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For example a CDS rule, using the SNOMED CT US edition, dated 20160901 (September 1st 2016), may refer to the concept

scg-expression5281000124103
Concept
ShowPartsterm
ShowFormatnospace
t5281000124103 |Persistent
asthma|
. If this rule was executed against the SNOMED CT International Edition (20170131), then this extension concept would not be found, and the rule could not be executed.

Similarly, a CDS rule using the International edition (20170131) may refer to the concept

scg-expression721039003
Concept
ShowPartsterm
ShowFormatnospace
t721039003 |Dual
energy
computed
tomography|
. If the rule was executed against the 20160731 International edition (or an older version), then this concept (created in the 20170131 version) would not be found, and the rule could not be executed. This would also be true if the same CDS rule was executed against the US edition (20160901), because this edition is dependent on the 20160731 International edition.

Therefore, CDS knowledge artifacts referencing SNOMED CT concepts must be executed (by the inference engine) using a SNOMED CT substrate that includes the sameor same

Gloss
Spacetrue
tmodules,
or a superset of the modules included in the SNOMED CT substrate used to author the artifact. In addition, the SNOMED CT substrate used to execute the CDS artifacts must use the same version, or a more recent version of these SNOMED CT modules, to ensure that all the referenced concepts are present. Please note that if a newer version of the substrate is used to execute the rules, then it is possible that a concept or relationship used at the time of artifact authoring may have become inactive. Edition and version dependencies such as these should be checked when adopting new CDS artifacts or updating a CDS system to use a newer version of SNOMED CT.

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For example, if a CDS rule is triggered when the diagnosis recorded in the EHR is a descendant of

scg-expression195967001
Concept
ShowPartsterm
ShowFormatnospace
t195967001 |Asthma|
, that is: scg-expression
Concept
ShowPartsterm
ShowFormatblock
IF < 195967001
t IF < 195967001 |Asthma|
THEN
...
ShowFormatinline
and this rule is executed over the SNOMED CT International edition, dated 20170131 (January 31st 2017), then EHR records which capture a diagnosis of scg-expression
Concept
ShowParts
t
term
5281000124103
|Persistent
asthma|
ShowFormatinline
from the SNOMED CT US edition (20160901) will be unsuccessful in triggering the CDS rule.

Similarly, if a CDS rule is triggered when the diagnosis recorded in the EHR is a descendant of

scg-expression
Concept
ShowPartsterm
ShowFormatnospace
19829001
t19829001 |Pulmonary
disease|
, that is: scg-expression
Concept
ShowPartsterm
ShowFormatblock
IF < 19829001 |Pulmonary disease| THEN
t IF < 19829001 |Pulmonary disease| THEN ...
ShowFormatinline
and this rule is executed over the US edition (20160901), then EHR records which capture a diagnosis of scg-expression
Concept
ShowParts
t
term
12240951000119107
|Squamous
cell
carcinoma
of
left
lung|
ShowFormatinline
will be unsuccessful in triggering the CDS rule. This is because the US edition (20160901) is dependent on the International edition (20160731), and the concept referenced above was added to the International edition (20170131).

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