TOPIC 2: Global Promotion of Content

Assumptions

Content is currently created locally due to the perceived delay in getting content through the process into a published International Edition
There will continue to be data which is not available in the International Edition (will this be initially large volumes but level off once those have been tackled)?
SNOMED International does not have the capacity to author all the content requested by members and the wider community
Some SNOMED CT extensions contain the same content as other SNOMED CT extensions.

The global challenge is, as always, a capacity one. If too much continues to be promoted, the central team does not have the capacity to review everything, whilst doing other International work.
Can templates be used more locally to enforce editorial and modeling guidelines?
All identifiers (concept, description and stated relationships) would be kept in the promotion.
The workflow still needs to reflect the one currently used by CRS, which would imply that any solution needs to use CRS as the entry point. This is technically feasible, but the functionality would need to be added (import RF2 for example).
Following the CRS workflow still means a concept by concept approach... is this efficient or the right way to do it? What are the other options?
The better modelled the data, the easier to review and include
- What training or accreditation should be required by terminology authors who request content be promoted into the International Edition?

Currently only concept ID is kept, creating overhead and duplication for descriptions and relationships in the local extension. Being able to promote all identifiers will resolve this issue.
If this was done, does this make the international 'upgrade' an easier, less painful process?
How many members have the ability to provide an RF2 of only content to be promoted? Is this a solution only applicable to a minority?
This is also functionality that should be built into the Managed Service by SNOMED International anyway... a concept promotion button directly creating a CRS request.

Organizations in countries have to currently go through their NRC, and this is unlikely to change outside of identified bodies who take ownership (whatever this means) of a domain of knowledge.
Is there a more efficient way for local organizations to participate in getting content promoted? In fact, is there even a lot of this very local content?
Are these exclusions to what can be promoted, including interface terms?

If multiple SNOMED CT extensions contain overlapping content, then how do we decide which version of the content gets promoted?
- Will this lead to greater overhead for those NRCs whose content is not promoted, who need to modify implementations to use the identifiers of the content that was selected for promotion
  - Note: This challenge already exists when new content is added into the international release, which was modelled independently in an extension - However will the scale of this challenge increase? And if NRCs don't resolve these overlaps, then will the existing issues just continue?
- Should additional tools and/or mechanisms be put in place to support those countries whose content was not chosen for promotion - e.g. mapping tools, history mechanisms, guidance etc.