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For example, in 

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 below, the system on the left uses the 'Family history' structural heading to indicate that the selected disease is a family history, while the system on the right precoordinates this within the terminology. When integrating or querying across these data sources, these semantics need to be harmonized to ensure accurate queries can be performed.

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Even when the same information model is used, different systems may populate this model with differing levels of precoordination. For example, the three clinical systems shown below in

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 each collect data about a 'suspected lung cancer' diagnosis in a different way. For this reason, when given a common data model (as shown in
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), different systems may populate this in different ways. When this occurs, queries must be careful to consider all possible representations of the data, to ensure that contextual and qualifying information about each code is correctly interpreted.

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Three ways of recording suspected lung cancer

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Some cases exist, however, where SNOMED CT is not currently able to automatically establish equivalence. These cases primarily relate to concepts for which the SNOMED CT concept model does not yet fully model their meaning. For example, the two approaches for representing a 'twin pregnancy' shown below (

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) are currently not able to be computed as equivalent using SNOMED CT.

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