SNOMED CT is the most comprehensive, multilingual clinical healthcare terminology in the world. It is a resource with comprehensive, scientifically validated clinical content. SNOMED CT enables consistent, processable representation of clinical content in electronic health records. When implemented in software applicationsSNOMED CT can be used to represent clinically relevant information consistently, reliabl comprehensively as an integral part of producing electronic health information. SNOMED CT supports the development of comprehensive high-quality clinical content in health records. It provides a standardized way to represent clinical phrases captured by the healthcare professional and enables automatic interpretation of these. SNOMED CT is a clinically validated, semantically rich, controlled vocabulary that facilitates evolutionary growth in expressivity to meet emerging requirements. SNOMED CT based clinical information benefits individual patients and clinicians as well as populations and it supports evidence based care. The use of an Electronic Health Record (EHR) improves communication and increases the availability of relevant information. IHTSDO works with other standards oganisations to ensure interoperability and a key area has been the work with ICN to enable the use of ICNP and SNOMED CT by the nursing profession internationally.

Due to fundamental differences in design and editorial policies, semantic interoperability between two de facto standard terminologies in the healthcare domain--the International Classification of Diseases (ICD) and SNOMED CT (SCT), requires combining two different approaches: (i) axiom-based, which states logically what is universally true, using an ontology language such as OWL; (ii) rule-based, expressed as queries on the axiom-based knowledge. We present the ICD-SCT harmonization process including: a) a new architecture for ICD-11, b) a protocol for the semantic alignment of ICD and SCT, and c) preliminary results of the alignment applied to more than half the domain currently covered by the draft ICD-11.

The upcoming ICD-11 will be harmonized with SNOMED CT via a common ontological layer (CO). We provide evidence for our hypothesis that this cannot be appropriately done by simple ontology alignment, due to diverging ontological commitment between the two terminology systems. Whereas the common ontology describes clinical situations, ICD-11 linearization codes are best to be interpreted as diagnostic statements. For the binding between ICD codes and classes from the ontological layer, a query-based approach is favoured.

Semantic Interoperability, i.e., preserving the meaning among health related data, is one of the crucial topics of Health Informatics. The International Classification of Diseases by WHO and SNOMED-CT, by IHTSDO, are the most prominent systems currently available for coding health data. In 2010 a collaboration agreement between the maintainers of ICD and SNOMED-CT has been signed, and gave birth to a Joint Advisory Group (JAG), aimed at defining a common basis between both terminological systems, in the form of a Common Ontology. In fact, in addition to the base task of defining the logical structure of the Common Ontology, JAG also designed a workflow for identifying its content items. As a preliminary step, the investigation of three specific ICD11 chapters has been designed to understand the total workload and calendar of activities. The present paper briefly describes the method and the tool that has been developed to support the latter investigation.

The improvement of semantic interoperability between data in electronic health records and aggregated data for health statistics requires efforts to carefully align the two domain terminologies ICD and SNOMED CT. Both represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation, requires a specific resource, named Common Ontology. We present the ICD-11 SNOMED CT Common Ontology building process including: a) the principles proposed for aligning the two systems with the help of a common model of meaning, b) the design of this common ontology, and c) preliminary results of the application to the diseases of the circulatory system.

In order to support semantic interoperability in eHealth systems, domain terminologies need to be carefully designed. SNOMED CT and the upcoming ICD-11 represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation requires a thorough analysis of the intended meaning of their representational units. We present the ICD11 SNOMED CT harmonization process including: a) the clarification of the interpretation of codes in both systems as representing situations rather than conditions, b) the principles proposed for aligning the two systems with the help of a common ontology, c) the high level design of this common ontology, and d) further ontology-driven issues that have arisen in the course of this work.

A collaboration between the International Health Terminology Standards Development Organisation (IHTSDO®) and the World Health Organization (WHO) has resulted in a priority set of cross maps from SNOMED CT® to ICD-10® to support the epidemiological, statistical and administrative reporting needs of the IHTSDO member countries, WHO Collaborating Centres, and other interested parties. Overseen by the Joint Advisory Group (JAG), approximately 20,000 SNOMED CT concepts have been mapped to ICD-10 using a stand-alone mapping tool. The IHTSDO Map Special Interest Group (MapSIG) developed the mapping heuristics and established the validation process in conjunction with the JAG. Mapping team personnel were selected and then required to participate in a training session using the heuristics and tool. Quality metrics were used to assess the training program. An independent validation of cross map content was conducted under the supervision of the American Health Information Management Association. Lessons learned are being incorporated into the plans to complete the mapping of the remaining SNOMED CT concepts to ICD-10.