The SNOMED CT Implementation Maturity Framework (IMF) can be used independently of the interactive assessment tool to support structured, collaborative evaluation of implementation maturity.
This approach is particularly useful for:
Facilitated workshops
Strategic planning sessions
Cross-functional reviews
Early-stage assessments prior to formal scoring
A manual self-assessment enables organizations to build a shared understanding of their current state, validate assumptions, and identify improvement priorities.
Conducting a self-assessment involves five key steps:
Preparation
Scoring Individual Questions
Calculating KPA Scores
Determining Domain and Overall Maturity
Interpreting Results and Identifying Actions
Each step is described below.
Stakeholder type (Member, User Organization, or Vendor)
Organizational boundary (national, regional, or local)
Systems or products included
Include representatives from:
Clinical leadership
Technical/IT teams
Terminology specialists
Data/analytics teams
Governance or strategy roles
A multidisciplinary group ensures balanced and accurate scoring.
Where possible, collect documentation to inform scoring:
Policies and governance documents
System architecture and integration details
Training materials
Usage reports and analytics
Interoperability specifications
Each question within a Key Process Area (KPA) includes a set of answer options mapped to a score (typically ranging from 0 to 100). Questions are usually presented with a six-option response scale, and scores from 0 to 100 are progressively assigned across options 0 to 5. The progression between response options is not uniform; instead, different values were assigned by the authors based on their assessment of the maturity level represented by each option.
Review the question and its context carefully
Select the option that best reflects your current state
Assign the corresponding numerical score
Be evidence based: Avoid aspirational scoring
Score current state only: Not planned or future capabilities
Use consensus: Discuss differences and agree as a group
Be consistent: Apply the same interpretation across all KPAs
If your organization sits between two options, select the lower score unless there is strong evidence to justify the higher level.
Each KPA contains multiple questions.
Sum the scores for all questions within the KPA
Divide by the number of questions
Formula:
KPA Score = (Sum of Question Scores) ÷ (Number of Questions)
If a KPA has 4 questions scored:
50, 75, 50, 25
KPA Score = (50 + 75 + 50 + 25) ÷ 4 = 50
Each domain consists of one or more KPAs.
Calculate the average of all KPA scores within the domain
Domain Score = (Sum of KPA Scores) ÷ (Number of KPAs)
Use the following ranges to determine maturity level:
0
Level 0 – None
1–20
Level 1 – Basic
21–40
Level 2 – Emerging
41–60
Level 3 – Advanced
61–80
Level 4 – Integrated
81–100
Level 5 – Optimizing
Two approaches may be used:
1. Weakest Domain Approach (Recommended for decision-making)
Overall maturity = lowest domain level
Ensures balanced capability across all areas
2. Average Score Approach (Recommended for tracking progress)
Overall score = average of all domain scores
Provides a general view of maturity progression
Both perspectives should be considered together.
Highlight domains with higher maturity (strengths)
Identify domains with lower scores (priority gaps)
Maturity should be relatively balanced. Significant variation between domains may indicate:
Over-investment in technology without adoption
Strong governance without implementation
Adoption without interoperability
Focus on:
Low-scoring domains
KPAs with the greatest impact on interoperability and data quality
Areas that enable progress across multiple domains
Set realistic goals:
Short-term: Improve by one level in priority domains
Medium-term: Achieve balanced Level 3 or Level 4 maturity
Long-term: Progress toward Level 5 optimization
Conduct assessments collaboratively rather than individually
Document assumptions and rationale for each score
Repeat assessments periodically (e.g., annually)
Compare results over time to track progress
Use results to inform strategic planning and investment decisions
Manual self-assessment:
May be subjective without supporting evidence
Can vary depending on participant perspectives
Does not automatically generate reports or benchmarking
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