The best way to organize an NRC depends on a wide range of factors, including the number of potential Affiliates, the vision and strategy for use of SNOMED CT in the country, the national eHealth infrastructure, the extent of customization, etc. But Members of SNOMED International are, at a minimum, required to fulfill a set of core responsibilities within the Member's territory, as shown in Figure 2 and specified in the Articles of Association. Typically, the NRC fulfills most of these obligations, however a Member may make other arrangements to fulfill some of the obligations.

The Articles of Association for SNOMED International can be found here: http://snomed.org/articles.

Figure 2 Obligations of Members.

NRCs are required to serve as primary points of contact for SNOMED International with regards to all aspects of the management of the terminology products.
NRCs are the primary points of contact for Affiliates within a Member country.
- Affiliates should be able to contact the NRC for guidance and direction with respect to implementation and use of SNOMED CT within the Member country.
- The NRCs should serve as intermediaries between the Affiliates and the SNOMED CT community, for example:
  - Encouraging experts and other appropriate persons to contribute to the work of SNOMED International;
  - Assisting SNOMED International to communicate with Affiliates and experts entitled to and wishing to be enrolled as SNOMED International Affiliates.
NRCs are required to establish and maintain processes necessary for distribution and licensing of SNOMED CT and the otherterminology products.
- This includes developing the appropriate mechanisms for users to gain access to National (where applicable) and International Editions of SNOMED CT and related products, and mechanisms to retrieve and manage Affiliate licenses. (See section 9 on tooling for process support.)
- This includes managing license reporting annually and reporting Affiliates' activities in non-Member countries to SNOMED International.
NRCs are required to ensure that any deployment of a terminology product owned by SNOMED International conforms to SNOMED International standards.
NRCs must facilitate feedback from users on SNOMED CT, including managing change requests.

Besides these areas, there is a range of other responsibilities that NRC may decide to undertake. The table below lists a set of possible responsibility areas. The list is not exhaustive but includes the main areas that NRCs currently cover. Some of the areas are marked as "Required," as these are part of the core responsibility areas.

Table 1. NRC Responsibility areas

Responsibility area	Required	Optional
Manage licenses (manually or automatically)
Distribute International Releases
Manage Extensions (Authoring, release, distribution and maintenance)
Manage Reference sets (Authoring, release, distribution and maintenance)
Manage Mappings (Authoring, release, distribution and maintenance)
Manage Translations (Authoring, release, distribution and maintenance)
Offer Tooling As user service: To enable users to access and explore SNOMED CT As NRC tool: Support SNOMED CT management


Manage change requests for organizations in the country
Offer education, promotion and training
Engage stakeholders
Offer implementation consultancy

NRC competencies

The competencies required for an NRC are dependent on what services the NRC chooses to deliver. However, most NRC staff should have a general understanding of SNOMED CT and SNOMED International.

If an NRC is unable to provide a specific type of service, it should seek to identify other resources that are able to meet the requirements of implementers and users in the Member country.

The following core competencies are typical for the work of an NRC. Some of these competency areas can be considered assignment-specific, as they will not be required as a constant competency within the NRC but are required to fulfill specific assignments, such as translation, mapping and development of Reference sets.

General competencies required	Terminology
	Technical and IT skills
	Communication
	Implementation
	Education
Assignment-specific competencies	Clinical and scientific domain specialty knowledge
Assignment-specific competencies	Linguistics and translation

Specific competencies required to undertake particular NRC related tasks are outlined in Table 2.

Table 2 Competencies and skills required to undertake particular NRC tasks¹

Tasks	Main competencies	Knowledge/Skills areas
Distribute International Release and National Extension	Communication Technical/IT	Communication with Affiliates, e.g. news updates Tooling support for access to the International Release and National Extension
Manage extensions
Content	Terminology Domain specialty Translation	Content development Terminologies, description logic
Technical	Technical/IT	Tooling support for extension development and management (See "Technical/IT" responsibility)
Manage Reference sets
Content	Terminology Domain specialty (clinical experts, etc.)	Reference set development and maintenance Domain insight, depending on the purpose of the Reference Set Concept selection Logical and concept model Search techniques
Technical	Technical/IT	Tooling support for Reference set development and management (See "Technical/IT" responsibility)
Manage Mappings
Content	Terminology Domain specialty	Map development and maintenance Knowledge of current practice for use of classifications and terminologies in the Member territory
Technical	Technical/IT	Tooling support for Reference Set development and management (See "Technical/IT" responsibility)
Tooling Developments Browsing, Developing content, and Refsets, QA, Distribution	Technical/IT	SNOMED CT technical specifications and File formats Software and database design and development Information modeling/information model standards SNOMED CT search and data entry techniques and software Authoring and distribution requirements Quality assurance techniques
Manage translations	Terminology Linguistics Domain specialty	Translation processes Concept definition Quality assurance Terminology authoring technology
Change requests	Communication Terminology Translations	Content development Terminologies, description logic
	Technical/IT	Terminology authoring tool Tooling support for change request submissions and management of change requests. (See "Technical/IT" responsibility)
Education, promotion and training Engaging stakeholders	Communication Implementation Education	Dissemination competencies Users and user needs Broad and deep knowledge of SNOMED CT, users and implementation aspects. Examples, use cases National health IT-infrastructure, current practices and regulation
Implementation consultancy	Implementation Technical/IT Business Analysis	Broad and deep knowledge of SNOMED CT, users and implementation aspects. Examples, use cases Implementation levels and technical opportunities Ability to understand requirements and relate to terminology
Manage licenses (manually or automatically)	Communication Technical/IT	Communication with Affiliates Tooling support, e.g. license repository

Footnotes
Ref	Notes
1	Note that the range of tasks that different NRCs undertake may vary.

SNOMED Documentation Search

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NRC competencies

SNOMED Documentation Search

3. NRC responsibilities

NRC competencies