Implemented and live
Electronic health record
CIEL provides a standardized, multilingual, multinational concept dictionary consisting of interface terminology mapped to reference terminologies including SNOMED CT to support the OpenMRS EHR (particularly in low resource settings).
The OpenMRS platform is used in over 50 countries throughout the world (see http://www.openmrs.org/atlas). CIEL provides subscription content to over 40 countries. The dictionary has 50,000 concepts, of which the major it are mapped to SNOMED CT, ICD-10-WHO, LOINC, etc.
OpenMRS is implemented primarily in low-resource settings, having originated in Africa. CIEL was developed as part of the Millennium Villages Project out of Columbia's Earth Institute. OpenMRS is used as a medical record, data repository, or database for mobile community health workers, clinical providers in outpatient clinics, and even in hospital implementations in places like India and Haiti. AMPATH, Partners In Health, and MVP use OpenMRS and CIEL in large implementations. Countries like the Philippines, Kenya and Rwanda have national scale-up projects also using OpenMRS.
How SNOMED CT will be used
SNOMED CT is the primary reference terminology used as maps to the concept dictionary. Users are able to leverage SNOMED CT for interoperability as well as subsumption queries for analytics and clinical decision support. SNOMED CT is not distributed with the CIEL dictionary, but can be joined to the maps if the user has a license.
Why SNOMED CT will be used
SNOMED's pre-eminent position as reference terminology of choice, its modeling and IS-A hierarchy and the fact that it is license-fee-free for most of the countries where OpenMRS is being implemented.