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1.5

Following this introduction (Section 1), the implementation guide 'Using SNOMED CT in HL7 Version 3' contains both normative and informative sections.


Section 2 (normative) provides detailed guidance on dealing with specific overlaps between RIM and SNOMED CT semantics. It contains normative recommendations for use of SNOMED CT in relevant attributes of various RIM classes including Acts, ActRelationships and Participations. It also contains a subsection providing recommendations on Context conduction. Each subsection in consists of:


  • A brief introduction to the item;
  • An explanation of the potential overlap;
  • A statement of rules and guidance on usage;
  • A supporting discussion and rationale.

Section 3 (informative) provides a set of examples and patterns for representing common clinical statements. The approaches taken are consistent with the normative statements in Sections 2 and 5, as well as work being done within HL7 domain committees.


Section 4 (informative) describes normal forms, including their use with SNOMED CT. It also discusses considerations for transformations between various common representations and SNOMED CT or HL7 RIM based normal forms.


Section 5 (normative) contains a number of constraints on SNOMED CT Concepts applicable to relevant attributes in each of the major classes in the Clinical Statement model. These normative constraints are presented as a series of tables in section 5.3. This section also summarises the benefits and weaknesses of the constraints offered (see also Appendix E).


Appendix A (informative) provides a general discussion of the potential overlaps between an information model and a terminology model and the pros and cons of various possible approaches to managing these overlaps.


Appendix B (reference) provides references to relevant documents including SNOMED CT specifications and also outlines the compositional grammar used to express many of the examples in this document.


Appendix C (informative) notes the changes to this document since its the last ballot draft.


Appendix D (informative) identifies known open issues in SNOMED CT that limit the completeness and consistent application of some of the guidance in this document.


Appendix E (informative) provides a more detailed discussion of approaches to normative constraints on SNOMED CT and identifies the need for further development of formal vocabulary rules to support this.