What are we trying to achieve

1
What are we trying to achieve?

• Dr Grant Kelly
• NHS CFH Clinical Lead for SNOMED
• SNOMED Structured e-Records Programme
• (SSeRP)

2
An easier, safer life!

• NHS CFH is all about
• Changing from paper to e-records
• Large-scale NHS Change Management
• Nothing ever becomes simpler
• Managing/easing those changes crucial
• Changes must offer visible added value
• No clinical terminology, no added value

3
Changes

• Continuity of carer ? continuity of care
• The mobile workforce
• The mobile patient
• The complexity of conditions/patients/care
• The audited/monitored environment
• Assumes consistency of meaning
• Not inherent in e-records

4
Without clinical terminology

• In a world of shared records -
• Meaning collapses
• Audit goes
• Decision support goes
• Safety decreases
• Efficiency falls off
• Costs escalate
• Acceptance is tough

5
With a clinical terminology

• Paradise gained!
• Accuracy
• Consistency
• Reproducibility
• Clinical structure develops
• Added value prompts appear
• Trust develops
• People get on board

6
Implementing SnCT General problems

• The scale of NPfIT
• The Bleeding edge
• Greenfield and Brownfield
• The size and readiness of SnCT
• The layers of complexity in e-records
• The Ostrich
• The blame game

7
Specifically technical

• HL7 CDA messaging standard
• openEHR - pioneer archetype
• 13606 archetype ref model
• Archetypes Constrain bind
• Logical data model/Architecture
• Care Record Elements
• SNOMED
• MIM
• Terminfo (SNOMED into HL7)

8
Specifically political

• Costs
• Potential for failure
• Responsibility
• Primary vs secondary
• What is and isnt CfH
• What is and isnt NHS

9
Other specifics

• Contractual margins and installed base
• Consistency/Congruence
• The knowledge base (dmd, subsets, PbR)
• Education Training
• Buy-in
• Roll-out
• Worlds beyond the NHS

10
How do we do it?

• Display technical assurance
• Transmissibility
• Testing acceptance safety
• i.e. proof of concept and a product
• Socialise subsets
• Help Adopters
• Get the education spectrum going

11
Necessarily develops

• Agreed record keeping methods
• Record keeping standards
• A clinical architecture
• A firm structure
• A community of interest

12
SSeRP

• Function presentation
• Early adopters
• Content
• ET
• Working with
• Tech Office
• CUI

13
Were hoping for

• Understanding
• Enthusiasm
• Growing the community of interest
• Improved sharing of knowledge/skills

14
This is your future

• We want it to be easier and safer
• SSeRP is in listening mode
• Thank you