Country / Region
EMEA
Tags
Data quality, Implementation, Innovation, Research
The Spanish National Reference Center has developed a Reference Implementation for Databases (IRBD in its Spanish acronym),which is regularly updated and made available to all national licensees. This initiative aims to promote the adoption of SNOMED CT as the standard for clinical normalization and interoperability within the Spanish National Health System by facilitating the integration and deployment of the terminology and its national extensions across multiple relational database platforms.
The IRBD is distributed in three database formats‚ MySQL, PostgreSQL, and Oracle‚ allowing broad adaptability and integration with existing information systems. In parallel, the team is leveraging SNOMED International's Neo4j tools to implement graph-based models of the Spanish extensions, enabling advanced semantic querying and reasoning
Description
The Reference Database Implementation (IRBD) is a core component of Spain's strategy for SNOMED CT distribution as a database. Developed and maintained by the Spanish National Reference Center, IRBD provides a ready-to-use, easy to implement and pre-configured database with the full structure of SNOMED CT and its National Extensions. The project addresses multiple strategic goals:
1.MultiplatformDi stribution: IRBD is released in three database systems (MySQL, PostgreSQL, and Oracle), ensuring compatibility with a wide variety of local systems used by health organizations and research institutions.
2. Semantic Consistency: The databases follow the RF2 standard and include regularly updated reference sets and logical definitions, ensuring terminological coherence across implementations and the appropriate dependency of national extensions on the International Editions. Both Snapshot and Full RF2 files are used in the implementation, allowing flexibility for different use cases‚ such as point-in-time loading or full version tracking‚ depending on the organization's needs.
3. Advanced Use Cases: The IRBD supports complex queries and terminology services, enabling its use in clinical decision support systems, data analytics, and AI applications.
4. Graph-Based Extension:Within the framework of this project, national extensions are implemented in Neo4j using the official SNOMED Database Loader from SNOMED International. This allows exploration of semantic relationships in a graph-based environment, ideal for research and advanced analytics.
5. Support and Customization: IRBD is accompanied by documentation, which supports implementation across diverse database systems.
Furthermore, with the aim of ensuring the quality and usefulness of this SNOMED CT database implementation, as part of Spanish NRC a Technical Unit composed of experts and users has been created.
Together, these implementations empower organizations to integrate SNOMED CT and national terminologies directly into their workflows while ensuring long-term maintainability and adaptability.
Scope
In the Spanish context, SNOMED CT represents the essential foundation for harmonizing clinical documentation across autonomous communities, enabling cross-institutional data exchange and normalization.
The IRBD initiative simplifies the use of SNOMED CT by offering preloaded, structurally validated databases, removing barriers to adoption and accelerating integration. The inclusion of SNOMED CT in graph databases such as Neo4j would introduce a new paradigm of semantic access and inference, which is critical for research, AI, and decision support systems.
Furthermore, SNOMED CT's ongoing development and community support ensure its scalability and sustainability, making it the ideal candidate for national-level terminology deployment.
How SNOMED CT will be used
SNOMED CT serves as the foundational terminology embedded within the IRBD. The implementation is structured following the RF2 standard and includes the international edition, Spanish national extension, besides the national extensions. Each database version (MySQL, PostgreSQL, Oracle) includes:
- Core components (Concepts, Descriptions, Relationships)
- Reference sets from both the international release and national extensions
-Full and snapshot versions of SOMED CT content
- Extended fields for enhanced querying
In addition to the official editions, the implementation includes an aggregated global database that consolidates content from the International Edition, the Spanish Edition, the National Extension for Spain, and the National Medicines Extension. Although these supplementary tables are not part of the officially released content, they are provided to facilitate integrated queries requiring access to combined and complementary information from all four versions.
In addition, through the Neo4j implementation, the SNOMED CT data would be transformed into a graph structure. This structure would enhance the efficiency of semantic queries and clinical reasoning by supporting intuitive navigation across hierarchical and associative relationships.
Why SNOMED CT will be used
Contact
