This section provides an overview of:

• SNOMED International
• Members and National Release Centers
• SNOMED International Forums, Advisory Group and Special Interest Groups
• SNOMED International Collaborative

Why is this important?

SNOMED International is the not-for-profit organization that owns and administers SNOMED CT, and owns the rights to SNOMED CT and related terminology standards.

What is this?

SNOMED International the trading name of IHTSDO¹  is an association governed by a General Assembly that contains one representative of each of its national Members.

SNOMED International seeks to improve the health of humankind by fostering the development and use of suitable standardized clinical terminologies, notably SNOMED CT, in order to support safe, accurate, and effective exchange of clinical and related health information. The focus is on enabling the implementation of semantically accurate health records that are interoperable.

The purpose of SNOMED International is to develop, maintain, promote and enable the uptake and correct use of its terminology products in health systems, services and products around the world, and undertake any or all activities incidental and conducive to achieving the purpose of the Association for the benefits of the members.

The bodies and forums of SNOMED International are the foundation for the continuous maintenance, development and distribution of SNOMED CT, and they provide the organizational framework for communication and collaboration between the different parts of the SNOMED community.

Members of IHTSDO

SNOMED International now has 47 national Members. An updated list of the current members can be found at the SNOMED International web page (http://snomed.org/members/). Members can be either an agency of a national government or another body endorsed by an appropriate national government authority within the country it represents. SNOMED International welcomes new Members.

Members pay a fee, based on national wealth, to SNOMED International which gives them the right to a seat on the General Assembly. SNOMED International does not charge Affiliate Licensees for use of the SNOMED CT International Edition within Member countries. Licensing is also free in the poorest countries and for certain approved public-good uses in other countries. In other cases, low-cost per-institution charges apply to the use of SNOMED CT in operational systems involved in data creation and/or analysis. All use of SNOMED CT is subject to the acceptance of the terms of the SNOMED CT Affiliate License agreement (https://www.snomed.org/get-snomed) and the terms of sublicenses issued to end-user organizations by Affiliate Licensees. Members may also impose additional conditions on use of SNOMED CT within their countries. For example, a Member may require licensees to support and include its National Extension in its implementations.

National release centers

Members undertake a range of activities related to their involvement in SNOMED International and their role in distributing, extending and supporting the use of SNOMED CT in their country. The organization or agency that coordinates this role in each country is referred to as a National Release Centre (NRC). National Release Centers provide a single point of contact for communications with SNOMED International and other Members. Within their own countries, NRCs manage the use of SNOMED CT and communicate with a range of stakeholders, including SNOMED CT Affiliate Licensees, healthcare institutions, clinical groups and end users.

Governance

An overview of SNOMED International governance and advisory structures are shown in the following figure.

General Assembly

The General Assembly is the highest authority in SNOMED International and contains one representative from each of its national Members. The General Assembly is collectively responsible with assuring that the Purpose, Objects and Principles of the Association are pursued and that the interests of SNOMED International are safeguarded. It can make binding decisions regarding all matters relating to IHTSDO, subject to and in accordance with the provisions of the Articles of Association, such as budget, work plan and strategic goals. It is recommended though not required that General Assembly representatives attend all meetings. Face to face meetings occur usually twice per year with occasional teleconferences and electronic voting.

Management Board

The Management Board is appointed by the General Assembly. Members have the opportunity to nominate delegates to the Board. The Management Board directs the Association and has the responsibility for key business decisions. It has at least three face-to-face meetings per year with teleconferences between these meetings.

The Management Board also appoints the Chief Executive Officer (CEO), who has day-to-day responsibility for running the organization. A Management Team, with members each responsible for a particular line of business, supports the CEO and directs the work or additional employees.

Advisory bodies

Member Forum

Each Member is entitled to choose a representative to the Member Forum (MF). The MF acts as an advisory body to the Management Board.

The MF is also a means for optimizing the collaboration and coordination among Member countries provides a means for Members to have discussions on specific Member issues. Moreover, the MF facilitates contact and communication between countries with similar foundations, needs, priorities, etc. It is recommended that each Member gets involved with and makes use of the MF.

The MF can raise issues of concern to the Management Board and is asked by the Management Board for specific feedback on items. The MF is the conduit for communicating widely on consultations that SNOMED International may undertake. These consultations may include specific issues related to SNOMED CT content or SNOMED International documents, products and services. The MF is also a key player in determining which SNOMED International work items should be undertaken and prioritized.

Vendor Forum

The structure and role of the Vendor Forum (VF) is currently being revised as part IHTSDO's vendor strategy. As an expert group from a range of industry sectors, the VF will identify ways to facilitate use of SNOMED CT.

Advisory groups

The role of each Advisory Group is to provide advice to the applicable Management Team member(s) on specific areas that are included in the Terms of Reference to further the knowledge and direction of the organization. At the beginning of each year, each Advisory Group develops a group work plan outline, determines whether Task and Finish sub-groups are required, outlines any resource requirements needed, and lays out a set of measures in order to monitor the progress of the applicable group work plan.

Advisory Group members are selected by two different nomination processes. The Terms of Reference of each Advisory Group describes which of the two is relevant (or if a combination of the two is used). 

• Member-based nominations are used when SNOMED International seeks to create a forum for SNOMED International staff to work closely with Members. Under this system, Members nominate representatives to serve on an Advisory Group, so the Advisory Group members are representing their Member countries. 
• Standard nominations rely on a standard, open, skills-based nomination process. Advisory Group members selected through this process may submit to SNOMED International any approved travel expenses for reimbursement to attend approved face-to-face Advisory Group events (SNOMED International Travel Policy has more information about approved expenses and means of submission).

More information about Advisory Groups can be found at http://snomed.org/advisory. 

Clinical Reference Groups

Clinical input to support the development of SNOMED CT is delivered through Clinical Reference Groups. These groups are focused on clinical specialities, with each specialty are having its own Confluence based site. Each site supports discussion and knowledge sharing. Access to the Clinical Reference Groups is though a central Confluence portal focused on clinical engagement activities at http://snomed.org/crg. 

SNOMED International Collaborative Space – Confluence

Confluence is an online forum/space where the people within SNOMED International Governance and Advisory Bodies can communicate and share information. Confluence facilitates a range of types of communications, including written discussions, meeting announcements and document sharing.

Members, Affiliates, or other interested parties can gain access to the Collaborative Space to learn more about IHTSDO, SNOMED CT, or to participate in a Special Interest Group. More information about Confluence is available at https://confluence.ihtsdotools.org/.