2010 Update

United States, April 8, 2011

Statement of who the National Release Centre organization is:
The National Library of Medicine (NLM), part of the National Institutes of Health in Bethesda, Maryland, U.S.A., is the world's largest medical library and the central coordinating body for clinical terminology standards within the US Department of Health and Human Services.

Contact representatives:

          General Assembly – Betsy Humphreys (GA Alternate – Vivian Auld)

          Management Board – Andy Wiesenthal (MB Alternate – Simon Cohn)

          Member Forum – Jan Willis and Vivian Auld

National Activities:
NLM promotes use of SNOMED CT as part of a suite of vocabulary and messaging standards needed for interoperable infrastructure for health information technology. NLM is building upon the IHTSDO's Workbench to develop an open and transparent process, accessible to all stakeholders, for coordinating US input to SNOMED CT content development.

James Case, DVM, Ph.D., joined NLM in January 2010 as our SNOMED CT specialist coordinating activities relating to the US request submission process and development of the US Extension to SNOMED CT. He has participated in standards activities for many years, and is active in HL7. He was instrumental in the development of the National Animal Health Laboratory Network, a cooperative effort between USDA and a national group of cooperating institutions and which involved using standard terminologies from LOINC and SNOMED CT. 

Access to SNOMED CT was significantly improved with implementation of the new UMLS Terminology Services (UTS), which provides a streamlined license request interface for Unified Medical Language System (UMLS)/SNOMED CT Affiliate licensing. It introduces a new SNOMED CT Browser that enables searching by SNOMED CT identifiers (ConceptID and DescriptionID), and a term search feature that leverages the added value of synonyms from over 130 other terminologies in the UMLS Metathesaurus. 

NLM collaborated with IHTSDO Management and Kaiser Permanente to establish an arrangement for the donation of Kaiser Permanente's Convergent Medical Terminology (CMT).

Implementation Plans and Other Activities:
In 2010 final regulations were issued implementing the first phase of the US incentive program that will promote "Meaningful Use" of electronic health record technology, in accordance with legislative provisions enacted in 2009. Standardized collection and exchange of health data using standard vocabularies and formats, including SNOMED CT, will be phased in between now and 2015. 

NLM introduced MedlinePlus Connect (http://medlineplus.gov/connect), a free service that allows EHR systems to draw patient specific information from MedlinePlus, an authoritative up-to-date health information resource for patients, families and health care providers. MedlinePlus Connect accepts requests from EHRs based on diagnoses (problem codes) and medications. NLM has mapped MedlinePlus health topics to two standard diagnostic coding systems (SNOMED CT and ICD-9-CM) used in EHRs to support "Meaningful Use".

NLM released the SNOMED CT Route of Administration (ROA) Subset, a listing of the current set of terms related to the location of administration for clinical therapeutics, designed to facilitate the use of SNOMED CT as the primary coding terminology for substance administration documentation. Additionally NLM continues to maintain the CORE Problem List Subset of SNOMED CT and to work with relevant parties on development of other use specific subsets that will facilitate adoption and use of SNOMED CT. 

Number of Affiliate Licensees:
UMLS licensees:
                         3560 (2657 US; 903 international)

Relevant Home Pages:
NLM Website: http://www.nlm.nih.gov
UTS Page: https://uts.nlm.nih.gov/home.html
SNOMED CT Page: http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html
Affiliate License Page: https://uts.nlm.nih.gov/license.html (see Appendix 2)

E-mail: custserv@remove-this.nlm.nih.gov

Affiliate activities:
NLM distributes SNOMED CT (both English and Spanish versions) as part of the UMLS Metathesaurus. NLM licensees have access to SNOMED CT in multiple formats as part of the UMLS Metathesaurus, where it is linked to many other biomedical terminologies and natural language processing tools. UMLS licensees also have access to SNOMED CT in its native file formats from the UTS.