Spotlight

Irish National Release Centre leads vendors in using SNOMED CT

SNOMED International adopts and endorses the vendor specification document created by the Irish NRC

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The Irish National Release Centre, was established in November 2016 within the Office of CIO as part of the Enterprise Architecture function in collaboration with the Department of Health and HIQA. 

At the time there had been a number of policy documents including WHO Strategy 2012, eHealth Ireland Strategy 2013, and a Knowledge and Information Plan in 2015, advocating the use of SNOMED CT in systems. Following the procurement of the SNOMED licence, as the National Release Centre (NRC) was being established there were a number of key activities that needed to be decided and undertaken, as laid out by SNOMED International.

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Ireland was the 29th country to join the organisation with 6 more joining since. Some of the key decisions included establishing a Governance Board, which was established in September 2017, and meetings are held 2 monthly.

It was agreed within this Governance Board that some of the key stakeholders were the vendors/suppliers, clinicians and the technical and project teams within that HSE that were involved in delivering ICT systems.

A vendor engagement day was held in Dr Steevens Hospital Board Room  on 14th February  2018 with approximately 70 attendees all from various software companies.

The Enterprise Architecture team gave a presentation of their various work areas. There were 3 attendees from SNOMED International including the Client Relationship Manager, the Technical Lead and the Vendor Engagement manager. In the afternoon there was round table discussions where the vendor community had the opportunity to ask questions directly to the vendor engagement team, the various discussion groups were, E.H.R, Radiology, MN-CMS/MEDLis, Summary Care Record (SCR). The vendor community found the event to be very useful and wished to enquire when or where the next events would be held in this space. A survey was carried out on the day and the results are attached here.

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Problem Statement

It was identified at this event, that whilst there many approaches to how vendors would use and display SNOMED in their systems, the vendors were having to meet different requirements for every implementation and this lead to rework, and end users having varying experiences of using SNOMED in their systems. The vendors perspective was that if they had clear instructions on how to manage SNOMED in their system and that it was uniform for every system they would understand how to deliver this.

Actions Taken

The Irish NRC manager,  then undertook to do an appraisal of what other countries use for procurements, she contacted a number of other NRC’s and they were very forthcoming with some of their documents and knowledge. It became clear that there was no one document and different countries had used varying specifications for different use cases. The NRC manager, then amalgamated the various documents taking out any content that was not required for an Irish perspective and condensed this into one document.

As it happened one of the ICT projects at the time in Ireland the Acute Floor Information System (AFIS) were progressing their business case, and had asked the NRC to give input as to what procurement specification would be required for their system. The project managers co-ordinated a number of workshops with a clinicians’ involved in the project and they collaboratively along with the NRC manager, concluded the vendor specification document.

Outcome

This document, was then brought before the Governance Board for sign off and endorsement, the document was then submitted along with the procurement documentation for this project and with the National EHR business case.

SNOMED International were informed of the document in April 2019 at the London SNOMED business meetings and subsequently realised the benefit of such a document and endorsed it for use across their global community.

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Endorsement from SNOMED International

“As the clinical terminology of choice for EHR systems throughout the world, SNOMED CT is increasingly being used to improve the quality, consistency, and safety of healthcare delivery. However, SNOMED CT can be implemented in many ways, and the range of benefits that can be achieved depends on the selected approach and functionality. Therefore, successful procurement of SNOMED CT enabled systems relies on the clear documentation of specific requirements. The "Vendor Engagement Procurement Specification Document", developed by the Irish National Release Centre (NRC), provides a valuable example for other countries who wish to develop national SNOMED CT requirements to support procurers within their national context. SNOMED International plans to incorporate this document in its SNOMED CT Implementation Course to illustrate how requirements can be formulated clearly and at an appropriate level of specificity, to assist procurers in achieving positive outcomes from the SNOMED CT enabled systems they procure.”

Anne Randorff Højen | Education and Product Support Specialist SNOMED International One Kingdom Street | Paddington Central | London W2 6BD | United Kingdom