Transcript The International Health Terminology Standards Development

The International Health
Terminology Standards
Development Organisation
A Perspective by the Potential
Charter Members
Professor Martin Severs
Conference Thought
“Minds are like parachutes they only
function when open”
–Thomas Dewar
I am going to be very open but it
should be noted we are in a state of
negotiation and rapid change so
some of the details or labels may
change
Who are the Potential Charter
Members?
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Australia
Canada
Denmark
Lithuania
New Zealand
United Kingdom
United States
• Plus ongoing
discussions with two
other countries who
are as yet undecided
What is going on now?
Potential
Charter
Members
[PCMs]
College
American
Pathologists
[CAP]
A Group of Countries have got together with
the intent of purchasing SNOMED CT from
College of American Pathologists [CAP]
What is going on now?
CAP
PCMs
Own
Manage &
Support the
SNOMED
portfolio
IP & IPR
Support
Requirements
New Legal Entity
Fair Share
Funding
mechanism
The PCMS have had to specify:
What Intellectual Property &IPR they
wish to purchase
What is required to support it
What type of organisation is needed to
run it
How to fund the operation
What is going on now?
CAP
PCMs
IP & IPR
Support
Requirements
New Legal Entity
Negotiation [Current]
Own
Manage &
Support the
SNOMED
portfolio
What may happen?
CAP
International
Health
Terminology
SDO
Own Manage &
Support the
NON- SNOMED
CT portfolio
SNOMED CT
IP & IPR
CAP Support Service
Supply a Support
Service
SDO Managed Support Services
New Technical Infrastructure
Potential result of
successful negotiation
Open Market
Derivative Products
SNOMED Enterprise
Components
SNOMED CT
International
Release
[Core]
National
Extensions
& Releases
Open
Market
Works
What is the SNOMED
Terminology? (1)
• Documents describing the SNOMED CT
standard(s) [specification(s)]
• The terminology database consisting of:
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–
–
–
Concepts
Descriptions
Relationships
Attributes
• A set of specified technical tools for supporting
development and request processing
What is the SNOMED
Terminology? (2)
• A set of SNOMED allied standards, which
enable SNOMED to effectively
interoperate with and/or map to, other
international information standards
• Includes implementation standards for the
successful use of SNOMED including:
– Translations
– Reference implementation instructions
Why are we doing this?
• More costly develop alternative [$25-50m]
• Delay the e-health agenda by developing an
alternative [<5 years]
• Vendor costs would increase with multiple
standards
• Avoid huge cost of data migration later
[$28B]
• Avoid patient safety risks from data
migration [both deaths and injury]
Why are we doing this?
Commercial Benefits
• Costs are minimal (compared to an Electronic
Patient Record System ~ $100s of millions)
• Charges are affordable and shared, and based
on the ability to pay
• Charges reduce as new Members join OR
greater investment in improvement
• The investment risks are significantly reduced
• Protect Healthcare IT investment now
Why are we doing this?
Improved Governance
Enhanced Contribution
• Validated Product
• Sustainable Model
• Shared Ownership
• Code of Conduct
• Localisation Support
• Simple Licensing
• Global Collaboration
• Vendor Engagement
• Compatible with Other
Standards
• Clear and transparent
management processes
Why are we doing this?
• Validated Product BUT it needs to be better
• Leading Global Terminology from independent
assessment [Problems noted]
• Most ready for Local Implementation
• $100 million already invested in SNOMED CT [let
us build on the intellectual & financial resources]
Three Principle Drivers
• Purpose
– Support clinical care of patients internationally
– Primary and secondary purposes
• Integrity
– Ensure clinical, organisational and technical integrity
• Funding
– Stable and secure governance structure
– Financial sustainability
What is intended to be included?
• SNOMED CT and its allied standards with
their artefacts and associated Intellectual
Property and Intellectual Property Rights
• Inclusions are based on Two Tests
– Content necessary for international
conformance and interoperability
– Standards and policies required to maintain
the principles
What is intended to be included?
• A set of requirements with products and
performance metrics delivered through:
– A set of services to be delivered by CAP over
3-5 years
• Would include some contract/license migration
– A set of services to be delivered by the
• SDO or
• SDO subcontractor or
• National Release Centres
How is it Governed and Managed?
• Legal Entity is hoped to be a Danish
Society
• ‘Not for Profit’ type organisation, but has
an unusual name ‘Commercial Society’
• The legal entity holds liability not the
Members of it
• Described in its Articles of Association
which will be published and open
• Registered in Denmark
Global Membership
Global Outlook
Europe
The Americas
Africa and the Asia and Oceania
Middle East
SDO Structure
GENERAL ASSEMBLY
Harmonisation
Boards
Management Board
Vendor Forum
Content
Committee
Technical
Committee
Research &
Innovation
Committee
Finance &
Operations
Committee
Working
Groups
Working
Groups
Research
Teams
Task & Finish
Groups
SDO Structure
GENERAL ASSEMBLY
Harmonisation
Boards
Content
Committee
Management Board
Technical
Committee
Research &
Innovation
Committee
Vendor Forum
Finance &
Operations
Committee
The financial framework ends above the line i.e. WG’s will normally NOT be funded
Working
Groups
Working
Groups
Research
Teams
Task & Finish
Groups
New SNOMED Enterprise
Model
National
Release
Centre
National
Release
Centre
SNOMED
SDO
National
Release
Centre
National
Release
Centre
Shared technology environment enables collaboration
Local/National
Health Entities
Membership and Licenses
• Member [Countries]
– Governments or their responsible agencies
– Access by ALL citizens and users within the
jurisdiction
– Charter Members have Management Board Rights
until 2011
• Vendor License
– Required in non-member states when SCT is used for
money generating activities
– Additional benefits
• Affiliate License
– Required in non-member states when SCT is required
for R&D, interest, etc [postage and package fee]
Emergent Phenomena
• PCMs
– View of a standard is the specification, the software
product and its implementation guidance: All need to
be kept in alignment in real time. Maintenance is key
– Want to see increasingly specific requirements and
performance metrics
– Explicit balloted and endorsed production process
standards
– Perceive the quality of the terminology as important
as the quality of the finances
Emergent Phenomena
• PCMs
– Are contemplating both internal and external
quality processes; external could
• Assess the extent of the quality processes
• Adherence to the quality process
• Recommend actions for the future
– Are aware of real world tensions between
contribution and alignment, innovation and
consolidation, systemic desirability and
practical feasibility
Emergent Phenomena
• There needs to be the purchase of a new
technical infrastructure over the next 5
years starting as soon as possible
• The capacity in terminology competencies
and related subjects needs to be improved
• Accreditation of organisations and
certification of individuals may need to be
considered
Conclusion
• We will uphold the principles of the endeavour
• We are committed as 7 countries to work
together and with any other willing partners to
make SNOMED CT and its Allied Standards:
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–
–
–
Available
Accessible
Open to
Valued by
• Patients, Clinicians, Health Informaticians, Policy
Leads, Managers & Vendors across the world
Please wish us well!