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Target releasen/a
Document statusDRAFT
Document owner

Robert Turnbull

Rory Davidson


  • Provide a tool that enables the management & creation of reference sets (refsets) against the International edition of SNOMED CT and Member extensions.
  • Provide a directory of existing reference sets that can be searched and downloaded to be used by others

Background and strategic fit

Reference set management is another part of the authoring and management of SNOMED CT and there is no tool currently which is sufficient to provide that capability alongside the capability for the community to search for existing reference sets.


  • IHTSDO Terminology Server (TS) platform to retrieve the terminology. The TS already provides the backend functionality to manage reference sets but there is currently no REST API for this, nor any front end interface.
  • IHTSDO Identity Management Server (IMS) for user accounts and authentication - IHTSDO Identity Management Service Documentation
  • IHTSDO Component Identifier Service (CIS) for assigning identifiers to new reference sets (within the correct namespace) - ICIS - (this is still in beta/testing)


High Level Requirements

The following high level requirements still stand:

  1. The creation and maintenance of both extensional and intensional reference sets including version management of these reference sets
  2. Version management of reference sets including draft and published reference sets
  3. Import of existing reference sets as content
  4. Role based access control to the maintenance of reference sets
  5. The computation of the effect of a related SNOMED CT version on a reference set
  6. Workflow for approval before publishing but also to provide a facility for external feedback
  7. A searchable directory containing existing reference sets, as well as entries about reference sets that may be available elsewhere
  8. The ability to host SNOMED CT extensions in the same instance as International editions.
  9. Separation between a tool for ‘sub-setting’ SNOMED CT components and a tool for managing releasable SNOMED CT reference sets.

Specific epics that have been identified follow.

Reference Set Management Epics


Directory of reference sets

  • The directory solution will contain reference sets that currently exist on the IHTSDO Terminology Server against the SNOMED CT International Release
  • The directory will contain reference sets that are not on the IHTSDO Terminology Server
  • The directory solution will allow a user to search reference sets based on the reference set members

Create an extensional simple refset


Create an intensional simple refset


Import and host extension simple refsets

  • Import existing RF2 files

Visualize the members of simple refset


Edit the members of simple refsets


Compute the effect of an update to a dependant SNOMED CT version


Create extended-pattern refsets

9Edit extended-pattern refsets 

Design Epics 


Version management for extensional refsets




Version management for intensional refsets


Managing dependencies between refsets and SNOMED CT versions across extensions


Access to extension content either by multi-tenancy or other integration strategies


Management of extension content within the scope of reference sets


Creation of refset identifiers (with namespaces) using the IHTSDO component identifier service


Module dependency management


Release process for new or updated refsets

9Distribution of refset products (including documentation, exemplars, links to human-readable versions) 

Workflow/Business Process Epics 


refset identifier concept management (in relation to product & SNOMED releases) 


Management of refsets in the context of a product development process


Management of expert review feedback loops

  • during “derived product” development

  • during alignment with dependent SNOMED release

User interaction and design



Below is a list of questions to be addressed as a result of this requirements document: