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ONC Regulation FAQs

#47 Question [2-15-047-1]

Are versions of the U.S. Edition of SNOMED CT® acceptable for the purposes of certifying EHR technology to 2014 Edition EHR certification criteria that include SNOMED CT® as a required standard? Further, is only the U.S. Edition of SNOMED CT® necessary for certification and not the International Release of SNOMED CT®?

Answer: Yes to both questions. The U.S. Edition of SNOMED CT® is now the official source of SNOMED CT® for use in US healthcare systems. Since its March 2013 release, it has been composed of:

  • The International Release of SNOMED CT®
  • The U.S. Extension to SNOMED CT®, a formal extension to the International Release containing US-specific content (concepts, descriptions, relationships, and history).

The September 2012 Release of the U.S. Extension to SNOMED CT® marked the last time that National Library of Medicine (NLM) made the standalone US Extension files available for download. Future releases of the U.S. Edition will include the latest International Release of SNOMED CT®. See http://www.nlm.nih.gov/research/umls/Snomed/us_edition.html

For certification to the 2014 Edition EHR certification criteria that include the SNOMED CT® standard, EHR technology must, at a minimum, be certified to the July 2012 International Release of SNOMED CT® and the March 2012 Release of the US Extension to SNOMED CT®. However, per 45 CFR 170.555, an ONC-Authorized Certification Body (ONC-ACB) may certify EHR technology to a newer version of SNOMED CT® and a certified Complete EHR or certified EHR Module may be upgraded to comply with a newer version of SNOMED CT® than the one that has been adopted in the Code of Federal Regulations (i.e., the July 2012 International Release of SNOMED CT® and the March 2012 Release of the US Extension to SNOMED CT®) without adversely affecting its certification status, unless the Secretary prohibits the use of a newer version for certification.

We further note that an EHR technology developer could immediately include a version of the U.S. Edition of SNOMED CT® (or a newer version of another “minimum standards” code set) when presenting its Complete EHR or EHR Module for certification rather than having to use the older version adopted in the Code of Federal Regulations in order to get certified. The inclusion of the newer version would be voluntary, and the EHR technology developer would still have the option for its EHR technology to be certified to the version specified in regulation (in the case of SNOMED CT®, the July 2012 International Release of SNOMED CT® and the March 2012 Release of the US Extension to SNOMED CT®).

 

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