Challenge

European eHealth systems used different clinical terminologies, making it difficult for healthcare information to retain the same meaning when exchanged between systems, organisations and countries. This lack of semantic interoperability could limit continuity of care and create risks for patients. Europe therefore needed reliable evidence on whether SNOMED CT, a comprehensive clinical terminology, could support interoperable eHealth services across different languages and national health systems.

Solutions

ASSESS CT conducted an independent assessment of SNOMED CT, comparing its adoption with two alternatives: taking no coordinated action at EU level or developing a European interoperability framework without SNOMED CT. The project combined:

• Surveys and national focus groups examining existing SNOMED CT use
• Studies using clinical data in several European languages
• Tests of manual and automated clinical-text annotation
• Analysis of terminology coverage and compatibility with clinical information models
• Assessment of financial, organisational, governance and socioeconomic implications
• Expert workshops involving specialists and Member State representatives

This evidence was used to develop recommendations for the European Commission, Member States and standards-development organisations.

Results

ASSESS CT concluded that SNOMED CT was the strongest available candidate for a core reference terminology supporting European, national and regional eHealth interoperability. Its coverage of health concepts was broader than that of any other individual termniology assessed.

However, the project found that SNOMED CT should not be used as a standalone solution. It recommended incorporating it into a wider ecosystem that includes international classifications and national, multilingual interface terminologies.

The project proposed gradual adoption based on clearly prioritised use cases, accompanied by cooperation between Member States, common governance arrangements and solutions for historical data. Its evidence and recommendations provided the European Commission and national authorities with a stronger foundation for developing coordinated terminology and semantic-interoperability strategies.