A variety of implementation approaches were outlined in Section 4. This section references the approaches summarized in Section 4, and discusses some potential SNOMED CT implementation strategies, factors influencing implementation success, and possible measures of success.

Staged Implementation

Numerous pathways exist for the incremental implementation of SNOMED CT. These allow control of the timing and degree to which the existing designs and terminology resources are superseded.

Some Vendors have chosen to introduce SNOMED CT as part of a distinct, new product in their line of products. Many Vendors have introduced SNOMED CT in increments, with minimal disruption to their customers or end users. If a Vendor builds a new product, it is likely that a single-stage implementation would be appropriate.

Section 4 summarizes a range of implementation approaches that differ in the extent to which they utilize different features of SNOMED CT.

Single vs Multi-stage Implementations

Single stage implementations can:

Multi-stage implementations can:

One possible example of a staged implementation could involve a sequence of:

Relationships and Dependencies

Commercial and technical concerns about dependence on third-party components may be a valid reason for in-house development of all the required 'terminology services'.

However, a range of off-the-shelf terminology resources, such as SNOMED CT subsets, may be available to reuse, for example, to improve the user's data entry experience. Some of these resources will be usable worldwide and free of charge, while others may be available under some type of license. A dependence on a third party to maintain derivatives, such as subsets, can be eliminated by taking that responsibility in-house. Three distinct options are therefore:

Language and Dialect strategies

SNOMED CT implementation can greatly simplify the configuration of an EHR product with terms expressed in the language or dialect required by the customer. A SNOMED CT implementation strategy should exploit the benefits of SNOMED CT for language and dialect localization. For example, using a SNOMED CT language reference set, which represents the preferred and acceptable terms in a given language or dialect, a subset used to populate a drop-down box can be simply re-configured to show terms in a different dialect. For other parts of a localization, such as the headings in a form, it is also possible to use SNOMED CT language reference sets as a reference source. The extent of use of language reference sets should be considered as part of a product strategy.

To exploit the language and dialect capabilities of SNOMED CT, a Vendor can use the localized content provided by a National Release Center.

A language or dialect variant needed by the customer can be used in any of the following scenarios:

Measures of Implementation Success

The extent to which a SNOMED CT implementation is successful can be evaluated in many ways, including the evidence-based evaluation of:

Factors which Influence Implementation Success

Vendor Perspective

The factors which may influence implementation success, from a vendor perspective, include:

Customer Perspective

The factors which may influence implementation success, from a customer perspective, include: