It is important that all Members are familiar with the existence and responsibilities of the different bodies and forums of SNOMED International in order for the them to know what roles and responsibilities the Member and, more specifically, the NRC plays (or can play) within these, but also to be acquainted with the support and benefit each Member can get by engaging in the different forums.

The bodies and forums of SNOMED International are the foundation for the continuous maintenance, development and distribution of SNOMED CT, and they provide the organizational framework for communication and collaboration between the different parts of the SNOMED CT community.

An overview of the different Bodies and Forums is shown in Figure 14-1.

Figure 14-1: SNOMED International Governance and Advisory Structures

General Assembly

The General Assembly is the highest authority in SNOMED International and contains one representative from each of its national Members. The General Assembly is collectively responsible with assuring that the Purpose, Objects and Principles of the Association are pursued and that the interests of SNOMED International are safeguarded. It can make binding decisions regarding all matters relating to SNOMED International, subject to and in accordance with the provisions of the Articles of Association, such as budget, work plan and strategic goals. It is recommended though not required that General Assembly representatives attend all meetings. Face to face meetings occur usually twice per year with occasional teleconferences and electronic voting.

Management Board

The Management Board is appointed by the General Assembly. Members have the opportunity to nominate delegates to the Board. The Management Board directs the Association and has the responsibility for key business decisions. It has at least three face-to-face meetings per year with teleconferences between these meetings.

The Management Board also appoints the Chief Executive Officer (CEO), who has day-to-day responsibility for running the organization. A Management Team, with members each responsible for a particular line of business, supports the CEO and directs the work or additional employees.

Advisory bodies

Member Forum

Each Member is entitled to choose a representative to the  Member Forum (MF). The MF acts as an advisory body to the CEO and Senior Management Team.

The MF is also a means for optimizing the collaboration and coordination among SNOMED International Member countries provides a means for Members to have discussions on specific Member issues. Moreover, the MF facilitates contact and communication between countries with similar foundations, needs, priorities, etc. It is recommended that each Member gets involved with and makes use of the MF.

The MF can raise issues of concern to the CEO and Senior Management Team and is also requested to provide specific feedback on priorities and other matters. The MF is the conduit for communicating widely on consultations that SNOMED International may undertake. These consultations may include specific issues related to SNOMED CT content or SNOMED International documents, products and services. The MF is also a key player in determining which SNOMED International work items should be undertaken and prioritized.

Vendor Forum

The structure and role of the Vendor Forum (VF) is currently being revised as part SNOMED International's vendor strategy. As an expert group from a range of industry sectors, the VF will identify ways to facilitate use of SNOMED CT.

Advisory Groups

Advisory Groups were established in June 2015 to conduct specific activities that contribute to the fulfillment of the Management Team's responsibilities or the organization's mandate. They are meant to be agile in nature, given the changing needs and direction of the organization, and therefore each group is reviewed on an annual basis to determine if it is still required or if changes in the Terms of Reference are needed.  Generally the Advisory Group members have specific skills and abilities related to that particular group.

The role of each Advisory Group is to provide advice to the applicable Management Team member(s) on specific areas that are included in the Terms of Reference to further the knowledge and direction of the organization. At the beginning of each year, each Advisory Group develops a group work plan outline, determines whether Task and Finish sub-groups are required, outlines any resource requirements needed, and lays out a set of measures in order to monitor the progress of the applicable group work plan. The organization, with the approval of the Management Board, may elect to seek approval for a separate budget items in the annual budget to assist the Advisory Groups in the completion of their approved work plans. All work plans are to be submitted to the CEO annually for review and approval.

NRCs should note that Advisory Group members are selected by two different nomination processes. The Terms of Reference of each Advisory Group describes which of the two is relevant (or if a combination of the two is used).

Member-based nominations

Member-based nominations are used when SNOMED International seeks to create a forum for SNOMED International staff to work closely with Members. Under this system, Members nominate representatives to serve on an Advisory Group, so the Advisory Group members are representing their Member countries. Typically the Management Team member who chairs the Advisory Group contacts the General Assembly and Member Forum representatives in May or June and invites them to nominate a representative with a particular skill set. SNOMED International then accepts all of those nominees or a subset of them. Any travel expenses of the Advisory Group members to attend approved face-to-face events are then assumed to be the responsibility of the Member. A Member's refusal or inability to pay these expenses does not invalidate or prejudice the nomination in any way, and teleconferencing for those who cannot attend in person is a typical option.

Standard nominations

Other Advisory Groups rely on a standard, open, skills-based nomination process. Advisory Group members selected through this process may submit to SNOMED International any approved travel expenses for reimbursement to attend approved face-to-face Advisory Group events (the SNOMED International Travel Policy has more information about approved expenses and means of submission).

Can Members nominate individuals to serve on Advisory Groups that utilize the standard nomination process? Yes. For example, you might nominate your NRC IT expert to serve on the Modeling Advisory Group, which uses the standard nomination process. SNOMED International might select her based on her skills. Who then pays for her travel expenses to attend an Advisory Group face-to-face meeting? She would be entitled (but not required) to submit her expenses for reimbursement from SNOMED International, because she is serving on the Advisory Group as an expert, not as a representative of her Member country.

Table 14-1: Advisory Groups and their Nomination Processes

More information about Advisory Groups can be found at http://snomed.org/advisory. 

Clinical Reference Groups

Clinical input to support the development of SNOMED CT is delivered through Clinical Reference Groups. These groups are focused on clinical specialities, with each specialty are having its own Confluence based site. Each site supports discussion and knowledge sharing. Access to the Clinical Reference Groups is though a central Confluence portal focused on clinical engagement activities at http://snomed.org/crg. 

SNOMED International Collaborative Space – Confluence

Confluence is an online forum/space where the people within SNOMED International Governance and Advisory Bodies can communicate and share information. Confluence facilitates a range of types of communications, including written discussions, meeting announcements and document sharing.

Members, Affiliates, or other interested parties can gain access to the Collaborative Space to learn more about SNOMED International and SNOMED CT. The Confluence space also enables participation in Advisory Groups, Clinical Reference Groups and Project Groups.

Information about Confluence is available at https://confluence.ihtsdotools.org.

SNOMED International Meetings and Events

SNOMED International arranges two events a year. In April it holds a Business Meeting and in October a second Business Meeting is combined with the annual SNOMED CT EXPO. The venue of the October event varies each year and Members encouraged to submit proposals for hosting the event in their country.

Business Meetings

SNOMED International Business Meetings include face-to-face meetings of SNOMED International Governance Bodies and Advisory Groups. Business Meetings may also include face-to-face meetings of some Project Groups and Clinical Reference Groups.

While meetings of Advisory Groups are open to observers, some sessions of other groups are closed and may only be attended by members of the relevant bodies.

A key part of each Business Meeting is the open meeting of the General Assembly, where the key strategic decisions, plans and achievements are made and announced.

SNOMED CT EXPO

The SNOMED CT EXPO is an open event for anyone interested in SNOMED CT and practical applications of the terminology. The event includes invited keynote speakers and several tracks of peer-reviewed presentations about SNOMED CT in general with a focus on implementation experiences and developments that facilitate more effective use of the terminology.

The EXPO also includes tutorials and workshops for those seeking greater understanding of SNOMED CT, an exhibition of vendor products that use SNOMED CT and a range of poster presentations on related topics.

The EXPO is the main annual event in SNOMED International calendar for anyone interested in the use and development of the global healthcare terminology. In addition to the scheduled sessions, it provides an excellent opportunity to network with others with a shared interest in SNOMED CT.