The SNOMED CT Maturity Framework is a five level model that can be used to categorize implementations based on a scale of increasing SNOMED CT capabilities. Each level provides for increased value from the use of SNOMED CT. This framework can be used to assess the current maturity level of a SNOMED CT implementation, or to help plan for higher maturity levels which provide additional benefits.
It is important to note that having SNOMED CT coded data embedded in a clinical information system, a health data and analytics platform, or an interoperability solution is necessary for SNOMED CT to function.
Conversely, clinical information systems, health data and analytics platforms, and interoperability solutions need clinical terminologies like SNOMED CT for them to function effectively. However, it is only when health organizations implement SNOMED CT at level 3 or above of the SNOMED CT Maturity Framework that the SNOMED International vision of '... better health and improved patient outcomes, supported by one language of health" can be fully realized.
Level 0 - Plans to use SNOMED CT
SNOMED CT is not yet used within the health record, but there are plans to do so. Clinical information is currently stored as free text or using local or vendor-specific code systems.
Information is captured using simple value lists, text fields, or radio buttons.
Data retrieval is primarily one record at a time. Some reporting is available using selected codes from a simple code system.
Level 1 - Mapping to SNOMED CT
SNOMED CT is not recorded directly in the health record. SNOMED CT is used indirectly by mapping to SNOMED CT.
Another code system is used to enter the clinical data, with mapping to SNOMED CT in the background.
Another code system is retrieved in the clinical record, with mapping used to display corresponding SNOMED CT codes or terms.
Level 2 - Simple Code System
SNOMED CT is recorded directly in the health records, and used as a flat list of codes. Support for translated terms or multiple synonyms may also be provided.
SNOMED CT codes are stored directly in health record based on clinician input, using flat value lists. Support may be provided for translated terms, multiple synonyms or clinical decision support based on manually defined subsets.
SNOMED CT codes are aggregated or queried using manually defined subsets. May support string-based searches over multiple (or localized) synonyms.
Level 3 - Use the hierarchy
SNOMED CT is recorded directly in the health record and used as a hierarchy of codes to support various system functions.
SNOMED CT codes are stored directly in health records based on clinician input, with searching or navigation using hierarchy. Clinical decision support may be provided, with rules based on hierarchical relationships.
SNOMED CT codes are aggregated or queried based on automated subsets or queries that use SNOMED CT's hierarchical relationships.
Level 4 - Use the semantic network
SNOMED CT is recorded directly in the health record and used as a semantic network of relationships with simple ECL queries. All defining relationships may be traversed to support various system functions.
SNOMED CT codes are stored directly in health records based on clinician input. Searching or navigation using defining relationship is provided. Clinical decision support may also be provided, with rules based on defining relationships.
SNOMED CT codes are aggregated or queried based on automated subsets or queries that may use any defining relationship (including both 'is a' and attribute relationships).
Level 5 - Advanced use
SNOMED CT is recorded directly in the health records and used as an ontology. Support for expressions, expression constraints (ECL), and the Machine Readable Concept Model (MRCM) may be provided.
SNOMED CT codes or expressions are stored directly in health records based on clinician input. Searching or navigation uses Description Logic reasoning or Natural Language Processing. May also use Clinical Decision Support with Description Logic or Artificial Intelligence.
Querying is performed over SNOMED CT codes and expressions using computable languages, such as the Expression Constraint Language (ECL). Reasoning over SNOMED CT codes and expressions using Description Logic.