Maturity Levels evaluation guide

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Level 0

SNOMED CT is not used yet, but there are plans to do so. Clinical information is stored as free text or using other code systems, like local value lists or classification codes. Data retrieval is primarily one record at a time. Some reporting available using selected codes and simple groupers from other code systems.

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Level 1

SNOMED CT is not directly recorded in the clinical records. It's used indirectly, using a mapping mechanism. The system uses other code system as a controlled vocabulary, and each code is mapped to SNOMED CT on the background. The diversity of SNOMED CT codes available through mapping is limited by the mapping quality. A great effort is required to maintain the maps, adding new codes depending on user needs and updating to new SNOMED releases. SNOMED CT can be used in a limited way to support data retrieval.

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Level 2

SNOMED CT is directly recorded in the clinical records, based on clinician input. It's used as a flat list of codes imported into the clinical system. Support may be provided for translated terms, multiple synonyms or Clinical Decision Support based on manually defined subsets. Data retrieval is supported by SNOMED CT codes aggregated or queried using manually defined subsets. May support string-based searches over multiple (or localized) synonyms.

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Level 3

SNOMED CT codes stored directly in health record based on clinician input, with searching or navigation using hierarchy. The hierarchical structure of SNOMED CT, the inferred relationships, are imported into the system. Clinical Decision Support may be provided, with rules based on hierarchical relationships. Data retrieval is supported by SNOMED CT codes aggregated or queried based on automated subsets or queries that use SNOMED CT’s hierarchical relationships.

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Level 4

SNOMED CT codes stored directly in health records based on clinician input. Searching or navigation using defining relationships is provided. All the inferred relationships are imported into the system. Clinical Decision Support may also be provided, with rules based on defining relationships. Data retrieval is supported by SNOMED CT codes aggregated or queried based on automated subsets or queries that may use any defining relationship (including both ‘is a’ and attribute relationships).

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Level 5

SNOMED CT codes or expressions stored directly in health records based on clinician input. Searching or navigation uses Description Logic reasoning or Natural Language Processing. The SNOMED CT release is loaded into an advanced terminology server. May also use Clinical Decision Support with Description Logic or Artificial Intelligence. Data retrieval is supported by reasoning over SNOMED CT codes and expressions using Description Logic. Querying over SNOMED CT codes and expressions using computable languages, such as the Expression Constraint Language (ECL).