The University of Nebraska Medical Centre (UNMC) started using the Snow Owl terminology server and the thick client to author their SNOMED CT extension that models phenotype and genomic concepts. They moved their entire terminology authoring and release process to Snow Owl including the creation of maps between their extension and LOINC.
Snow Owl allows complex concept modeling that extends the limits of the international concept model. The phenotype and genomic knowledge representation relies heavily on this extension.