7.1. How often is there a national update and is it mandatory for all organizations to update at the same time? Do all organizations update automatically as soon as an update is published?
International updates are currently published every 6 monthsmonth. Members who have a national edition usually update their edition at least every 6 months, although this can vary. Organisations within the Member country/territory may update their local implementations at different frequencies, depending on national agreements.
7.2. Who is responsible for the updates? The NRC?
The Member NRC is responsible for making international and national updates to SNOMED CT available. If there is no operating NRC then updates are available from the international MLDS (Member Licencing and Distribution Service). Healthcare organisations are responsible for their local implementation updates. SNOMED International recommends updating to the newest version of the International Release within 180 days of its publication.
7.3. Are the end users notified that there is an update or is it an ongoing background process?
This depends on the vendor system. There are examples of both.