The Charter Members of the International Terminology Standards Development Organization (IHTSDO® - also to be known as the SNOMED SDO®) have developed and agreed its Articles of Association. These establish the IHTSDO® under Danish law as a not-for-profit organization headquartered in Copenhagen.

The Charter Members are health sector organizations from nine nations (Australia, Canada, Denmark, Lithuania, New Zealand, Sweden, The Netherlands, The United States and The United Kingdom) who agreed, in the fall of 2006, to establish a standards development organization (SDO) that would acquire the Systematized NOmenclature of MEDicine Clinical Terms (SNOMED CT®) standard from the College of American Pathologists (CAP) and then maintain and promote it internationally. What follows is a much abbreviated version of the Articles of Association intended to give readers a quick overview of some of the main features of the Association. To download the complete Articles please click here.

As set out in its Articles of Association the purpose of the IHTSDO® is to:

• Acquire, own and administer the rights to SNOMED CT®, other health terminologies and/or related standards and other relevant assets (collectively know as “Terminology Products”);

• Develop, maintain, promote and enable the uptake and correct use of its Terminology Products in health systems, services and products around the world; and 

• Undertake all related incident activities conducive to achieving this purpose.

In doing this, its objectives are to:

• Enhance the health of humankind by facilitating better health information management; 

• Contribute to improved delivery of care by clinical and social care professions;

• Facilitate the accurate sharing of clinical and related health information, and the semantic interoperability of health records;

• Encourage global collaboration and cooperation with respect to the ongoing improvement of the terminology products; and

• Provide the foregoing on a globally coordinated basis, thereby enabling the members and the related organizations within their Territories to pool resources and share benefits relating to the development and maintenance of, and their utilization of and reliance upon, the terminology products.

The following principles will guide all the IHTSDO®’s activities:

• The Association will seek to govern itself and conduct all of its activities in accordance with principles of openness, fairness, transparency and accountability to its members.

• The Association will seek to conduct all of its activities in a prudent, responsible and ethical manner that is conducive to ensuring its long-term viability, the overall value and utility of all of its assets and, in particular, the technical and clinical fitness of the terminology products. 

• The Association will seek to work with other parties relevant to achieving its purpose and objectives in a spirit of collaboration and will, as appropriate, seek to facilitate interoperability of its terminology products with other relevant standards and products.

• The Association will seek to encourage intellectual contributions to the terminology products from other entities upon terms that permit such other entities to use and distribute their own work for any purpose that does not conflict with the Association's purpose and objectives.

• The Association will strive to avoid taking any action which is expected to confer upon certain members or other parties undue advantages over other members or over the Association, except with respect to the rights, privileges and obligations granted to the Members specified in these articles.

At the time of its establishment, the core business of the IHTSDO is to develop, maintain, license and distribute the International Release of SNOMED CT® (initially on a twice yearly basis).  In doing this, it will provide for a range of supporting services and operate governance arrangements designed to ensure openness, transparency and appropriate stakeholder engagement and participation in its activities. 

Membership of the IHTSDO® is open to either agencies of national governments or other bodies (such as corporations or regional government agencies) endorsed by an appropriate national government authority within the country they represent. Two kinds of memberships exist: Ordinary and Charter.  The Charter or founding members of the Association are:

• The National E-Health Transition Authority Ltd (NEHTA), a public company limited by guarantee, as the Charter Member for Australia;

• Canada Health Infoway Inc., as the Charter Member for Canada;

• The Danish National Board of Health as the Charter Member for Denmark;

• The Lithuanian Ministry of Health as the Charter Member for Lithuania;

• The Minister of Health, Welfare and Sport (the “DMH”) as the Charter Member for the State of The Netherlands;

• The New Zealand Ministry of Health, as the Charter Member for New Zealand;

• The Government of the Kingdom of Sweden, represented by the Ministry of Health and Social Affairs, as the Charter Member for Sweden;

• The Secretary of State for Health, acting through its agency National Health Service (NHS) Connecting for Health, as the Charter Member for The United Kingdom of Great Britain, Northern Ireland, the Channel Islands and the Isle of Man; and

• The U.S. National Library of Medicine (a unit of the National Institutes of Health, Department of Health and Human Services) (NLM), a U.S. federal government agency, as the Charter Member for The United States of America.

No other Charter Members will be permitted. All future IHTSDO® members will be Ordinary Members. The rights and obligations of ordinary and Charter members are essentially the same, with the following exceptions:

• Charter Members are entitled,  but not required, to have a nominee hold one of the positions on the IHTSDO® Management Board until the conclusion of the first meeting of the General Assembly that is held after 31 December 2011; and

• may remove or replace any such nominee from time to time at their own discretion.

To ensure the integrity of its Terminology Products and protect the interests of the Association all its members are required, among other things, to ensure that they:

• Use, adapt or distribute the Terminology Products and the Association’s trademarks within their territory is in accordance with the IHTSDO® Articles of Association;

• Establish arrangements for licensing and distribution of the Terminology products within their territory; and

• Provide documentation on recommendations for enhancements, changes, updates and corrections, maintain a register of all licenses granted and encourage experts and other appropriate persons to contribute to the work of the Association.

Overarching governance of the Association is exercised by its General Assembly, which is the Association’s highest authority and can make binding decisions on all matters pertaining to the Association and its Articles. IHTSDO® members each appoint a member of the General Assembly, each of whom have one vote.  The General Assembly is charged with assuring that the purpose, objectives and principles of the Association are pursued and safeguarded. Its meetings will be open to the public except in regard to matters that the Management Board judges to be inappropriate for public disclosure i.e. discussions or disclosures which may be contrary to the Association’s interests.

 
The General Assembly will meet in April and October each year. The April meeting will focus on the Management Board’s annual report, financial accounts, auditors report, appointment of the external financial auditor and any general or specific business referred by the Board or IHTSDO® members.  The October meeting will focus on the presentation and adoption of the Management Board’s annual strategic, business and operation plans as well as membership fees for the coming years, the election of Management Board and committee members and any general or specific business referred by the Management Board or IHTSDO® members.

 
The IHTSDO® Management Board has overall responsibility for the management and direction of the Association. It appoints the executive officers of the IHTSDO® who are accountable to it for the day-to-day operation of the Association.

The Board consists of at least three and no more than twelve Directors. Each of the nine Charter Members is entitled to appoint a Board member until the first meeting of the General Assembly that is held in 2012. After that meeting all Board members will be elected by the General Assembly. From this point forward it is intended that the Board will be composed of a maximum of three directors from each of four geographical areas: Africa, the Americas, Europe and Asia/Oceania.

 
Much of the ongoing work of maintaining and developing the Association’s Terminology Products will be conducted by a series of Committees (and associated Working Groups). There will be two kinds of committees – standing and ad hoc.

The four IHTSDO Standing Committees are:

• Content: The Content Committee will be responsible for and shall advise the Management Board on priorities and issues pertaining to the definition and maintenance of the clinical content and structure of SNOMED CT and its related standards and the Association's other Terminology Products.

• Technical: The Technical Committee will be responsible for and will advise the Management Board on the specification and monitoring of the technical framework and tools for the development and maintenance of SNOMED CT and its related standards and the Association's other Terminology Products and framework for doing business.

• Research and Innovation: The Research and Innovation Committee will be responsible for and will advise the Management Board on the primary or secondary investigation of terminology challenges that will be required in the 3-5 year time frame and for testing new and unproven ideas in terminology development for their potential implementation.

• Quality Assurance: With a view towards managing and lowering the risks of the Association, the Quality Assurance Committee shall have responsibility for the development and quality assurance of SNOMED CT® and its related standards and the Association's other Terminology Products in harmony with proper respect to external standards. 

The Management Board may establish Ad hoc Committees to assist the Management Board or the Executive Officers for a specific purpose.

The Association, as part of its mandate to develop and achieve a high degree of interoperability and harmonization between SNOMED CT® and relevant standards produced by other Standards Development Organizations (SDOs), will create harmonization bodies with these SDOs. These bodies will focus on such areas as development plans, implementation guidance, conformance criteria, overall management and governance of joint work, clarifying and describing intellectual property implications of joint work and securing funding for that work.