1. SNOMED CT Vendor Introduction 27 th October 2014 11:30 (CET) Implementation Special Interest Group Tom Seabury IHTSDO

2. ▪ Vendor Introduction: Purpose ▪informative practical introduction to SNOMED CT focused primarily on the needs of EHR vendors and developers ▪Companion to Starter Guide, National Release Center Guide ▪ Audience ▪Providers of EHR systems and related services ▪ Brief: July 2014 ▪Leading officer, Committee: I&E ▪ Current draft ▪13 chapters ▪56 pages ▪23 figures Introduction … people engaged in provision of EHR systems and related services. The document will also be of interest to a broader audience including anyone engaged in designing, developing, procuring, deploying, configuring or managing EHR systems and services. As the word vendor suggests, the primary focus of this document is commercial vendors of products and services but most of its content is equally applicable to not-for-profit enterprises and in-house developers of EHR systems and services.

3. ▪ Document draft held on I&E Committee document store ▪Shared with Implementation SIG attendees ▪This version is not in its review cycle ▪Changes will occur: as a subsequent draft ▪Link: https://csfe.aceworkspace.net/sf/go/doc11052https://csfe.aceworkspace.net/sf/go/doc11052 Draft document access Please submit review comments using the online feedback form: http://goo.gl/forms/NtQJQt5mT9 Comments on this version close 23-October-2014 http://goo.gl/forms/NtQJQt5mT9

4. ▪ Lead officer, Committee: I&E ▪ First informal review: ▪I&E Committee 22 nd September 2014 ▪ Amended in response to informal review comments ▪ First formal review cycle I&E, Tech Committees ▪Initiated 1 st October 2014 ▪Closed 23 rd October 2014 Development

5. ▪ Draft document ▪13 chapters ▪56 pages ▪23 figures Currently

6. Chapters Table of Contents 1.Introduction 2.Benefits to Vendors: why implement SNOMED CT 3.Key characteristics of SNOMED CT 4.Accessing SNOMED CT and related IHTSDO services 5.Using SNOMED CT with other standards 6.User experience of SNOMED CT 7.Implementation Strategies 8.Choosing an approach to Implementation 9.SNOMED CT Services 10.EHR design for use with SNOMED CT 11.Customization Extensions and configuration 12.Licensing 13.References

7. Selected highlights 2.Benefits to Vendors: why implement SNOMED CT

8. ▪ Staged implementation ▪ Relationships and Dependencies ▪ Territories and Languages, language and dialect strategies ▪ Variations around a Basic Configuration – provision of tools and services ▪ Measures of implementation success ▪ Factors which influence implementation success Selected highlights

9. 8.Choosing an approach to Implementation Figure 10 Schematic illustration of an EHR system

10. Selected highlights 8.Choosing an approach to Implementation

11. ▪ Target Configurations 1 SNOMED CT as a Reference Terminology for Communication 2 SNOMED CT as an indexing system for data retrieval 3 SNOMED CT as a code system for clinical data in the EHR 4 SNOMED CT as an Interface Terminology for EHR data entry 5 SNOMED CT as a dictionary for simple aggregation and analysis of data 6 SNOMED CT as a dictionary for analytics using Description Logic 7 SNOMED CT as a dictionary of rules for Knowledge Linkage 8 SNOMED CT as an Extensible Foundation for Representing Clinical Data 9 Full use of SNOMED CT to deliver all its powerful features in an EHR Choosing an approach to Implementation

12. ▪ Concept identification – unique and persistent ▪ Descriptions and terms ▪ Comprehensive and granular ▪ SNOMED CT expressions ▪ Logical representation of meaning ▪ Meaning based retrieval ▪ Subsets of concepts or descriptions ▪ Mapping to and from other code systems ▪ Extension mechanism ▪ Standard release format with built in versioning ▪ Continuous improvement ▪ Guiding principles for content addition Key characteristics of SNOMED CT

13. ▪ Reviewing SNOMED CT content ▪ Using SNOMED CT for data entry and analysis ▪ Obtaining SNOMED CT release files ▪ Documentation ▪ Education ▪ Tools and Services ▪ Requests for changes and additions Accessing SNOMED CT and related IHTSDO services

14. ▪ World Health Organization classifications: ICD-10 ▪ LOINC (Logical Observation Identifiers Names and Codes) ▪ Clinical Information Modelling Initiative (CIMI) ▪ HL7 message standards, CDA and FHIR Using SNOMED CT with other standards

15. ▪ Include SNOMED CT data within the clinical records storage schema ▪ Mapping from existing data entry templates or message templates to a SNOMED CT equivalent ▪ Introduction of SNOMED CT into the suite of data entry tools ▪ Propagating SNOMED CT changes as part of scheduled product maintenance ▪ Introducing SNOMED CT into the payload of electronic messages ▪ Migrating clinical records between systems in bulk ▪ Replicating existing reports or other outputs but with SNOMED CT EHR design for use with SNOMED CT

16. ▪ Terminology service options ▪ Import, store and update SNOMED CT from release files ▪ General factors applicable to services ▪ Basic services ▪ Search services ▪ Mapping services SNOMED CT Services

17. Further Questions?

18. 10.EHR design for use with SNOMED CT Include SNOMED CT data within the clinical records storage schema Mapping from existing data entry templates or message templates to a SNOMED CT equivalent Introduction of SNOMED CT into the suite of data entry tools Propagating SNOMED CT changes as part of scheduled product maintenance Introducing SNOMED CT into the payload of electronic messages Migrating clinical records between systems in bulk Replicating existing reports or other outputs but with SNOMED CT 11.Customization Extensions and configuration Drug Extensions Localization of descriptions: Language and dialect preferences Localization of derivatives Queries Ownership 12.Licensing 13.References