Current Release 1

Release Scope

1. Request for change received from Canadian implementers from September 15, 2018 to March 14, 2019 - InfoRMS SNOMED CT RFC Project
   1. Requests to add, change or inactivate content in both English and French 
   2. Corrections to content (typographical errors, metadata, others)  
   3. EN CA concepts promoted to international version of SNOMED CT
      
      
2. Subsets - InfoRMS Subset RFC Project
   1. Subsets updated: Immunization subsets, Primary Health Care subsets and the Communicable Disease subset. 
   2. New subset created: PrescriptionMedicationCoverage and PrescriptionIndicationForUse
   3. No subsets inactivated
   4. The CA Edition Refset module contains the filter definition for 14 of the extensional published reference sets. They can be found in the Simple query specification reference set (foundation metadata concept). 
   5. Note that all reference sets are also published as a simple reference set (enumerated).
      
      
      
      
3. New in this release
   1. Modules changes
      

      1. The Canadian Edition of SNOMED CT was "modularized" to allow

         1. Selection of the terminology "products" according to the different audiences requirements. For example: not all stakeholders require the French content.
         2. Publication of different Canadian terminology content in different release cycles. This pattern enables the tracking of dependencies between releases from different modules that are related but asynchronous. For example: Update and publish reference sets (subsets) that are impacted by terminology changes or when new CA Edition content has been developed.
            
            
      2. Since 2016, the SNOMED CT Canadian Edition RF2 baseline content has been distributed in three modules: 
         1. The Canadian English extension, the basic component 
         2. The Canadian French extension, as an optional component
         3. The Canadian extension Refsets. They were distributed in a separate module since they could require more frequent release cycles than the basic component.
            
            
      3. In 2019, simplification of the module dependencies is desirable to simplify the development, management, publication and implementation of the Canadian Terminology content. 
         1. This change will simplify the modeling of Canadian content
         2. This change will allow for a more agile release cycle
            
            
      4. Proposed change:
         1. Promote the refsets to the basic Canadian English module. The Canadian Edition will then be composed of two modules, instead of three.
         2. The identifiers of the refsets and the refset members would not change, they would be moved to the basic en-CA module. 
         3. The change is not expected to significantly impact implementations as the component identifiers would be moved to a higher level extension and transparently available for routine usage.
         
         
         
   2. OWL DL Enhancement

1. 1. 1. To enable improvements to the quality and analytics capabilities of SNOMED CT, SNOMED International is enhancing the underlining logic profile of the terminology. The changes require expressing the concept definitions using Web Ontology Language (OWL). These expressions will be published as an RF2 compliant reference set, replacing the stated relationships file. It is planned that the stated relationships file will be deprecated in the July 2019 International release. 
         
         
      2. You may be affected by the coming changes if your implementation requires classification or rely on relationships and subsumptions. In fact, the changes being introduced expand the Description Logic features used to define concepts in SNOMED CT. These changes affect the RF2 distribution format, and particularly the stated and inferred relationships file content and interpretation. 
         
         
      3. As of the July 2019 release of SNOMED CT, the stated relationships file will be inactivated and replaced by one OWL expression refset. The profile for the extended set of features SNOMED CT will use is defined at http://snomed.org/lps. While the stated relationship file is still present and individual concept definitions do not yet use extended features, the content of the inferred relationships file will be affected in the January 2019 release. Any implementations performing subsumption testing based on the distributed inferred relationship file may be affected and should be reviewed and carefully tested prior to upgrading.

1. 1. 1. Proposed change and guidance:
         1. There is a refset OWL expression file added in each of the release types of the CA Edition. 
         2. If you need to classify, please contact Infoway for support and guidance.
         
         
         
      c. French translation

1. 1. 1. As part of the PrescribeIT Project many subsets have been updated with the translation of French synonyms. These French terms were added to different code systems such as UCUM, HL7 FHIR and SNOMED CT. 
         1. These synonyms have been added to PrescribeIT subsets V.3 (SR-145)

1. 1. 1. Validation of existing translated synonyms has been completed by Dr Beauchemin 
         1. On behalf of Infoway, a warm thank you Dr Beauchemin for providing clinical expertise and guidance for this review.
         2. This review was done in order to assure high quality of translation where Canadian translation differed from the SNOMED International French Starter Set and/or the France PHAST translation
         3. All issues were reviewed and outcomes documented in the Informs RFC tickets: BSCT-8534, BSCT-7338, BSCT-8098.

1. 1. 1. The French Editorial Guidelines have been updated.
      
      
      d. Immunization

1. 1. 1. Infoway has received a request to change the Manufacturer for the Marketing Authorization Holder (MAH) on vaccine concepts where this information appears. (BSCT-8425)
      2.  Refer to the Immunization Main Page, for more details
         
         
         
2. Known issues
   1. The recent Immunization request for change (to change the Manufacturer for MAH) has targeted only a small number of concepts. Infoway is aware that other concepts should be modified. The review of potential changes will be done for the next CA Edition release.
      
      

Refer to section 5. Questions and Comments, if you want yo know more about SNOMED CT or if you have comments for us.

Refer to section 6. Requests for Change (RFC), if you need more information on how to request on terminology content or subsets. 

Refer to section 7. Updates and Publications, if you want to be aware of when changes are published.