Helping Members & Prospective Members Build the Business Case for SNOMED CT. Project Report

Transcription

1 Helping Members & Prospective Members Build the Business Case for SNOMED CT Project Report

2 Overview Project Genesis Project Approach Delivered Result

3 Members and prospective members are seeking materials to support the development of Business Cases to help sustain and expand their investments in SNOMED CT to drive health system improvements PROJECT GENESIS

4 Project Genesis The Need Perennial pressures on health IT budgets drive the need for strong justification of specific investments, particularly those made at a national level Members and prospective members often need to explain the benefit of their investments in SNOMED CT in both qualitative and quantitative terms The Opportunity A project was undertaken by Canada Health Infoway (the Canadian ehealth accelerator) in 2012 to build an internal analysis of the costs and benefits for broad, nation-wide SNOMED CT adoption. That project used a variety of techniques to project the potential value of SNOMED CT, particularly as a foundational tool to drive health care innovation and improvement. The opportunity emerged to leverage the team which undertook that work in order to develop a generic tool

5 A collaborative journey to develop a document which explains and quantifies the potential of SNOMED CT to unlock deeper value of Electronic Health Record investments PROJECT APPROACH

6 Project Approach Mission, People, and Engagement Gordon Point Informatics Ltd. (now Gevity Consulting Inc. as a result of a merger and subsequent name change) was engaged to: Provide the IHTSDO and its members with tools to understand and communicate the benefits of adopting SNOMED CT within electronic health records systems and, in turn, to evaluate the potential returns to be realized from investments in IHTSDO membership as well as in developing (or procuring) products and services to enable local adoption. Stakeholder Engagement A steering committee and working group were struck to oversee and provide input to the external consulting team. A series of SNOMED CT implementers were also engaged in interviews. People Gevity Project Team Steering Committee Working Ggroup Russell Buchanan Marc Koehn Iqbal Sian Liara Tutina Vivian Auld Muhammad Khadzir Sheikh Ahmad Kate Ebrlll Anna Adelöf Liara Tutina Dr. David Markwell Ian Green Pablo Orifice Fernando Portilla Nilesh Jain Erika Ericsson Ian Arrowsmith

7 Project Approach Phase 1 October 2013 to April 2014 Work Focus Development of models for to provide frameworks to; Unpack EHR / SNOMED CT value chain Establish Maturity Model Identify key tactical options at different levels of maturity Develop quantification techniques for costs and benefits An initial plan to establish a series of archetypical country models was pursued but ultimately abandoned in favor of a generic approach Engagement Working group and Steering committee members provided valuable feedback throughout this phase During April meeting, these stakeholders suggested a number of structural changes and suggested the need to reach out to current implementers in order to seek: Examples to help illustrate various facets Quantified benefits / techniques

8 Project Approach Phase 2 May 2014 to October 2014 Work Focus During the summer, the team engaged a number of implementers in order to gather evidence to support the value chain in the report and quantification approaches. Between late August and early October the cost and benefit quantification models were finalized. Stakeholder Input Interviews were informal, structured discussions focused on project objectives, role of SNOMED CT, benefits and quantification techniques. Several interviews resulted in the following profiles used in the report: Healthcare Software, Australia NexJ Systems, Canada Hong Kong Hospital Authority, China Kaiser Permanente, United States Denmark Health Regions, Denmark EPSOS, European Commission

9 Building the Business Case for SNOMED CT Promoting and Realising SNOMED CT s value in enabling highperforming health systems DELIVERED RESULTS

10 Executive Summary International investment in Electronic Health Records (EHR) systems or Health Information Exchange infrastructures is often taxpayer funded. Policy makers expect that these investments will help stem a tide of rising healthcare costs by making our healthcare systems more effective and more efficient. EHR systems can help enable systematic improvements in healthcare by bringing essential information to clinicians attention when and where it can best influence their decision making. They are also a valuable source of evidence to support healthcare innovation, management and policy making. Information must be consistently codified, aggregated, processed and reused to realize these goals particularly across an entire health system. SNOMED CT is a unique terminology product with a range of features that work together to help EHRs better connect, exchange and use health information. Significant benefit can be realized when SNOMED CT encoded information is used to support health system improvement initiatives these initiatives provide a strong basis for a quantification within business cases. The Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) is the most comprehensive, multilingual clinical healthcare terminology in the world. Source: One-VA Technical Reference Model v14.8, accessed September, 2014.

