SNOMED International in a Global Perspective

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SNOMED International in a Global Perspective

• Kevin Donnelly
• Semantic Mining Conference
• October 3, 2006
• Copenhagen,Denmark

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Presentation

• SNOMED CT History
• Uses of SNOMED CT
• Changing Governance For SNOMED CT
• The SNOMED Enterprise
• The SNOMED SDO (Standards Development
  Organization)
• The current situation

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SNOMED

• SNOMED International
• The division of the College of American
  Pathologists responsible for maintenance and
  release of SNOMED CT
• SNOMED CT
• Releases twice yearly (January July) of the
  terminology commonly called SNOMED

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SNOMED History

• SNOP 1965 basis for ICD-O
• SNOMED 1974
• SNOMED II 1979
• SNOMED Version 3.0 1993
• SNOMED Version 3.5 1998
• SNOMED RT 2000 (Merge with UK NHS)
• SNOMED CT (SNOMED RT CTV3) 2002
• SNOMED CT Spanish Edition April 2002
• SNOMED CT German Edition - April 2003
• Free in USA - Agreement with NLM June 2003
• SNOMED SDO Proposal 2006

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Uses of SNOMED CT
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Current Use ofPrevious SNOMED Versions

• SNOMED II (1979-92)
• Used for coding by most US pathology labs, and
  many worldwide more than ten thousand users
• Migration to SNOMED CT will be driven by the
  benefits of interoperability with other HIT
  systems
• SNOMED 3.5 and 3.5m (1993-1998)
• More than a thousand users worldwide
• SNOMED RT (1999-2001)
• More than a thousand users worldwide

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SNOMED CTUsage Around the World

• Multiple sources for SNOMED CT
• Licenses issued directly by the CAP
• National licenses within the US and UK
• Sub-licenses issued by CAP-licensed vendors
• Broad range of current SNOMED CT licenses
• National licenses allowing use throughout a
  country
• Vendor implementation in commercial products
• End-user use in commercial or proprietary systems
• Individual or academic licenses for research

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Countries with SNOMED CT Users
Australia Hungary New Zealand Sweden
Austria Iceland Norway Switzerland
Belgium Iran Oman Taiwan
Canada Ireland Poland Thailand
China Israel Portugal Turkey
Denmark Italy South Korea U.A.E.
Estonia Japan Saudi Arabia United Kingdom
Finland Malaysia Singapore United States
France Namibia South Africa
Germany Netherlands Spain
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SNOMED CT in the UK

• Provides the foundation for NHS Connecting for
  Health services
• Current Project Status (as of 14 March 2006)
• 200,000 users registered for Spine access
• Electronic Prescription Services
• 525 participating physician practices
• Over 550,000 electronic prescriptions transmitted
• More than 7,600 active practice locations

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SNOMED CT in the United States

• US National Library of Medicine license
• Available at no charge to US vendors and
  end-users
• FDA mandates SNOMED CT for drug labels
• SNOMED CT required on SPL by June 2006
• Independent recommendations as a national
  standard for clinical terminology in the US
• National Committee on Vital and Health Statistics
  (NCVHS)
• Consolidated Health Informatics Initiative (CHI)

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SNOMED CT Vendor Adoption

• Software vendors are actively developing SNOMED
  CT-enabled applications
• Currently, more than 30 vendors have deployed
  SNOMED CT-enabled software systems to end-users
• More than 50 others are actively working to
  implement SNOMED CT in new or legacy systems
• At least 20 of those 50 are expected to deploy
  their systems to end users within the next 12
  months
• Overall, 53 of vendors report that they are
  using SNOMED CT in their products (AHIMA 2004)

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SNOMED CT Implementations
Cancer Registries Laboratory Info Systems
Clinical Guidelines Medical Research
Clinical Trials Nursing Systems
Decision Support Pharmaceutical Databases
Disease Surveillance Publication Indices
Electronic Health Records Radiology
Electronic Prescriptions Tissue Annotation
Hospital Mgt Systems Veterinary Medicine
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Current SNOMED CT Vendors
A-Life Medical Genelogic mTuitive
Allscripts Health Language Oracle Corporation
Apelon HealthySoft Picis
Atlas Development In Practice Systems Rxworks
Cerner iSoft Seetec
CareCom Language Computing Siemens Medical
Dictaphone McKesson Singapore Comp Systems
Egton Medical Systems McKesson Info Solns UK Soft Comp Consultants
Epic Systems Medical Info Engineering Theradoc
EvaWare Microtest Visual Read
GE Healthcare Misys Wellmed/WebMD
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Challenges Facing Software Vendors

• The most commonly cited barrier to vendor
  adoption of SNOMED CT is uncertainty about future
  standards
• Achieving interoperability is the single biggest
  priority for software vendors
• More than 50 of vendors name it as one of their
  top priorities for the next 12 months (HIMSS
  2005)

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Changing Governance For SNOMED CT
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SNOMED CT and theCollege of American Pathologists

• The CAP is the Creator of SNOMED CT
• 41 years of terminology experience
• More than 40 million invested by the CAP
• NHS collaboration to incorporate READ codes
• CAP Commitment to Establish SNOMED
• as the global leader in healthcare terminology
  for the benefit of practitioners, patients and
  users of healthcare information

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SNOMED Enterprise Components
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SNOMED Enterprise Old and New
National Centre
National Centre
National Centre
SNOMED SDO
National Centre
Current SNOMED Enterprise
National Centre
National Centre
National Centre
Open Market Activity
National Centre
National Centre
National Centre
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SNOMED Enterprise Components

• SNOMED SDO Core
• Content necessary for international conformance
  and interoperability
• Standards and policies required to maintain the
  principles of the SSDO

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SNOMED Enterprise Components

• National Extensions
• National conformance and interoperability
• Maintain the SSDO principles
• Open Market Works
• Extend the Core and national extensions
• Subject to SSDO standards and policies

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Global Membership

• Open Membership
• All potential members are welcome
• Accessible Membership
• Minimize barriers to membership
• Involved Membership
• All members must have a voice in governance

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The SNOMED SDO Proposal

• Create a Governance Structure that will
• Increase international acceptability
• Provide a stable financial foundation
• Allow SNOMED CT to achieve its potential
• The Proposed Solution
• Transfer SNOMED CT to a SNOMED Standards
  Development Organization, which will be jointly
  controlled by its member nations

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The SNOMED SDO

• An international effort to produce and enhance a
  global clinical terminology standard
• An organization supporting that effort
• A set of products and services produced by that
  organization
• Set of principles that guide decision making

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Potential Charter Member (PCM) Countries for SDO

• Australia
• Canada
• Denmark
• Lithuania
• New Zealand
• United Kingdom
• United States

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Current Position

• Potential Charter Membership of 8 countries with
  another 2 making decisions in Fall 2006
• Ongoing discussions with several other interested
  countries
• Ongoing discussions within European Community
• WHO Role continues to be evaluated
• Momentum for SDO continues to build

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The Systemized Nomenclature of Medicine SNOMED
Clinical Terms (SNOMED CT)

• Contact us
• SNOMED International 325 Waukegan Road
  Northfield, IL 60093-2750 Phone [phone]
  ext. 7700
• E-mail snomed_at_cap.org
• Web site http//snomed.org