Observational Health Data Sciences and Informatics

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Greetings

I am requesting that Athena/Usagi split the SNOMED CT load into individual Country specific editions. Meaning that when downloading SNOMED CT content from Athena or importing SNOMED CT into Usagi, the user would have the option to import:
  * Solely the international edition
  * Australian Edition
  * UK Edition
  * U.S. Edition

While I am not aware of a country referencing content that only exists in another country's extension, the possibility for this situation does exist. I believe the preferred method would be if a concept is required for use in more than one country, then a request should be submitted to a national release center to have the concept promoted to the international edition.

Please reference the following documents from IHTSDO:
- https://confluence.ihtsdotools.org/display/DOCESG/2.6.4+Guidance+on+Promoting+Components
- Editorial Guide: https://confluence.ihtsdotools.org/display/DOCEG
- Technical Implementation Guide: https://confluence.ihtsdotools.org/display/DOCTIG


Please refer to Github ticket: GB English concepts appearing in mapping selection list for SNOMED CT  #23


Justification for the request:

1. As a specific country maps their local codes to SNOMED CT, they will likely only have access to content in their country's edition. (e.g. International edition + Country Extension). Usagi does not differentiate content from different country extensions, so it is possible for a mapper to map to a concept that only exists in another country's extension and is not available for general use within their on country.

2. On the technical side, there is a "risk" that by combining content from multiple national extensions you could end up with duplicate representations of the same concept from the different extensions with different concept identifiers

3. As a comparitive international example, HL 7 FHIR wg has decided to only use international edition concepts or request that concepts in the U.S. national extension be promoted to the international edition so that they do not encounter licensing restrictions imposed by a country's national release center.

Please let me know if you need additional information to consider this request.

Thanks
John Snyder, DTR, RDN