SNOMED on FHIR

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Date

20:00 UTC on Tuesday 30 October 2018 - 90 minutes.   NB One hour earlier in Europe due to Summer Time ending!

Objectives

  • FHIR Terminology Services and Resources

Meeting Details

Online: https://snomed.zoom.us/my/snomedhl7

Phone: See https://zoom.us/zoomconference for available phone numbers (meeting id 242-348-6949)

Chat: https://chat.snomedtools.org/channel/snomed-fhir
          (instructions and guide here - Getting Started with Rocket Chat)


Attendees

Peter G. Williams, Rob Hausam, Michael Lawley, Peter Jordan, Jim Case, Reuben Daniels, Linda Bird, Jane Millar

Apologies

Meeting Recording

https://snomed.zoom.us/recording/share/w9BmW079YjXMuy8dfHnDFU25ySEvS7zZkoQ46UHZwL6wIumekTziMw 

Discussion items

ItemDescription

Mins

OwnerNotes & Actions
1Welcome and introductions5

Peter G. Williams

Rob Hausam

Recording & notes.

2Summary of previous week5

Rob Hausam

3Format of Meetings10

Peter Jordan

Michael Lawley

Views on meeting length and format - focus topic, required output? Summary of previous TS meeting?

Working group vs Advisory Group - more of a "Bridging" group with concrete deliverables.

4Publication of FHIR Free Set20Peter G. Williams

Free SNOMED CT set for FHIR

  •  Rob Hausam reach out to Jay and Keith at the VA to elicit use cases / requirements - any update?

Considering question of 'who publishes what', RH thought SI should publish a refset as the authoritative source which HL7 could then use to derive FHIR friendly forms eg Concept Map.

5Options for Validate Code40Peter Jordan

Options for validate code - mapping between various data issue scenarios and true/false result flag. See also https://www.hl7.org/fhir/operation-valueset-validate-code.html

  •  All to review options. Note that validate code applies to both ValueSet AND CodeSystem. Examples would be helpful, with expected responses (could be used to drive unit tests also).

Note that changes suggested are additive in nature, rather than "breaking".

RH: FHIR Ballot currently open, closing on 24 September. Published late December/January.

Final Position of Group:

  • Validation should be strict. That is, any errors in the term (including case) would result in a false result field being returned.
  • In all cases, the requested (or if not specified, default for the server) preferred term should be returned - Best Practice.
  • Default language / dialect should be made clear in the capability statement for the server - Best Practice.
  • The messages shown in the table (see power point attached) should be returned in each situation - Best Practice.
  • Client callers can make the call for a 2nd time without including the term in order to determine if SCTID on its own is acceptable.
  • The Lookup operation would be more appropriate for clients interested in different preferred terms.

Note that this advice is most applicable to validating codes of Code Systems. Validating codes in a Valueset may take a different tack since alternative display values may be present.

RD: Coded return value (rather than a boolean) could be added as an extension could be added to allow machinable capacity for dealing with various scenarios.

6Work suggestions from last meeting10


Proposals for expand

  •  Dion McMurtrie to progress the proposal through Zulip
  •  Rob Hausam to create tracker item to socialize this for the next FHIR Release (R5 2019 Q3?) Hold for Zulip discussion.
7SNOMED with FHIR10

Revisit 4.2.1.0 Using SNOMED CT with FHIR

All participants are invited to review this local copy of that page.

  • Section 4.2.1.0.5 Clarity needed on which Normal Form is being represented (eg breaking sufficiently defined concepts down to their primitive components, unlike what is supplied in the browser). Further discussion needed on what these properties are being used for. Perhaps only 1 is necessary since terms can be added/removed as required. Update 28 Aug: A link to the definition of NNF is desirable (MAG - define what this should be for PCEs?)
  • Supplements are a possible way to allow language reference set type functionality.

Update October 9

8Ongoing items10

Dion McMurtrie

  • SNOMED CT Canonical CodeSystem resource
    • Review and attempt to resolve detail questions
    • Issue around extensions and what this CodeSystem resource actually represents
    • Update: URIs populated. Intention to provide short URLs for normalForm and normalFormTerse to point to appropriate definition of terms.
    • Update 28 Aug: Official endpoint should be hosted somewhere (SI?)
  • SNOMED CT "Universal" Edition
    • Definitely useful to have a catalogue of all concepts ever issued if not a proper edition which may be much harder?
    • Is this work for this group, or should this be handed on to a more appropriate SI group?
    • Update 14 Aug - Are we going to shelve this item as not currently practical? Hand to MAG/TRAG?
  • Check and fix ECL in the FHIR spec
    • Is there a way to systematically identify all ECL expressions in the FHIR spec?
    • If we run these through validation is there appetite/volunteers to review and fix them as feedback to the spec?
    • Is there a way to integrate ECL validation into the FHIR spec tooling to prevent recurrence?
  • Linda Bird to progress defining Terse Normal Form with the Family of Languages group (Rob Hausam confirms needed for July)
    • SLPG agreed that the Languages group is not the appropriate forum for this definition. Instead, we believe this should be defined in the DL subgroup of the Modelling Advisory Group.
    • Also agreed that the terms that need defining are "Canonical Normal Form" (which is terse by definition) and "Necessary Long Normal Form"

Update 14 August See draft (doesn't specify particular normal forms) :

9Mechanism for working with Languages.15Reuben Daniels

HL7 Vocab Item: https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=15806

ML: Supplement would hopefully only add additional descriptions that are not described in the base content.

Precedence (fallback) for multiple language reference sets only really discussed in Languages Group for ECL - other use cases not yet brought to light.

Update 28 Aug: Keen to see an implementation using Supplements to see how it would actually work. Option to explore this at Baltimore Connectathon?

Language reference set could be an implicit code system supplement.

Update 11 September

Do we need a parameter for the expand operation for this - Reuben looking into this currently.

  •  Peter Jordan to supply material as offered for next meeting - thank you!
10

Any other business




Next Meeting: Tuesday 13 November

Actions for next week: Progressing the SNOMED Implementation Guide and specific guidance of "Best Practice" of using SNOMED with FHIR. Can we include tests for 'correctness' - using existing FHIR Testing platforms?

How can we represent the definition of a concept as a Post Coordinated Expression given that NNF may not fully express the stated form. MAG?



Meeting Files

Attachments