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9:00am - 12:00pm on Tuesday 17th October 2017 (Bratislava local time)

Meeting Details

Venue: Crowne Plaza, Bratislava, Slovak Republic
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  • To plan, scope and progress collaborative work between SNOMED International Members relating to the use of SNOMED CT with HL7 FHIR

Discussion items

1Welcome, introductions and apologies
  •  General introductions and welcome
2Review existing and planned work
  • Members to report on existing and planned work with using SNOMED in HL7 FHIR
  • HL7 International and SNOMED International to report on existing and planned work with using SNOMED in HL7 FHIR
3Collaborative deliverables and plans
  • Discuss the proposed scope of collaborative deliverables, for example:
    • What format will the deliverables take?
    • Are we providing general guidance for SNOMED CT use, or specific guidance for each resource (or both)?
  • Consider what existing or planned work can be leveraged
  • Who will be doing (and coordinating) the collaborative work?
  • Collaborative platforms for sharing the work as it progresses
  • Communication and meeting requirements
4Implementation Guidance Principles
  • Discuss the principles we should follow in developing the collaborative deliverables.
  • For example:
    • Is the goal to provide homogeneous population of the resources for interoperability or permissive guidance to cater for a greater degree of localisation?
    • Do we restrict value sets (in a computable way) to ensure that the same information cannot be represented in 2 different ways - for example:
      • The same semantics can/can't be represented both precoordinated and in separate fields
      • The same semantics can/can't be represented in more than one resource (e.g. Condition, Observation, Family History, Allergy Intolerance)
    • How widely do we require/recommend SNOMED CT to be used across the data elements within each resource, versus permitting other code systems to be used? E.g. vital signs, statuses
    • Which are the following are potentially in scope?
      • Restricting existing SNOMED CT value sets already bound to a FHIR resource to subhierarchies that are more semantically appropriate to the relevant data element
      • Defining new SNOMED CT value sets for data elements that do not currently use SNOMED CT
        • Unless they have a required binding to another code system?
      • Restricting the cardinality of data elements (e.g. body site) to reduce ambiguity
      • Splicing data elements to more closely align with the SNOMED CT concept model (only where necessary to avoid ambiguity?)
      • Providing mappings between FHIR value sets (e.g. statuses) and SNOMED CT codes (including context)
      • Providing SNOMED CT expression templates to allow implementations to transform between different ways of populating the same semantics in a FHIR resource
5Progress work
  • Progress specific work related to SNOMED CT use in FHIR artifacts, for example the SNOMED CT Implementation Guide for the Observation Resource
6Next steps
  • Discuss next steps, including future meetings and work items


Meeting Files

  File Modified
Microsoft Powerpoint Presentation SNOMED on FHIR Meeting (20171017).pptx 2017-Oct-17 by Linda Bird
Microsoft Powerpoint Presentation UK SNOMED on FHIR.pptx 2017-Nov-02 by Linda Bird
Microsoft Word Document MF SNOMED on FHIR workshop report 17 Oct 2017.docx 2017-Nov-05 by Linda Bird


Previous Meetings

No content found.


  1. A link on the possibilities on HL7 FHIR on Latin America:

  2. Here are some Ideas on collaboration areas, which probably break down to two main areas

    • Terminology Services
      • Review and maintenance of Using SNOMED CT with FHIR page
      • Changes to SNOMED CT to improve usage through Terminology Services (e.g. implicit ConceptMap metadata)
      • Setting up and operating centralised (e.g. national, organisational) terminology repositories
      • CodeSystem and ValueSet resource naming and versioning
      • Medication resources for representing drug terminologies
      • Content syndication
    • Profiling and binding
      • Sharing profiles, ValueSets and bindings
      • ConceptMaps for FHIR code systems to SNOMED CT where applicable
      • Principles and guidance for profiling/binding with SNOMED CT
      • Reviewing existing base resource bindings
      • Create base resource profiles with maximal SNOMED CT bindings as a library starting point

    If we can create sub areas of our collaboration spaces based on people's areas of interest and active work, we can try to progress these areas and possibly more - this is just a breakdown off the top of my head to stimulate discussion. Happy to alter this list based on interest.

  3. A link to a SNOMED browser that uses only* the FHIR Terminology Service APIs:


    * diagrams are actually served using FHIR's Binary resource

  4. NZ FHIR-based Terminology Service API...  Some features and resources can be requested via the Test page at