Updating the extension involves creating new versions of components and reference set members that are required in the extension. Please refer to 5.4 Authoring for more information about principles and process for adding, modifying and inactivating content in an extension. In some situations, content may also need to be promoted from the extension into the International Edition (or another extension on which it depends). Demoting content from one edition to a more dependent edition is generally considered to be unsafe, as this would make the content seem to disappear to other consumers of the parent edition.

Update Module Dependencies

When a new version of an extension is created, new rows must be added to the module dependency reference set to reflect the dependencies of the new version of the extension. The effectiveTime and the sourceEffectiveTime of the added rows must be set to the date of the new extension release. The targetEffectiveTime must be set to the version of the module on which the extension modules depends (as identified by the referencedComponentId).

Updates to the module dependency reference set are required:

• For all existing rows in the module dependency reference set, to indicate that the dependency now applies to the new version of each module - ie the sourceEffectiveTime must be updated to the date of the extension release. If the extension module is now dependent on a new version of the target module, then the targetEffectiveTime must also be updated.
• For any module dependency that is no longer applicable. In this case, the relevant member of the module dependency reference set should be inactivated.
• For any new module dependency that applies to the new version of the extension. In this case, a new reference set member must be added to the module dependency reference set.

Content Promotion

SNOMED CT components may be promoted from an extension module into a less dependent module to enable broader use. For example, an extension concept may be promoted to the International Edition to enable it to be shared by all users of SNOMED CT. Please note that a component may only be promoted to a module on which the extension module depends (as specified in the module dependency reference set).

To promote components from an extension into the International Edition, the donating organization (i.e. the owner of the extension) should submit a promotion request to SNOMED International with the details of all components to be promoted. The SNOMED International authoring team will subsequently process the request and consider whether the content is acceptable for inclusion in the International Edition.

Once promoted, a new version of the content will appear in the International Edition with a new EffectiveTime, an international moduleId, and the same SNOMED CT identifier as was used in the originating extension. From that point forward, SNOMED International becomes responsible for maintaining the promoted content. Future releases of the extension, which are dependent on the new version of the International Edition (that contains the promoted content), must remove the promoted content from their Snapshot and Delta release files. The promoted content will, however, continue to appear in the Full release files of the extension with an older EffectiveTime to reflect the ownership history of this content within the extension. Please note that the SNOMED CT identifiers of all promoted content will remain unchanged, and will therefore continue to include the namespace identifier of the originating organization.

Please note that it is important that the promoted content is not inactivated in the extension from which it was promoted, as this would make it appear to users of the extension that the content is inactive. It is also important that the meaning of the content remains the same after it has been promoted, to ensure that the component identifiers permanently represent the same clinical meaning.

The diagram below illustrates content being promoted to the SNOMED CT International Edition.