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A number of FHIR Terminology Service Operations have unique considerations when working with SNOMED CT

Operation NameResourceConsiderationsPriority for implementation
$validate-codeValueSetFurther discussion by the SNOMED on FHIR working group can be read here: Implementing Terminology Services with SNOMED CT2b
$validate-codeCodeSystem
2b
$expandValueSetImplicit valuesets (Valuesets defined using ECL), filters, POST (upload) valuesets1
$lookupCodeSystem
2
$translateConceptMap
5
$subsumesCodeSystem
3
$closureConceptMap
4
$find-matchesCodeSystemSee Find Matches, however using the $expand operation with ECL will allow for more expressive querying.6


Best Practice Discussions

Paging - note that the $expand operation defines its own offset and count (count be 0 if you're interested in the total number of matches)

Limits on value set sizes - 1M configurable limit, default page size of 1K

Default language considerations - http headers, server settings (Link to Reuben's work and discussion of X-headers for LangRefsets)

Algorithms for text searching (reference implementation course eg "PNE PNE" finding Pneumococcal pneumonia)

Implementation Notes

  • Default to JSON response
  • Discuss authentication for public server
  • Swagger interface to HAPI?
  • Response to context-root access
  • Command line switch
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