This page describes the formal agreement between SNOMED International and openEHR Foundation regarding use of SNOMED CT IP by openEHR, as well as an informal guide to how and where SNOMED CT is used in openEHR artefacts.


The folowing text reproduces the substantive elements of the letter of agreement between SNOMED International and openEHR Foundation, from 20 April 2017. (Original letter (PDF)).

We understand that you have a SNOMED CT Affiliate Licence issued by UK Terminology Centre for use of the SNOMED CT International Release and UK extension to undertake development of openEHR artefacts and usage in the UK. This licence is breached as soon as products are used outside the UK without a licence and the UK TC would normally expect to be made aware of usage outside the UK, particularly in IHTSDO non-member countries.

We are aware that openEHR does not have any information about or management of those who consequently use/implement the products outside the UK at this time. SNOMED International therefore asks that you undertake the following:

  1. Add the following statement to all openEHR artefacts containing SNOMED CT, regardless of where the artefact is to be deployed:
    This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyright of the International Health Terminology Standards Development Organisation (IHTSDO). Implementers of these artefacts must have the appropriate SNOMED CT Affiliate license - for more information contact or info@snomed.
  2. Provide on your website more detailed guidance about SNOMED CT, its usage in openEHR artefacts and licensing. The copyright and licence content can be further agreed with SNOMED International.

Use / reference of SNOMED CT IP in openEHR artefacts

SNOMED CT is used by reference in the following way by openEHR:

SNOMED CT element openEHR artefact Usage
Concept code Archetype, Template Reference
Value set reference Archetype, Template Reference
Ref set reference Archetype, Template Reference