1. Working Together to Advance Terminology Tooling Presentation to OHT Board, Birmingham Jennifer Zelmer & Karen Gibson

2. The Vision  To enhance the health of human-kind by facilitating better health information management  To contribute to improved delivery of care by clinical and social care professions  To facilitate the accurate sharing of clinical and related health information, and the semantic interoperability of health records 2

3. Just some of the challenges...  What is the patient’s problem list?  Is a new drug safe to prescribe?  What are the latest test results?  Is recommended preventive care due?  How long are patients waiting?  Are there emerging patterns in infectious disease outbreaks?

4. 4 Achieving the Vision will require  A globally co-ordinated effort  Agreement on a core Terminology for recording and sharing of health information  Pooling of resources to share the costs and benefits relating to the development and maintenance of the Terminology Products  Consistent promotion of the uptake and correct use of the Terminology  Active harmonization activity with other SDOs

5. What is SNOMED CT?  Systematized Nomenclature of Medicine Clinical Terms® (SNOMED CT)  A comprehensive clinical terminology covering diseases, clinical findings, and procedures  Represents the meaning of concepts using formal definitions  Helps to structure and computerize health records allowing for a consistent way of indexing, storing, retrieving and aggregating clinical data

6. To a clinician, these are related. But what about to a computer?  Myocardial infarction  Myocardial infarct  MI  AMI  Heart attack  Infarction of heart  Cardiac infarction ...

7. Enabling decision support: An Example  Influenza vaccination reminder  decision support program criterion:  chronic cardiorespiratory disorders  patient record:  mild persistent asthma 7

8. How big is SNOMED CT?  More than 310,000 concept codes  About 800,000 active terms (descriptions)  More than 1.3 million active defining relationships  Scale is a major issue in developing, using and maintaining the terminology … and we expect growth in use, in localization, in translation, etc. 8

9. IHTSDO Provides a New Organizing Structure  Strong and effective international governance  Broader participation and use  New ways to access and influence SNOMED CT  User-driven priorities for progress  Active discussions with potential new members & users – others always welcome!

10. Terminology core to effective capture, use and exchange of health information...... With tooling a key

11. OHT Charter Project: SNOMED CT Tooling

12. SNOMED CT Tooling Project  Goal: Provide 2nd generation tools to develop, maintain, promote and enable the uptake and correct use of SNOMED CT in health systems around the world  Enable fast and efficient development of SNOMED CT content  Provide tools to support uptake and implementation  Provide tools to facilitate and encourage the encoding of EHRs  Encapsulate best practice in the implementation of SNOMED CT  Initial sponsors: IHTSDO, NEHTA, NHS  First focus on SNOMED CT Modular Workbench

13. SNOMED CT Modular Workbench  Need for progress on a technical infrastructure to support the needs of IHTSDO and its members identified as a priority  Founded on technical architecture established by IHTSDO Technical Committee and more detailed specifications developed by Working Groups and others

14. Technical Architecture

15. Workbench Guiding Principles  Role based - an individual signs on in a particular role;  Secure - the role is used by the various applications on the bench to control user behaviour;  Context aware - various applications “know” what objects the user is working with and to what ends;  Session aware – the ability to pick up exactly where one left off;  Distributed - objects and the applications deployed both centrally and locally  Collaborative - the ability for authorised users to work together  Published Interfaces – open architecture encouraged but will assess offerings on their merits; expectation of published interfaces.

17. Rollout  Agreement between OHT and IHTSDO to work together  Prior Information Notice – already issued  RFP/RFI – issued early July; closing end of August  Initial evaluation – September  Interested parties’ meeting – October

18. Working Together to Make Progress  Joint Steering Committee  Roles of OHT  Key enabler of the process (e.g. posting and distributing the Prior Information Notice and RFP/RFI, liaison with bidders)  Contribute expertise in technical issues  Roles of IHTSDO  Authority and ultimate decision-maker  Overall project coordination, led by Duncan McNeil  Engaging Members and others in the Community of Practice  Contribute expertise in terminology and technical solutions

19. The Journey Ahead...