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Unified Medical Language System® (UMLS®)

SNOMED CT Affiliate Reporting Requirement FAQs

Q: What is an Affiliate?

A: A SNOMED CT Affiliate is anyone licensed to use SNOMED CT. The UMLS Metathesaurus license (License Agreement for Use of the UMLS Metathesaurus) includes the SNOMED CT Affiliate License Agreement as Appendix 2. Therefore, all UMLS Licensees are licensed to use SNOMED CT and are considered SNOMED CT Affiliates, whether or not they use SNOMED CT.

Q: Why does the UMLS Metathesaurus License include SNOMED CT?

A: The NLM is the U.S. Member of the IHTSDO and, as such, licensed to distribute SNOMED CT at no cost in accordance with the Member rights and responsibilities outlined in the IHTSDO's Articles of Association. Once NLM became a Member of the IHTSDO we determined that the quickest way to begin distributing SNOMED CT was to include the terminology in our existing distribution system, the UMLS Metathesaurus. The new license terms have therefore been incorporated into the License Agreement for Use of the UMLS Metathesaurus.

Q: We don't use SNOMED CT. How can we remove the SNOMED CT license but keep the UMLS license?

A: You can’t. The SNOMED CT license agreement has been incorporated into the UMLS Metathesaurus License as Appendix 2; there is no way to license the UMLS without agreeing to the SNOMED CT license.

Q: What is the Affiliate License Statement of Account? What is its purpose?

A: The Affiliate License Statement of Account is a place for Affiliates to document their use of SNOMED CT in non-Member countries. The information is collected by Members on behalf of the IHTSDO. Depending on the use described the Affiliate may be invoiced for their use of SNOMED CT in non-Member countries. The purpose is to avoid Members effectively subsidizing use of SNOMED CT in non-Member territories.

Q: I live in the U.S. so I assume I don't need to fill out the report?

A: The issue isn’t where you live but where you used SNOMED CT. If you used SNOMED CT in a system located in a Member Country then you do not need to fill out the report. If, however, you used SNOMED CT in a system located in a non-Member Country, then you should fill out the report.

Q: How are the fees assessed?

A: Fees are assessed twice a year (January and July) based on the feedback received from Affiliates via the Affiliate License Statement of Account. The fee structure for the use of SNOMED CT outside of the member countries is listed in Appendix B (License Fees in Non-Member Territories) of the SNOMED CT Affiliate License Agreement which is incorporated as Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus. Data Creation Systems, Data Analysis Systems, and Derivative or Third Party Extension Development are charged differently. In addition a number of research activities may be excluded from paying a fee. Please review Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus for more information.

Q: I only used it for research purposes, do I need to fill out the report?

A: If the research project will be conducted in a non-Member country then you should fill out the report. The IHTSDO and its members encourage the use of SNOMED CT in research that contributes to broadening our collective understanding and knowledgebase. Research projects may qualify for a free license if they:

  • Are supported by a formal proposal that has been peer reviewed,
  • Have been ethically approved in accordance with the prevailing legislation, regulations and guidelines in effect in the relevant territory,
  • Are conducted within a definite timeframe, and
  • The results of the research are offered for publication in peer-reviewed public journals and are provided to the IHTSDO free of charge.

To request a fee waiver, please contact the IHTSDO providing evidence that your research project meets the above criteria.

Q: I want to use it for humanitarian purposes, do I need to fill out the report?

A: If the project will be conducted in a non-Member country then you should fill out the report. The IHTSDO encourages the use of SNOMED CT around the world. The Articles of Association contain a provision whereby the organization can waive standard Affiliate License fees for use of SNOMED CT in non-Member territories for charitable and humanitarian purposes. To apply for a fee waiver please write to the IHTSDO at info@ihtsdo.org with information regarding:

  • The nature and scope of use of SNOMED CT proposed.
  • The product/service in which SNOMED CT would be used and the time frame for deployment.
  • What results do you hope to achieve through this work? How will you monitor and evaluate progress?
  • Is there a charge to health professionals (or others) for the use of SNOMED CT or the product/service in which it is used? If so, please describe.
  • Any other facts that you feel would be relevant for consideration.

Note: on January 14, 2009 the IHTSDO announced the free use of SNOMED CT in low income countries. This initiative is part of the organization’s commitment to enable broader use of standardized clinical terminologies world-wide.

Q: While the UMLS license includes SNOMED CT, I already had a SNOMED CT license from another Member Country (e.g. Australia). Do I still need to submit a report to NLM?

A: If you have used SNOMED CT outside of any member country then you should complete the report. It is up to you to determine whether you will submit the report to the NLM (the U.S. licensing authority) or another authority (e.g. the Australian licensing authority).

Q: I understood I could test SNOMED CT without being billed? What do I do?

A: Completing the report does not mean you will be billed. Appendix B of the SNOMED CT Affiliate License Agreement includes the fee listing. Please review Appendix 2 of the License Agreement for Use of the UMLS Metathesaurus for more information. Note - if you have only tested and not used SNOMED CT in a data creation or data analysis system you will not be charged, but you should still complete the report to record your usage.

Q: I am a U.S. citizen working on a project with colleagues from a non-member country. Will my project incur any fees if my colleagues use SNOMED CT in relation to this project?

A: Your colleagues can work with SNOMED CT to produce a product such as a data creation system or data analysis system as long as that product will be used in the U.S. or another member country. The issue is not the nationality of the individual or where the work is done but where SNOMED CT will be used. As long as the product of your project will be used in the U.S. or another SNOMED CT member country no fees will be assessed and you do not need to fill out a report.


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