Maturity Levels
Overview
The Implementation Maturity Framework (IMF) provides a consistent yet flexible model for assessing how SNOMED CT is adopted and used across the healthcare ecosystem.
The general maturity levels provide a shared foundation for assessing SNOMED CT implementation and ensure consistency across the ecosystem. However, their application varies by stakeholder, reflecting different roles, responsibilities, and objectives.
Members (National Release Centers) apply the maturity levels at a national or regional level, focusing on governance frameworks, policy alignment, infrastructure, and the breadth of adoption across affiliates and healthcare systems.
User Organizations apply the maturity levels to clinical and operational implementation, including how SNOMED CT is embedded within systems, integrated into workflows, and used to support care delivery, reporting, and decision-making.
Vendors / Software Providers apply the maturity levels to the capabilities of their products or platforms, such as terminology integration, usability, interoperability, and support for analytics and decision support.
While each stakeholder group uses tailored criteria and assessment questions, they remain aligned to the same overarching maturity scale. This ensures:
A common language for benchmarking and comparison
Alignment across the ecosystem
Support for coordinated progress toward higher maturity
Maturity Level Descriptions
These levels provide a common foundation for assessing SNOMED CT implementation maturity, regardless of stakeholder type. Each level represents a progression in capability, structure, and value realization.
Level 0 – None
No awareness or use of SNOMED CT
No governance, strategy, or supporting infrastructure
Clinical or operational data captured using free text or local codes only
No capability for interoperability or standardized data exchange
Level 1 – Basic
Limited awareness or early understanding of SNOMED CT
Minimal or experimental use in isolated areas
No formal governance, strategy, or implementation roadmap
Use is inconsistent and not embedded in workflows
Level 2 – Emerging
Initial strategy and planning activities underway
Pilot projects or early implementations in selected areas
Early governance structures and roles being defined
Growing stakeholder awareness and engagement
Level 3 – Advanced
Broader implementation across systems, departments, or affiliates
SNOMED CT integrated into key workflows and operational processes
Established governance, policies, and maintenance practices
Training and support mechanisms in place
Data increasingly used for reporting and operational insights
Level 4 – Integrated
Widespread, consistent adoption across the organization or ecosystem
Interoperability enabled through alignment with standards (e.g., HL7, FHIR)
Strong governance with monitoring, quality assurance, and performance tracking
SNOMED CT data actively used for analytics and decision support
Measurable improvements in data quality and outcomes
Level 5 – Optimizing
Fully embedded and sustained use across all systems and workflows
Advanced analytics, real-time decision support, and AI-driven capabilities
Continuous improvement embedded in governance and operations
High-quality, interoperable data supporting research, policy, and innovation
Leadership in terminology management and best practices
SNOMED CT Implementation Maturity Matrix
This matrix below provides a side-by-side view of SNOMED CT implementation maturity across Members, User Organizations, and Vendors, using a common set of levels from None to Optimizing. It highlights how each stakeholder progresses along the same maturity scale while focusing on different responsibilities - national adoption, clinical use, and product capability.
The matrix supports comparison, alignment, and a shared understanding of how coordinated advancement across stakeholders enables effective, interoperable, and data-driven healthcare systems.
Level 0 – None
No national activity, no governance, no awareness
No use of SNOMED CT, reliance on free text/local codes
No SNOMED CT support, no terminology integration
Level 1 – Basic
Awareness exists, informal discussions, no national program
Limited use in isolated areas, minimal workflow integration
Basic functionality in limited modules, inconsistent implementation
Level 2 – Emerging
Strategy forming, pilots underway, early governance
Use in selected departments, early workflow integration, basic training
Implemented in some modules, basic search/tools, early interoperability
Level 3 – Advanced
Expanding adoption, governance established, monitoring introduced
Regular use in key workflows, structured governance and training
Integrated across core features, improved usability, standards-based interoperability
Level 4 – Integrated
Widespread national adoption, strong governance, aligned with national strategy
Enterprise-wide implementation, interoperability, analytics and decision support
Broad implementation, advanced usability (e.g., NLP), integrated analytics and CDS
Level 5 – Optimizing
Fully optimized national ecosystem, advanced secondary use, global leadership
Fully embedded, AI-driven insights, continuous improvement
Intelligent platform, AI-driven features, real-time interoperability, continuous innovation
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