Working Together to Advance Terminology Tooling

Presentation to OHT Board, Birmingham

Jennifer Zelmer & Karen Gibson

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

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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?

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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

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

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 ...

Enabling decision support: An Example

Influenza vaccination reminder

decision support program criterion: chronic cardiorespiratory disorders

patient record: mild persistent asthma

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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.

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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!

Terminology core to effective capture, use and exchange of health information...

... With tooling a key

OHT Charter Project: SNOMED CT Tooling

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

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

Technical Architecture

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.

Single Sign On, Role Based Access, Context Management, Session ManagementAccess

Control

Directory

Services

Workflow

Repositories

Editor Translator Mapper

Document Manager Audit

Publish &Subscribe

Document Generator Quality

Knowledge Accessor

Other & Future Services

Import & Export

SNOMED CT MODULAR WORKBENCH

CONCEPTUAL ARCHITECTURE

RefSetManager

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

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

The Journey Ahead ...