At the October 2018 business meetings, the Cancer Synoptic Reporting Clinical Project Group met and Scott Campbell asked us to raise operational considerations for this work should SNOMED International agree to include the content in the International release.
So to get us started........
Governance and operational owner: The terminology content comes from the clinical content standard itself.
Final operational governance and processes need to be defined in order to keep the SCT content current and aligned with the clinical content standard
Should the ICCR or the CAP or both together be engaged to become the operational owners of the content? Another organization?
Should all requests for new content come from the new operational owner as part of the process to review and update the checklists?
Request for Change (RFC) Process: Currently the various countries submit requests for new content and changes etc to SNOMED International as part of our country specific duties.
With this content, will the RFCs come from the operational owner rather than the various NRCs?
If not, what changes are required operationally for the NRCs to support this content going forward?
Translations: There will be a requirement for this content to be translated into various languages.
Will each country be responsible for its language specific translations?
Could the ICCR with its access to pathologists speaking in various languages, provide translation support and/or validation?
And is there any way to tie the creation of new contents and translations together so that the English and other languages are all available at the same time?
Is this possible? Less re-work required if the translation is tied to the creation of the concepts?
Release Notes: Will there be release notes specific to this work and if so, who is responsible for them?
If not, will the release notes for the International release need to be augmented to support this work?
And if is this the case, who would support SI (if required) in the creation and updating of any release note content?
Or are release notes even required?
Editorial Guidelines: Should we consider creating some editorial guidelines as this new content is being created so that it can be transitioned to both SI and the operational owner?
Required?
If the answer is yes to editorial guidelines, would the responsibility for any updates to the Editorial Guidelines be the responsibility of the operational owner?
Is there any impact on the larger SNOMED International Editorial guidelines as a results of this work?
Are language specific editorial guidelines required?
English version: UK or US? Other?
In Canada, because most of our vendors are US based and we use the US CAP checklists, we have standardized on US English.
Will this be the case for this work?
Quality Assurance of Clinical content: Will the operational owner need to work with SI to provide QA on the clinical content as it is being created and added to the International edition?
I am not sure if everything I have listed here will be valid and/or required, but we can decide as a team. (You won't hurt my feelings if anything I have listed in not valid 
).
I think the answers to any of these questions need to come from all of us, and I am willing to help figure this out together.
I am sure that this is not a complete list of operational considerations, so please feel free to add or remove from this list as required.