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glossary-ref

Gloss
tHL7
develops standards for the exchange of health related data. Most new glossary-ref
Gloss
tHL7
standards developed over the last few years have been based on glossary-ref
Gloss
tHL7
Version
3
. The key features of glossary-ref
Gloss
tHL7
Version
3
include:

  • Anchor
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__3
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__3
    A glossary-ref
    Gloss
    tReference
    Information
    Model
    (RIM):
    Anchor
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__4
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__4
    • This provides a framework for the structure of communicated information.
  • A formal development method:
    Anchor
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__7
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__7
    • This described the various steps to turn a set of requirements into appropriate models and specifications that support communication of the necessary information.
  • Separation between logical models and implementation technologies:
    Anchor
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__8
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__8
    • Many implementations use XML but other technical approaches can be applied to implement the same models.
  • Use of external codes systems and terminologies to represent concepts:
    Anchor
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__6
    _dd448358-787a-4b6c-889c-94fe23eb9c9c__6
    • Model specifications include coding constraints expressed in abstract terms as Concept Domains which are implemented as glossary-ref
      Gloss
      tValue
      Sets
      drawn from one or more code systems.

Many

glossary-ref
Gloss
tHL7
Version
3
models use glossary-ref
Gloss
tSNOMED
CT
and this has led to growing demand for guidance on consistent patterns of use. In 2004, the glossary-ref
Gloss
tHL7
Vocabulary Technical Committee launched the glossary-ref
Gloss
tTermInfo
Project
to address this requirement. The project was initially conceived as having two work packages:
Anchor
_dd448358-787a-4b6c-889c-94fe23eb9c9c__d
_dd448358-787a-4b6c-889c-94fe23eb9c9c__d

  1. Specification of a general approach to resolving issues related to the interface between glossary-ref
    Gloss
    tHL7
    information models and terminologies or code systems;
  2. A guide to use of glossary-ref
    Gloss
    tSNOMED
    Clinical
    Terms
    in glossary-ref
    Gloss
    tHL7
    Version
    3
    communication standards.

The

glossary-ref
Gloss
tSNOMED
CT
specific package was actively supported by glossary-ref
Gloss
tSNOMED
International
as part of a charter agreement with glossary-ref
Gloss
tHL7
. After several rounds of revision and review, the 'Guide to Use of glossary-ref
Gloss
tSNOMED
CT
in glossary-ref
Gloss
tHL7
Version
3
' was accepted by glossary-ref
Gloss
tHL7
as a glossary-ref
Gloss
tDraft
Standard
for
Trial
Use
(DSTU).

The guide itself contains both normative and informative sections. The normative sections cover:

Anchor
_dd448358-787a-4b6c-889c-94fe23eb9c9c__0
_dd448358-787a-4b6c-889c-94fe23eb9c9c__0

  • Guidance on dealing with specific overlaps between RIM and glossary-ref
    Gloss
    tSNOMED
    CT
    semantics and recommendations for use of glossary-ref
    Gloss
    tSNOMED
    CT
    in relevant glossary-ref
    Gloss
    tAttributes
    of various RIM classes;
  • Constraints on glossary-ref
    Gloss
    tSNOMED
    CT
    concepts
    applicable to relevant glossary-ref
    Gloss
    tAttributes
    in each of the major classes in the Clinical Statement pattern.

...

  • Examples and patterns for representing common clinical statements;
  • A general discussion of the potential overlaps between an information model and a glossary-ref
    Gloss
    tterminology
    model
    and the pros and cons of various possible approaches to their management;
  • References to relevant documents and known open issues.

Following adoption the

glossary-ref
Gloss
tTermInfo
group have encouraged in-use testing and have elicited and addressed comments on the 'Guide to Use of glossary-ref
Gloss
tSNOMED
CT
in glossary-ref
Gloss
tHL7
Version
3
. Implementer feedback has further contributed to growing understanding of the issues and resulted in refinement of the guidance. Many of the recommendations included in the 'Guide to Use of glossary-ref
Gloss
tSNOMED
CT
in glossary-ref
Gloss
tHL7
Version
3
' have been incorporated into domain specific glossary-ref
Gloss
tHL7
Standards and national implementations.

One of the conclusions from the

glossary-ref
Gloss
tTermInfo
group is a recognition that terminology and information models are co-dependent. They need to evolve collaboratively to meet requirements for unambiguous processable representations of information. Work with other Information Models (including glossary-ref
Gloss
tEN13606
and glossary-ref
Gloss
topenEHR
) indicates that the issues raised by glossary-ref
Gloss
tTermInfo
are not specific to glossary-ref
Gloss
tSNOMED
CT
and glossary-ref
Gloss
tHL7
( Representing clinical information using SNOMED Clinical Terms with different structural information models). Harmonization efforts involving the glossary-ref
Gloss
IHTSDO
tSNOMED International
and glossary-ref
Gloss
tHL7
and other standards bodies continue to address these issues.

As part of the ongoing harmonization work the copyright of the ' Guide to use of SNOMED CT in HL7 Version 3 ' is jointly held by

glossary-ref
Gloss
tHL7
and glossary-ref
Gloss
IHTSDO
tSNOMED International
. In line with glossary-ref
Gloss
tHL7
policies, the document expired as a formal glossary-ref
Gloss
tHL7
DSTU after two years but it is included here in full as it continues to serve two glossary-ref
Gloss
tRoles
:
Anchor
_dd448358-787a-4b6c-889c-94fe23eb9c9c__a
_dd448358-787a-4b6c-889c-94fe23eb9c9c__a

  • A glossary-ref
    Gloss
    tDescription
    of the challenges of integrating an expressive terminology, such as glossary-ref
    Gloss
    tSNOMED
    CT
    , with a rich information model;
  • A pragmatic interim approach to these challenges, which allows for and anticipates the evolution of a more integrated solution.

...

Anchor
fntarg_2
fntarg_2
[2 In practice the relationship scg-expression
Concept
ShowParts
t
id+term
116680003|is
a|
= scg-expression
Concept
ShowParts
t
id+term
80146002|appendectomy|
is represented via intermediate supertype and is also represented by the following defining characteristics scg-expression
Concept
ShowParts
t
id+term
260686004|method|
, scg-expression
Concept
ShowParts
t
id+term
405813007|procedure
site
-
Direct|
= scg-expression
Concept
ShowParts
t
id+term
66754008|appendix
structure|
.

Anchor
fntarg_3
fntarg_3
[3 This is not the case in the first release as the appropriate defining characteristics are not in the release set.