1. Developments in The Netherlands focussed on the IHTSDO Workbench Jos Baptist, senior advisor standardisation processes IHTSDO, Stockholm, October, 2012

2. Nictiz in one sheet Stockholm, October 2012, sheet 2 dec 2001: one platform for ICT in Healthcare 2002 - 2006 make an EHR possible in NL – choice for national index registry and HL7v3 – problems with identifiers, privacy, safety, … 2007 - 2011 legislation for use of identifiers – EHR rejected in parliament on April 5 th 2011 (supposed privacy issues: politicians have 'cold feet') 2012 - … split up of Nictiz – funded by the Government Nictiz continues the standards and developments to improve Healthcare IT – denationalization of the national index registry and continuation in a private service centre for healthcare

3. search by domain hierarchy and ClaML partial terms combination string Soundex UK Soundex NL SNOMED CT LOINC Declarations thesauri: diagnoses, CPT, treatment, etc. ICD ICPC ISO-9999 mappings sub sets value sets code systems reference sets coordination Website NictizSAAS, webservice, … Make terminology available via portal and as a web service : Develop divers search routines to support intelligent search, find, select and use of terms and register the code(s) in the system chosen. Terminology services: availability of code- and terminology systems, tables, classifications and mappings, etc.. Maintenance and management conform NEN 7522 Central functions made available to ICT vendors and self programming institutions in order that care professionals will always and everywhere be able to use terminology and coding systems in an uniform way. Nictiz support for terminology use Create routines and make the source code available as open source to be built in in applications use semantic web technology Stockholm, October 2012, sheet 3

4. terminology support Stockholm, October 2012, sheet 4 Use existing developments on a national level and include SNOMED CT as essential terminology Find and support new implementations and domains for SNOMED CT (those people really want it !) Explain that Dutch terms are guaranteed for maximum connectivity to the terms and concepts of the International Release Create that bridge between their needs and SNOMED CT Make maximum use of the IHTSDO Workbench Support them with software and Terminology Explorers Support a NL extension for Dutch terms and synonyms

5. what we really do … Stockholm, October 2012, sheet 5 DHD (Dutch Hospital Data) We mapped > 6000 diagnoses in Dutch language to their SNOMED CT concepts (one-to-one) and imported that as a batch through the Workbench into the NL Extension 1000146 *We still have to reshape it as a language reference set for the DHD We started to work out more Dutch language diagnoses that do not fit in a 1-1 mapping but need post coordination We integrated the Dutch terms into our SNOMED CT Terminology Explorer so you will always find the Dutch term + the concept in the International Release Optometrists Using the SNOMED CT Terminology Explorer the optometrists association Netherlands (OVN) selected diagnoses, anatomy, examinations and treatments related to their domain We create software to support the maintenance of their reference sets and the Dutch translations of the English terms (+ 60%) * We still have to import the reference sets as well as the translated terms

6. what we really want … Stockholm, October 2012, sheet 6 Real clinical /medical registration with SNOMED CT ! - mappings from SNOMED CT to diagnosis declaration codes + mappings to ICD-10 either direct or via the NL codes + solutions for existing Dutch diagnoses terms in use that need post coordination - mappings from SNOMED CT to procedure codes for reimbursement - organise domains and manage their reference sets + integration of language reference sets + Question: one Dutch language reference set plus one Belgian Dutch ? - full integration in our SNOMED CT Terminology Explorers + make that available as open source software + organise the download support for registered users - combination of 'request submission system' with the NL extension and bring new concepts to the International Release