> For the complete documentation index, see [llms.txt](https://docs.snomed.org/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.snomed.org/snomed-ct-practical-guides/implementation-maturity-framework-guide/understanding-and-progressing-maturity.md). # Understanding and Progressing Maturity The SNOMED CT Implementation Maturity Framework (IMF) describes how organisations evolve in their use of SNOMED CT, from initial awareness and limited use to fully integrated, optimised, and data-driven implementation. This page provides general guidance on how maturity develops and how to progress to higher levels. ### What Maturity Represents Maturity reflects how effectively SNOMED CT is implemented and used to support healthcare delivery, interoperability, and data-driven decision-making across the ecosystem. It is not only about whether SNOMED CT is present, but how well it is adopted across relevant areas, systems, or products; embedded into workflows, services, or functionality; governed through clear ownership, policies, and strategy; exchanged consistently across systems and organisations; and used to generate insight, support decisions, and improve outcomes. At lower levels, SNOMED CT is typically used in isolated ways, often driven by specific projects or requirements. At higher levels, it becomes a core capability, enabling consistent, interoperable, and value-driven use of health information across the ecosystem. ### How Maturity Develops Maturity develops progressively, moving from isolated use toward integrated and optimised use. While the exact path differs by stakeholder type, the overall pattern is consistent. **Initial stage.** SNOMED CT is introduced in limited contexts, used in specific systems, products, or use cases, with little or no governance or coordination and minimal integration into workflows or functionality. This stage is often driven by local initiatives, pilot projects, or specific requirements. **Emerging stage.** Use begins to expand and formalise. Adoption extends to additional areas, systems, or customers; initial governance and strategy are defined; and early efforts toward standardisation begin. Organisations start to move from experimentation to structured implementation. **Advanced stage.** SNOMED CT is used consistently in key areas, embedded in core workflows, services, or product features. Governance structures are established and active, and interoperability capabilities are introduced. The focus shifts to consistency, coordination, and reliability. **Integrated stage.** SNOMED CT is fully embedded across systems and workflows, used consistently across the organisation, ecosystem, or product suite. Data is exchanged reliably using agreed standards, and analytics and reporting are widely enabled. At this stage, SNOMED CT supports both operational and strategic use of data. **Optimising stage.** SNOMED CT is continuously improved and used to drive innovation. Processes, governance, and implementations are regularly refined; advanced analytics and decision support are in use; and SNOMED CT enables new use cases and innovation. The focus is on maximising value and continuously improving outcomes across the ecosystem. ### Key Dimensions of Progression Progression requires coordinated development across multiple dimensions. These apply to all stakeholder types, though their implementation differs in practice. **Governance and strategy.** Clear ownership, defined roles, and alignment with organisational or national priorities ensure consistent and sustainable implementation. **Adoption and integration.** SNOMED CT must be used across relevant areas and embedded into workflows, systems, or product functionality. Adoption without integration typically leads to inconsistent or limited use. **Interoperability.** The ability to exchange and interpret SNOMED CT-coded data across systems, organisations, and products is essential for scaling value. **Capability and skills.** People, tools, and processes must support effective use. Without sufficient capability, adoption will remain limited or inconsistent. **Data use and value.** Higher maturity is characterised by the ability to use SNOMED CT data for analytics, reporting, decision support, and improvement. ### Principles for Progression Understanding how maturity typically develops helps organisations set realistic expectations and make better decisions about where to invest effort. **Progress is incremental.** Organisations rarely make large leaps in capability. More commonly, they build step by step, consolidating what is working before extending it further. Trying to skip stages tends to create fragility; apparent progress that is not underpinned by the foundations needed to sustain it. **Progress is not uniform.** Different areas or stakeholders will move at different speeds, and that is normal. What matters is that higher levels of maturity require broadly balanced capability across all dimensions. A single area of significant weakness can limit the value that stronger areas are able to deliver. **Foundations enable scale.** Governance, strategy, and workforce capability are not optional extras; they are the conditions that make it possible to move from isolated use cases to consistent, widespread adoption. Without them, technical progress tends to remain localised and fragile. **Integration drives value.** The benefits of SNOMED CT are realised when it is genuinely embedded in clinical workflows, systems, and products, not when it exists as a standalone component used in isolation. Integration into the places where work actually happens is what converts terminology capability into practical impact. **Data use unlocks impact.** The greatest value comes from using SNOMED CT-coded data to support insight, decision-making, and improvement. Capture and integration are necessary steps, but they are not the end goal. ### Identifying Where to Improve Assessment results provide a structured basis for identifying priorities, regardless of stakeholder type. In most cases, effort should be directed first toward the areas with the lowest maturity, since these tend to act as constraints on overall progress. Other capabilities can only go so far if foundational elements are weak. Beyond that, priority should go to capabilities that enable broader adoption and integration, and to areas where greater consistency would improve interoperability with others. It is also worth paying attention to imbalances across dimensions. An organisation that is technically strong but weak on governance, for example, may find that its technical investments are not delivering the value they should. Identifying those imbalances is often as instructive as identifying the lowest scores. ### Moving to the Next Level Progressing to a higher level of maturity is rarely achieved by improving a single thing. It typically requires coordinated development across multiple dimensions: expanding adoption into new areas, systems, or products; strengthening governance and coordination; embedding SNOMED CT more deeply into workflows and functionality; enabling interoperability across systems and organisations; and making greater use of data for analytics and decision support. The specific actions required will vary depending on the stakeholder type and context. What works for a national health authority will differ from what is needed by a software vendor or an individual healthcare provider. The framework provides the structure; the roadmap needs to be grounded in the organisation's own situation. ### Continuous Improvement Maturity is not a destination. As implementation deepens, new challenges emerge: systems change, staff turn over, and the broader healthcare environment evolves. Periodic reassessment helps organisations check whether progress is being sustained, identify new gaps, and adapt their strategies accordingly. Treating maturity as an ongoing process, rather than a one-time achievement, is what ensures that SNOMED CT continues to deliver value over time, not just at the point of initial implementation. Provide Feedback --- # Agent Instructions This documentation is published with GitBook. GitBook is the documentation platform designed so that both humans and AI agents can read, navigate, and reason over technical content effectively. Learn more at gitbook.com. ## Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. 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