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Building the Business Case for SNOMED CT® Promoting and Realising SNOMED CT®’s value in enabling high-performing health systems Russell Buchanan Marc Koehn A Gevity Consulting Inc. Company Building the Business Case for SNOMED CT® Promoting and Realising SNOMED CT®’s value in enabling high-performing health systems Copyright © 2014, International Health Terminology Standards Development Organisation (www.ihtsdo.org) Gordon Point Informatics Ltd. (GPi), Gevity Consulting Inc., and IHTSDO recognize all trademarks, registered trademarks and other marks as the property of their respective owners. Gordon Point Informatics Ltd. A Gevity Consulting Inc. Company (Gevity Consulting Inc. was formerly known as Global Village Consulting Inc.) #350 - 375 Water Street Vancouver, British Columbia Canada V6B 5C6 Telephone: +1-604-608-1779 www.gpinformatics.com | www.gevityinc.com ii Acknowledgments The authors would like to gratefully acknowledge a number of contributors without whose advice and support this paper would not have been possible. PROJECT STEERING COMMITTEE MEMBERS Members of the project steering committee provided overall guidance and insights throughout the project: • Liara Tutina, Customer Relations Lead (Asia Pac), IHTSDO • Vivian A. Auld, Senior Specialist for Health Data Standards, National Library of Medicine, USA • Dr. Md Khadzir Sheikh Ahmad, Deputy Director, Health informatic Centre, P&D Division, Ministry of Health, Malaysia • Kate Ebrlll, Head of National Service Operation and Management, National eHealth Transition Authority (NEHTA), Australia • Anna Adelöf, Customer Relations Lead (EMEA) , IHTSDO WORKING GROUP MEMBERS Our working group offered not only ongoing advice and reviews but also provided access to critical materials and contacts: • Liara Tutina, Customer Relations Lead (Asia Pac), IHTSDO • Dr. David Markwell, Head of Education & Implementation Facilitation, IHTSDO • Ian Green, Head of Content, IHTSDO • Pablo Orifice, Coordinador Nacional de Historia Clínica Electrónica - Programa Salud.uy en AGESIC, Uruguay • Fernando Portilla, Consultor Estándares Internacionales de Informática Médica - Programa Salud.uy en AGESIC, Uruguay • Nilesh Jain, Executive Lead - Products and Services, IHTSDO • Erika Ericsson, Programme Officer, The National Board of Health and Welfare, Sweden • Ian Arrowsmith, Chief Terminologist, Health and Social Care Information Centre, UK OTHER CONTRIBUTORS Many other stakeholders and colleagues supported the project, including the following teams and individuals: • Iqbal Sian, Project Co-ordinator, GPi / Gevity Consulting Inc. • Interviewees from the organizations profiled in Appendix A • Reviewers from NEHTA and the Swedish National Board of Health and Welfare • Gevity team members including Dr. Margaret Kennedy and Louise Brown iii Building the Business Case for SNOMED CT® Promoting and Realising SNOMED CT®’s value in enabling high-performing health systems This page intentionally left blank. iv Table of Contents EXECUTIVE SUMMARY ......................................................................................................... 9 1.0 INTRODUCTION ........................................................................................................ 13 1.1 Purpose .......................................................................................................................... 13 1.2 Background ..................................................................................................................... 13 2.0 WHY SNOMED CT? ............................................................................................... 16 2.1 A Comprehensive and Multilingual Foundation .............................................................. 16 2.2 A Controlled Vocabulary with Extensive Content Coverage ........................................... 16 2.3 A System of Formal Structured Meaning ........................................................................ 17 2.4 A Scope that is Clearly International ............................................................................... 18 2.5 A Well Connected Standard Supporting Well Connected Solutions ............................... 18 2.6 An Extendable Model ...................................................................................................... 20 2.7 A Unique Terminology Offering ...................................................................................... 20 3.0 HOW TO INSTIGATE ADOPTION & SUSTAIN MEANINGFUL USE ...................................... 22 3.1 Enable Access ................................................................................................................ 23 3.2 Develop local expertise ................................................................................................... 24 3.3 Focus on High-Value Use Cases .................................................................................... 25 3.4 Be empathetic to stakeholder needs .............................................................................. 26 3.5 Build upon a foundation of success ................................................................................ 26 4.0 UNDERSTANDING THE BENEFITS ............................................................................... 28 4.1 Clinically Validated Vocabulary ....................................................................................... 28 4.2 Improved Decision Support ............................................................................................ 29 4.3 Interoperable Information and Knowledge Resources .................................................... 30 4.4 Improved Clinical and Business Intelligence .................................................................. 32 4.5 Network Benefits ............................................................................................................. 34 5.0 QUANTIFYING THE BUSINESS CASE ........................................................................... 36 5.1 Approach ........................................................................................................................ 37 5.1.1 General ................................................................................................................... 37 5.1.2 Investment Categories ............................................................................................ 38 5.1.3 Quantifiable Benefit Categories .............................................................................. 41 5.2 A Staged View of Costs and Benefits ............................................................................. 41 5.2.1 Enabling Basic Access ............................................................................................ 45 5.2.2 Establishing Initial Localization & Adoption ............................................................ 46 5.2.3 Enabling Decision Support ...................................................................................... 46 5.2.4 Enabling Exchange of Clinical Information and/or Knowledge Resources ............. 47 5.2.5 Enabling Clinical and Business Intelligence Systems ............................................. 47 5.2.6 Expanding to Derive Deeper Network Benefits ...................................................... 48 6.0 CONCLUSION ........................................................................................................... 49 APPENDIX A IMPLEMENTATION PROJECT PROFILES ........................................................ 50 APPENDIX B C-KM - PUTTING CLINICAL INFORMATION TO WORK .................................... 71 APPENDIX C SNOMED CT ADOPTION MATURITY MODEL .............................................. 84 APPENDIX D COST AND BENEFIT QUANTIFICATION METHODS .......................................... 95 APPENDIX E GLOSSARY ............................................................................................. 128 v Building the Business Case for SNOMED CT® Promoting and Realising SNOMED CT®’s value in enabling high-performing health systems APPENDIX F REFERENCES & READING LIST ................................................................. 130 vi List of Figures Figure 1: SNOMED CT Concept - Bacterial pneumonia (http://browser.ihtsdotools.org/) .......... 17 Figure 2: Staged Benefit and Cost Packages ............................................................................. 42 Figure 4: Core Capabilities of a Computerized Patient Record (CPR) System .......................... 74 Figure 3: Gartner 5-Generation Model ....................................................................................... 74 Figure 5: SNOMED CT enabled C-KM cycle .............................................................................. 77 Figure 6: C-KM Processes, Roles and SNOMED CT Facets ..................................................... 78 Figure 7: C-KM Flow Example .................................................................................................... 80 Figure 8: Benefits of Effective Knowledge Management ............................................................ 81 Figure 9: SNOMED CT Adoption Model ..................................................................................... 85 List of Tables Table 1: Implementation Stages and OOM Benefit Quantification ............................................. 10 Table 2: Investment Categories and Cost Components ............................................................. 38 Table 3: Quantifiable Benefit Categories ...................................................................................
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