All fields (data elements) used for data entry must be analyzed to understand what underlying context is implied. The appropriate Concepts should then be selected for the value set of each field. Concepts from the Clinical Findings, Procedures, and Observable entities hierarchies can be used directly if the default assumptions are true. Otherwise, Concepts from the Context Dependent hierarchy should be selected to explicitly code the underlying context of the clinical idea.
Particular care must be taken with systems that enable real time post-coordinated constructs to ensure that the appropriate context attributes are included.
To pre-coordinate Concepts that do not already exist in SNOMED CT, care must also be taken to determine if any axis modification is shifting the meaning of a Concept. If so, it should be moved to the Situation with explicit context hierarchy.