An IHTSDO perspective for
CIMI/SHN on information modeling
and terminology activities
David Markwell
Head of Implementation & Education
IHTSDO
International Health Terminology
Standards Development Organisation
Changes in IHTSDO
 New CEO Don Sweete
 “IHTSDO is open for business”
 Key focus on Customers – the 26 Members of IHTSDO
 More internal capacity reduced external dependencies
Implementation & Education
 Staff
 David Markwell
 Linda Bird
 Tom Seabury
 SNOMED CT Implementation Advisor Scheme
 Six people on 2014 SIA Scheme
 Eleven people went through SIA scheme in 2012 & 2013
 In 2014 main focus of Implementation & Education
 Information models, analytics, terminology binding & expressions
 Adoption, adaption and sharing of subsets
 Represented as Simple Refsets
 Need for descriptive data about sharable resources
 Online education
 Presentations and skills assessments
Useful EHR systems don’t just display raw data, they also
deliver derived knowledge about the current situation
A record of the full history of moves
in a chess game may not help a
player choose his next move
1. d4 Nf6
2. c4 g6
3. Nc3 Bg7
4. e4 d6
5. Be2 e5
6. dxe5 dxe5
7. Qxd8 Kxd8
8. f4 Nfd7
9. Nf3 c6
10. O-O exf4
11. Bxf4 f6
12. Rad1 Ke8
13. e5 fxe5
14. Bg3 Nc5
15. Bxe5 Bxe5
16. Nxe5 Be6
17. b4 Ncd7
18. Nf3 Ke7
19. Ng5 Nf8
20. Nxe6 Nxe6
21. Bg4 Nd7
22. Rde1 Ndf8
23. Ne4 Nd8
24. Nc5 Kd6
25. Rf6 Kc7
26. Re7 Kb8
27. Rxb7
… but , a chess board view derived
from that record of moves makes
the current situation understandable
Geographic knowledge linkage

A map, a satellite view, crime
statistics, photographs, local
restaurants
Linked knowledge in action

Longitude and latitude provide a common
reference model for geographic information that we
now take for granted
Journey
log
Route
selection
Driving
Drive times
Latitude
&
Longitude
Inference
Road
conditions
Route advice and
local information
Knowledge
Satellite
mapping
A common coordinate system
for navigating the knowledge cycle
EHR
Data Entry
Patient Care
Aggregation
SNOMED CT
Repositories
Inference
Decision Support
Knowledge
Research
Recognising interdependencies

Practical consequences of interdependency between terminology
and structural information models are often underestimated

Information models cannot be terminology neutral
 SNOMED CT implementation is dependent on tight integration with
standard information models

Developers of clinical terminologies and clinical information models
should adopt policies that facilitate ‘dependency aware evolution’ of
their contributions
There must be collaborative development
between the SNOMED CT Concept Model
and an information model in order for
effective implementation of SNOMED CT
IHTSDO Concept Model
Special Interest Group April 2008
www.ihtsdo.org
8
How many bridges?
How many bridge building techniques?
IHTSDO … open for business on information
models and terminology binding
 Information modelling and terminology binding is on the
IHTSDO work plan for 2014
 Additional strength in the team
 Linda Bird joining as Implementation Specialist
 + several SIAs with relevant skills and experience
 but …
 Which group(s) to work with and how
Puzzling questions for IHTSDO!
 Who to work with?
 How many groups to work with?
 Which model/pattern representations? (prefer ONE)
 Which representation of terminology components?
 Precoordination – one code
 Postcoordinated expressions
 Postcoordination in models
 How much of the model interests IHTSDO?
 Terminology of course … but also structural elements impact semantics
… where are the boundaries
 Very little interest in demographics
There are big mountains to climb …
What our customers need
 What do IHTSDO Members need?
 Meeting immediate needs
 Simplification without compromise
 What are the clinical use cases?
 Many and varied but they follow several common patterns
 What are the vendor drivers?
 Need scalable implementation approach
 Growth of market plus … retention or growth of market share
 Improvement of SNOMED CT while avoiding disruptive change
 Stepwise implementation from simplistic code use to rich
semantics
 An accessible base-camp and a route towards a summit
Resources for your interest
▪
SNOMED CT Starter Guide … not just for beginners … a great refresher
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www.snomed.org/starterguide_gb.pdf (A4 GB English)
www.snomed.org/starterguide.pdf (US Letter US English)
SNOMED CT Challenge (online test).
▪
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How well do you know SNOMED CT?
www.snomed.org/challenge
SNOMED CT In Use … example of use … add ones you know about
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www.snomedinaction.org
SNOMED CT Browsers … a list of browsers
▪
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www.snomed.org/browsers
SNOMED CT URI Specification
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IHTSDO Public Consultation on SNOMED CT URI Standard
http://www.ihtsdo.org/news/news-article/article/ihtsdo-public-consultation-on-snomedct-uri-standard/
IHTSDO’s own tools in development (Open Tooling Framework)
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OTF development - http://ihtsdo.github.io/
Browser - http://browser.ihtsdotools.org
API documentation
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Mapping - http://mapping.snomedtools.org/mapping-rest/index.html
Query Module - http://api.snomedtools.com/otf/
SNOMED CT Showcase – Amsterdam 30-31 October
▪
– CALL FOR PAPERS (2nd May)
Is there a pot
of gold ?
Questions?
 Contact: dma@ihtsdo.org
 Web site: www.ihtsdo.org