SNOMED CT National Release Centre

15. Our 3-years experience in the IHTSDO LT – small, non-English, modest resource Does not feel like that –Team spirit and democracy –Sensitive culture It is more than just SNOMED CT –Networking with national HIT organisations –Sharing resources –Joint harmonization effort We (can) get more than (can) contribute

17. From our perspective, IHTSDO: Pro-active with other organisations Clear priority for implementation IHTSDO Workbench 2009 IHTSDO Translation Tool 2010 Member Exchange Initiative 2010

18. TRANSLATION

19. Pilot translation timeline Approval for funding: 06 2008 Tender for translation tool: 09 2008 Tender for translation: 09 2008 Training from CAP STS, CARECOM: 09 2008 Translation methodology drafted: 11 2008 Subset selection: 11 2008 Translation accomplished: 12 2008 Translation review: 02 2009

20. Pilot translation 2008

21. Pilot Translation – Subsets Selected 3 top levels of SNOMED CT hierarchy - 361 concepts CAP eCancer Checklists – 2,176 concepts Anatomic Pathology Procedures - 766 concepts Specimen unsatisfactory for evaluation - 21 concept Echocardiography - 28 concepts

22. Translation Workflow

23. SNOMED CT LT, HealthTerm

24. Pilot Translation Outcomes DK, CA and SE experience studied Translation methodology developed Persons trained: 4+5 Concepts translated: 3,352

25. IMPLEMENTATION

26. LIFE-CYCLE OF IMPLEMENTATION IMPLEMENTATION-DRIVEN TRANSLATION

27. IHTSDO SNOMED CT for Pathology

28. IHTSDO Unsatisactory Sample

29. PAP Test – Unsatisf Sample Rpt LT EN

30. Potential Implementation Priorities Problem list Procedures Pathology and Laboratory Medicine Pharmacy Patient Safety Cancer prevention programs

31. Cervical Cancer Prevention System – A Concept NPF CRCR PCC 25-60 yr women PAP, HISTO Query PAP- Woman Invitation (A) Confirm (B) Invitation (B) PATHO PAP HISTO GYNGYN BIOPSY PAP+ Query PAP+ PAP+ Public Info 80% 100%

32. LT Efforts and Issues E-Health Program being reviewed 2010 Translation of 50,000 SNOMED CT 2011-2012 Implementation-driven translation – think of ROI Need competence More resource Synergize with international implementation efforts

33. www.vpc.lt lauar@vpc.lt