11 Executive Summary Successful adoption of SNOMED CT requires investment to (1) acquire the terminology and the associated tools, (2) develop skilled implementers, (3) appropriately (and consistently) localize a portfolio of terminology assets tuned for implementation in local systems, and (4) development of processes to maintain these assets as clinical and business needs evolve. The goal is to create a sustainable environment which aims to continuously: Deepen the scope of implementations as features of SNOMED CT are more fully used to enrich, connect, exchange and use information. Broaden the scope of deployment across an ever expanding array of health care settings and systems.

12 Executive Summary The report outlines various quantifiable prospective benefits along a spectrum of 6 notional implementation stages: Enabling Basic Access The benefits of SNOMED CT adoption begin to be realized early in the adoption cycle and can increase by orders of magnitude as SNOMED CT is used to collect, encode, connect and use health information to improve patient outcomes and health system performance. Build Tactics to ensure country wide access to SNOMED CT Intellectual Property (IP) in order to capture primarily Administrative Cost Avoidance benefits. Establishing Initial Localization & Adoption Tactics to ensure that SNOMED CT has utility within domestic health systems and to unlock basic EHR" Management Cost savings and initial Care Delivery benefits. Enabling Clinical Decision Support (CDS) Tactics that leverage SNOMED CT to direct Care Delivery and Patient Outcomes. Enabling Exchange of Clinical Information and/or Knowledge Resources Tactics that leverage SNOMED CT to enable sharing and reuse of patient health information and clinical knowledge across organizations. Enabling Clinical & Business Intelligence Systems Tactics that leverage SNOMED CT to precisely define patient populations and to measure and manage performance. Expanding to Derive Deeper Network Benefits Tactics to deepen and expand SNOMED CT adoption throughout the health care system to accelerate clinical knowledge translation and adoption. Deepen and Broaden

13 Executive Summary Potential Early Benefits: Terminology Cost Savings EHR Maintenance Cost Savings HIM Coding Costs Savings Potential Systemic benefits: More efficient use of health system resources Improved Patient Outcomes Healthcare System Cost Savings Broad Societal Benefits

14 Executive Summary Early administrative cost savings are meaningful: Reduced terminology development and maintenance (when assessed across existing processes) Streamlined and reduced SNOMED CT licensing vis-à-vis per-site/ system pricing Transcription cost savings when maps to ICD or other coding systems are leveraged Potential systemic benefits are dramatic given the types of costs which SNOMED CT enabled EHRs can help to avoid: Reductions in inappropriate or duplicate testing Reduction in adverse drug events Improved management of key disease groups (e.g. cardiac care, oncology, chronic disease) Encoded health information and decision support tools enable these benefits. When information is codified consistently this enables comparison, exchange and reuse throughout the health system. Therefore an open SNOMED CT based ecosystem presents an opportunity for exponential increases in benefits.

15 Core Report Content Executive Summary Why SNOMED CT? A summary of SNOMED CT features key to benefit stream How to Instigate Adoption and Sustain Meaningful Use? A framework for understanding the adoption process to help build strategy Understanding the Benefits The foundation for potential benefits Quantifying the Business Case Quantification techniques for different stages of implementation

16 Supporting Content Appendix A - Implementation Project Profiles Six Project Profiles from Stakeholder Interviews Appendix B - C-KM Putting Clinical Information to Work A primer on SNOMED CT enabled Clinical Knowledge Management Appendix C SNOMED CT Adoption Maturity Model A framework to support tactical planning as a SNOMED CT implementation program evolves. Appendix D Cost and Benefit Quantification Methods Methods to quantify costs and benefits across different implementation stages. Appendix E Glossary Appendix F - References

17 Accessing the Report The report is in the process of being formatted for final production and will be available on the IHTSDO website by October 20. URL will be made available shortly.