The first step in an implementation is to understand the details and constraints of the relevant eHealth environment and the high-level requirements of the use case. This information is needed to select an implementation approach for SNOMED CT and define an architecture for the planned system. 

This architecture will form part of a detailed implementation plan, and the implementation team will work with this information to produce the SNOMED CT integration plan. The recommended software architecture for a SNOMED CT enabled system is to use a Terminology Server to provide effective access to the terminology content.

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In order to get access to SNOMED CT releases and all future updates, implementations register as affiliates in local National Release Centers or directly with SNOMED International, obtaining credentials to access a
SNOMED CT distribution service.

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Many implementations also require the creation and maintenance of local SNOMED CT extensions, including SNOMED CT reference sets, maps, translations, and (in some cases) new content. These terminology artefacts will be managed by a terminology team to support the focus use cases, and made available to the deployment team to be included in the content on the terminology server.