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Figure 10. NRCs manage user requests for changes to both the National and International Editions of SNOMED CT 

How user requests are submitted to the NRC is up to each NRC to decide. An NRC can choose to have its own request submission system, but the solution could also be a simple mailing system or a file-transfer system. This depends on the level of SNOMED CT use (and hence, the number of requests) within the Member country. An NRC could decide to have a simple system in the NRC-establishment phase and then launch a more sophisticated system when the number of requests increases.

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SIRS is IHTSDO's online request submission system, which allows Member countries' NRCs and other authorized users to submit requests for change or addition of new content to the International Edition of SNOMED CT. Hence, all user requests for the International Edition of SNOMED CT should go via the NRC, and each NRC should have access to SIRS. Concepts of only national relevance should not be submitted to IHTSDO. It is the responsibility of the NRC to determine which request is specific to its country and which are of international relevance. NRCs should be aware of the editorial principles for SNOMED CT and only submit requests that meet those principles.
Requests submitted to SIRS are reviewed by IHTSDO Authors, and requests that meet the SNOMED CT International Edition inclusion criteria are added to the International Edition. SIRS is an online tool, which enables users to view the current status of all requests that have been made through the system, see Figure 11.

Figure 11 Screenshot from SIRS. Example of overview of requests submitted to the system. 

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