4. Create SNOMED CT artifacts
SNOMED CT is an extensible terminology system, that can be customized for specific use cases. The fourth step in the SNOMED CT implementation process is to create the SNOMED CT artifacts required to support the given use case.
The eHealth architecture designed in the previous step will help to determine what type of SNOMED CT artifacts are required - e.g. maps, translations, reference sets, new content. And the type of SNOMED CT artifacts required will help to determine the human resources and tooling required to create them.
It is important to understand that all SNOMED CT artifacts require ongoing maintenance. Therefore, it is important to establish a permanent terminology team, who can manage the updates and adaptation of the SNOMED CT artifacts to an evolving implementation environment.
Get SNOMED CT
SNOMED CT is distributed by SNOMED International and the National Release Centers in specific countries/territories. For implementations in Member countries/territories, implementers should get in contact with the local National Release Center (NRC) to obtain a free license. For implementations outside Member countries/territories, implementers should establish a license agreement directly with SNOMED International.
SNOMED International and many Member countries/territories use the Member Licensing and Distribution Service (MLDS) to distribute SNOMED CT. The release packages downloaded from MLDS may be uploaded into a terminology server or database for implementation.
New maps are required to establish links between existing terminologies and SNOMED CT. implementations require mappings to/from SNOMED CT for a wide range of reasons, including:
To submit statistical reports using classifications, like ICD-10
To generate codes from procedures vocabularies for billing
To support data interoperability and data integration
To enable advanced data analytics over existing data
To use national medication identifiers in the electronic prescribing process
To allow the user to select terms from a local interface terminology and record this using SNOMED CT
Once created, maps are loaded onto SNOMED CT Terminology Servers, allowing connected applications to use the maps in real time.
Create reference sets
SNOMED CT subsets are an important resource in many implementations. They allow sets of SNOMED components to be grouped together, to support specific use cases, e.g. for data entry of diagnoses for a clinical specialty, for prioritization of translations, and for data analytics queries. For example, in HL7 FHIR specifications, SNOMED CT value sets are specified in the terminology binding of relevant coded data elements. A SNOMED CT reference set is a standard format for maintaining and distributing a set of references to SNOMED CT components.
Translate SNOMED CT
SNOMED CT is a global terminology that was purposefully designed to be multi-lingual. SNOMED CT concepts are abstract clinical ideas, which can be described using many different synonymous terms. Translation tools support the creation and review of descriptions in different languages.
Create new content
SNOMED CT was designed to be an extensible terminology. SNOMED CT extensions can expand the coverage of the International Edition by creating additional content to satisfy national or local requirements. The SNOMED CT Concept Model ensures that content created in extensions continues to be logically compatible with the International Edition, and automated comparisons between content from different editions can be performed. Many Member countries publish national extensions that include concepts necessary to support national use cases. It is also possible to maintain local extensions, which satisfy use cases directly related to a specific implementation of SNOMED CT. Content authored in an extension of SNOMED CT can be shared with users using RF2 file packages, or via a shared terminology server for direct implementation use.
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