SNOMED Clinical Terms
Introduction
SNOMED CT® is a clinical terminology - the Systematised Nomenclature of Medicine Clinical Terms. It is a common computerised language that will be used by all computers in the NHS to facilitate communications between healthcare professionals in clear and unambiguous terms.
A joint development between the NHS and the College of American Pathologists (CAP) to improve and safeguard patient care by using an agreed terminology resulted in earlier iterations of SNOMED CT.
It has greater depth and coverage of healthcare requirements than the legacy versions of Clinical Terms (Read Codes) that it replaces. It will enable clinicians, researchers and patients to share and exchange healthcare and clinical knowledge worldwide.
The expertise of UK clinical professions is of huge importance in this work - both in its development and in its implementation. Specialist input to evaluate and endorse the terminology is an on-going process.
International Health Terminology Standards Development Organisation (IHTSDO)
In April 2007 the International Health Terminology Standards Development Organisation (IHTSDO) acquired the intellectual property rights of SNOMED Clinical Terms (SNOMED CT) and its antecedents from the College of American Pathologists (CAP) for $7.8 million.
By acquiring the SNOMED CT standard, the IHTSDO, which was established by a group of nine founding nations (Australia, Canada, Denmark, Lithuania, The Netherlands, New Zealand, Sweden, the United States and the United Kingdom), the IHTSDO and its member countries, will help to ensure the continued maintenance and evolution of SNOMED CT as well as its availability on an international scale.
The IHTSDO assumed responsibility for the ongoing maintenance, development, quality assurance, and distribution of SNOMED CT.
SNOMED Terminology Solutions (CAP) has been commissioned to support IHTSDO operations under an initial 3-year contract and will separately continue to provide SNOMED-related products and services as a licensee of the terminology.
As part of the new arrangements NHS Connecting for Health (NHS CFH), a key driver in the development and establishment of the IHTSDO, will act as the host organisation of the IHTSDO National Release Centre in the UK which will be known as the UK Terminology Centre (UKTC).
As part of NHS Connecting for Health's membership of the International Health Terminology Standards Development Organisation (IHTSDO), NHS Data Standards & Products also acts as host of the UK Terminology Centre (UKTC) on behalf of the UK.
The NHS Terminology Service manages the IHTSDO UK Terminology Centre (UKTC) on behalf of NHS Data Standards & Products.
Get more information on the IHTSDO and see the International Press Release.
Management of SNOMED CT in the UK
Through NHS Connecting for Health's membership of the IHTSDO, the UK Terminology Centre (UKTC) functions as an affiliate of the IHTSDO and provides a central point for managing, distributing, supporting and controlling the use of SNOMED CT and related assets throughout the UK.
The UKTC also provides an interface between the IHTSDO, release centres in other member countries, and all entities within the UK that have an interest in using the standard.
Licensing
Affiliate Licences
Developers of SNOMED CT enabled systems, individuals and organisations using SNOMED CT for research purposes within the UK must enter into a licence agreement with the International Health Terminology Standards Development Organisation (IHTSDO) Association. The Affiliate Licence Terms, thereby becoming an "Affiliate", prior to accessing any part of the UK Edition of the SNOMED CT release. In the UK this can be done through the UK Terminology Centre (UKTC).
(End users are covered by the UK license by virtue of our National membership of the IHTSDO).
Licences to use SNOMED CT
Suppliers
Any company selling a product in the UK which has SNOMED CT embedded within it, will need to obtain a UK sub-licence from the UKTC prior to selling a product embedded with SNOMED CT in the UK (even if that company is registered in another IHTSDO member country).
UK registered companies selling a SNOMED CT enabled product in another IHTSDO member country will need to obtain a sub-licence from that country's Product Management Centre / National Release Centre (PMC) / (NRC) prior to selling a product embedded with SNOMED CT in that country. A list of IHTSDO member countries is available in the 'Contacts' section of the IHTSDO website (http://www.ihtsdo.org/members).
Any company deploying a SNOMED CT enabled product in a non-Member country will be obliged to declare their business and will be charged by the IHTSDO accordingly.
NHS Staff & non supplier stakeholders (including academics/Private Healthcare providers)
NHS Staff indirectly using SNOMED CT by using a system provided by an NHS supplier which has SNOMED CT embedded within it DO NOT need a licence to use SNOMED CT if the supplier has obtained a UK sub-licence from the UKTC (Please see note above).
The UKTC will however need to sub-provide royalty-free licences to NHS and healthcare related organisations that require access to SNOMED CT for development and research purposes. The UKTC will also issue royalty-free end-user licences to NHS projects and to research organisations that can contribute to meeting NHS priorities for action.
Please note that the terms and conditions of all licences specifically forbid end-users from any form of modification, sale or reproduction of SNOMED CT content.
An online registration and licensing website is available at
Licensing enquiries
For SNOMED licensing enquiries please contact the UKTC through the NHS Data Standards & Products helpdesk - Email: datastandards@nhs.net Tel: 00 44 01392 206 248.
Quality data: quality care
SNOMED Browsers
There are a number of browsers available which allow users to view SNOMED content without the need of a clinical application. A comprehensive review of the most popular 'free-to-use' SNOMED CT browsers has been completed.
The importance of a clinical terminology
A clinical terminology is a structured list of concepts and their associated descriptions for use in clinical practice. These describe the care and treatment of patients and cover areas like diseases, operations, treatments, drugs, and healthcare administration.
This allows the detailed recording of treatment, either of a single incident or in summary of the patient's full care record.
By using the terminology and the computer system the clinician can record patient information in a consistent manner. Clinical data can be communicated efficiently and unambiguously between healthcare workers to cover, for example, prescribing, referrals, hospital discharges and business processes.
Research organisations will be able to report on health trends based on the common terminology, giving improved comparability and reliability of data from different organisations.
NHS Care Records Service
The clinical and information systems in the NHS depends on having a common language for gathering and sharing medical knowledge.
SNOMED CT is the language of the NHS Care Records Service and will cut down the potential for differing interpretation of information and the possibility of errors resulting from traditional paper records.
If clinical information is to be safely transferred and exchanged electronically, a standard clinical terminology is a necessary component of clinical systems.
There would be problems in exchange of information for clinical or managerial purposes if several vocabularies and terms for the same topic were used within the NHS. SNOMED CT therefore, is and will continue to be maintained and updated centrally.
There are opportunities to submit requests for terms to be amended or introduced at a 'submission request' area on the NHS Terminology Service website.
The use of SNOMED CT means that doctors and other NHS staff have consistent and easily understood information about a patient's medical history, illnesses, treatments, and test results wherever and whenever it is needed. The terminology can be used for diagnosis, treatment, sharing of information and for research.
The dictionary of medicines + devices (dm+d) provides unique identifiers and associated textual descriptions for medicines and devices.
It has been developed for use throughout the NHS (in hospitals, primary care and the community) as a means of uniquely identifying the specific medicines or devices used in the diagnosis or treatment of patients.
The dictionary provides a link to SNOMED CT terminology used in clinical systems. For more information please visit dm+d website.
SNOMED CT: the benefits
- Patients knowing that everyone in the NHS they meet will be using the same language to talk about their condition and treatment
- A single and comprehensive system of terms, centrally maintained and updated for use in all NHS organisations and in research
- Greater consistency in communication of patients' clinical records
- Simplified data entry and retrieval
- Reliable analysis and research based on a common understanding of health terms and concepts stored in a coded form (rather than as free text)
- Good links to recognised health classifications (International Classification of Disease and Related Health Problems) and surgical classifications (from the Office of Population, Censuses and Surveys) to assist research into disease and treatment
