SNOMED International Governance Documentation

Role of the Nominated Representatives

The Members' Nominated Representatives of the General Assembly (also known as "Nominated Representatives" or "GA members") represent collectively the interests of IHTSDO Members and have together the highest authority of the organization and can make binding decisions regarding all matters related to the organization, subject to and in accordance with the provisions of the Articles of Association. They have the ultimate responsibility to ensure that IHTSDO is achieving its purposes. The General Assembly owns IHTSDO and its products, including SNOMED CT. Any major changes to the organization or its products must be approved by the GA.

Ordinary and Extraordinary General Assembly Meetings

The Nominated Representatives meet twice a year in October and April in Ordinary General Assemblies to fulfill their responsibilities (AoA 8.2.5). Extraordinary teleconferences and electronic votes (AoA 8.2.6 and 8.3) may be called as required.

Chair, Vice Chair and Executive Committee

The Nominated Representatives nominate amongst themselves a chair (article 8.1.5), referred to hereafter as the "GA Chair." They may also elect a Vice Chair for a period that may not be longer than the election period of the Chair. Typically the Vice Chair is the previous GA Chair, although according to the Articles of Association he or she need not be.
The GA Chair, the Vice Chair, and next GA Chair (as selected by the Nominated Representatives) form the Executive Committee of the GA. In practice, the Executive Committee of the GA tends to be the past chair, the current chair, and the future chair.
Between the Ordinary General Assemblies in April and October, the GA Executive Committee and the Management Board Executive Committee hold periodic teleconferences. The Management Board Executive informs the GA Executive of important and significant occurrences, and the GA Executive may ask questions or provide advice. If the GA Chair feels it is appropriate, the GA Executive informs the other Nominated Representatives of the special or noteworthy occurrences prior to next scheduled General Assembly. Examples of these occurrences are:

  • Changes to the conditions surrounding the intellectual property owned by IHTSDO. This includes, but is not limited to, major harmonization or collaboration that involves legal agreements that the Nominated Representatives have not been briefed on or that have been flagged by the Nominated Representatives as requiring special communication;
  • Changes to IHTSDO standards that do not follow the agreed process or which have been flagged by the Nominated Representatives as requiring special communication;
  • Launching of a legal action;
  • An event that would likely have significant changes to the financial status of the organization, e.g. if a Member does not pay or a major contractor goes bankrupt;
  • Significant Work Plan development or delivery issues that require major changes to project plans or could damage the reputation or credibility of the organization or place it at financial risk;
  • Creation of a new Advisory Group;
  • Changes to licensing or other legal texts that impact Members;
  • Changes to the legal structure or governance of IHTSDO.

Responsibilities of the Nominated Representatives

At the October General Assembly (per AoA 8.2.17), Nominated Representatives must consider and vote on resolutions concerning:

  • The Management Board's annual strategic, business and operational plans for the next financial year;
  • The Management Board's proposed Aggregate Annual Fee for the next financial year;
  • Any general or special business referred by the Management Board or by any Member.

At the April General Assembly (per AoA 8.2.18), Nominated Representatives must consider and vote on resolutions concerning:

  • The Management Board's annual report for the prior financial year;
  • IHTSDO's financial accounts, including the External Financial Auditor's Report for the prior financial year;
  • The appointment of (or ratification of the appointment of) an External Financial Auditor for the current financial year;
  • Any general or special business referred by the Management Board or by any Member.

In order to elect Management Board members (per AoA 9.1.4):

  • The Nominated Representatives establish a timetable for Board annual elections (note: this is done by the joint GA/MB Board Nominating Committee);
  • Nominated Representatives may (and are encouraged to) nominate candidates and, during the election, vote on the Management Board nominees;
  • A committee of Nominated Representatives (the GA/MB Board Nominating Committee) may recommend a slate of candidates for the Nominated Representative to vote for;
  • If voting for individuals instead of a slate, each Nominated Representative may vote for up to 12 separate nominees;
  • Votes must be in writing, including by electronic form;
  • The results of the election are sent to the Members prior to the October meeting.

Although not laid out in the Articles of Association, by tradition the Nominated Representatives as a group also:

  • Vote on Award for Excellence and Lifetime Achievement Award winners;
  • Vote to approve the location of October General Assembly meetings, which are combined with the SNOMED CT Expo;

Individually, Nominated Representatives are strongly encouraged to:

  • Coordinate with their Member Forum counterpart(s) to most effectively represent the Members' priorities and challenges, particularly during the IHTSDO work plan and budget development process and prior to Ordinary General Assembly meetings;
  • Get individuals from their Member countries involved in IHTSDO voluntary groups, for example by nominating appropriate people to join IHTSDO Advisory Groups or encouraging such individuals to participate in Special Interest Groups;
  • Respond by the deadline to IHTSDO electronic votes or requests for input;
  • Encourage individuals from their Member countries to take IHTSDO educational offerings;
  • Coordinate with other Nominated Representatives on Electronic Health Records policies, interoperability, IHTSDO business, etc.
  • Make every effort to attend General Assemblies in person or, if that is not possible, then to call in and participate by teleconference;
  • Encourage Member funding of other individuals (such as Advisory Group members and Member Forum representatives) to General Assembly or other face-to-face meetings;
  • Volunteer to host an October General Assembly;
  • Represent IHTSDO's interests in the Member country's structure and bureaucracy, in so far as that roll does not conflict with other professional responsibilities;
  • Work with other stakeholders to further the goals of IHTSDO, increasing heath record interoperability and quality of care.


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