Berlin, 05/01/2021. The Medical Informatics Initiative (MII) – funded by the German Federal Ministry of Education and Research (BMBF), and whose members include all university hospitals in Germany and many other partners in research and the healthcare industry – introduced SNOMED CT international terminology in Germany in 2020 and rolled it out for use across its network. In accordance with Germany’s Patient Data Protection Act (PDSG), this successful pilot project will now be incorporated into the national e-health strategy ahead of schedule. Germany has been a member of SNOMED International since 1 January 2021. Moreover, institutions that are not within the MII network will also be able to use the corresponding licenses within Germany free of charge. Responsibility for the SNOMED CT national release centre, which administers the licenses, has been transferred from TMF (Technology, Methods and Infrastructure for Networked Medical Research) to the Federal Institute for Drugs and Medical Devices (BfArM) from the beginning of 2021.
“We are pleased that demand for SNOMED CT also outside the medical research community has been so strong and that we, in promoting interoperability, are enabling widespread use faster. Medical research is living up to its mission as a force for innovation,” stated Christian Luft, State Secretary at the Ministry of Education and Research (BMBF). "The 2020 coronavirus crisis has underlined how important early investment in data infrastructure is for research and healthcare – in particular the promotion of standardisation, such as the introduction of SNOMED CT. Standardised data sets required for COVID-19 research have already taken advantage of SNOMED CT and other standardisation efforts from experts in the Medical Informatics Initiative.”
The BMBF is providing around 160 million euros of funding to the initiative during the current development and networking phase from 2018 to 2022.
SNOMED CT terminology converts medical information and specialist terms – for which there are many differing designations and scales of measurement across the world – into language-independent, unambiguous and international numerical codes, i.e. into a “shared language”, that can be read and processed by computers. This lays the groundwork for intelligent data analytics in healthcare, medical research and health statistics. There are direct benefits, for example, to healthcare when standardised clinical parameters or data on medication can be exchanged across sites and even countries. Moreover, the medical information described in a uniform way by means of SNOMED CT can also be harnessed for the development of medical decision-making tools based on AI.
The use of international standardised data formats and the application of consistent terminology to medical documents are core components of the MII’s mission and data infrastructure. The data integration centres located at university hospital sites across Germany collect and prepare healthcare and research data locally and make them available in line with data protection requirements for multiple sites for clinical and healthcare research. The MII is therefore creating a pool of data that will support in-depth medical research, enabling the better study of diseases and their treatments, and allowing more targeted patient care.
Against this background, the MII’s national steering committee (NSG) had agreed back in December 2016, during the MII’s conceptual phase, that it was essential to adopt the internationally recognised and compatible SNOMED CT terminology standard for routine health data for research purposes. SNOMED CT is published by SNOMED International, a non-profit organisation; rights to its use and to participation in its workings are dependent upon the corresponding country’s membership in this organisation. Previously, Germany had not been a member. The BMBF, with the support of the MII coordination office, therefore negotiated and concluded a special agreement with SNOMED International for an up to three-year pilot phase. As a result, SNOMED CT has been available in Germany via the MII since mid-March 2020. As MII participants, almost all German university hospitals and other MII partners (universities, research institutions and industrial companies) received a SNOMED CT license. The license fees for this pilot phase were borne by the BMBF; TMF, acting as the MII coordination office, served as the national release centre.
With Germany becoming a member of SNOMED International on the basis of the provisions of the Patient Data Protection Act (PDSG), adopted on 14 October 2020, the pilot phase was ended ahead of schedule on 1 January 2021. The Federal Ministry for Drugs and Medical Devices (BfArM), which operates under the aegis of the Federal Ministry of Health (BMG), has assumed the role of national release centre and is therefore now responsible for issuing sublicenses for SNOMED CT users in Germany.
“We are pleased to have helped bring SNOMED CT to Germany – after 15 years of discussion and the joint efforts of many partners, including the GMDS, TMF, HL7 Deutschland and the former DIMDI,” states Sebastian C. Semler, Executive Director of TMF, head of the MII coordination office and of the first German SNOMED CT national release centre under TMF. “As the standardisation of medical information impacts healthcare and research equally, cooperation with the German National Association of Statutory Health Insurance Physicians (KBV) regarding the use of SNOMED CT for the content of statutory electronic patient records was especially important,” Semler adds. “However, the SNOMED CT licenses alone do not give us interoperability. Significant effort and support are still required to enable its use in documentation and the analysis of SNOMED CT-annotated data in medical research. So, we are really only at the very beginning. However, standardisation is not an end in itself. Ultimately, what counts is the ability to exchange data and to process them for patient treatment and further medical progress.”