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20:00 UTC on Tuesday 10 March 2020 - 90 minutes.   


  • FHIR Terminology Services and Resources

Meeting Details


Phone: See for available phone numbers (meeting id 242-348-6949) # snomed-hl7-fhir (ask for invite!)

Zulip Chat:

Discussion items



OwnerNotes & Actions
1Welcome and introductions2

Recording, notes & attendance.

2Summary of previous week and previous fortnight5
3Other Meetings10

Upcoming events:

SNOMED International April Business Meeting now entirely virtual. Provisionally saying we'll skip a week as that timeslot will be in high demand for business meetings.

San Antonio HL7 Meetings + Connectathon May 16 -17 (Update 10 March: meeting next week to decide if meeting going ahead in light of Covid-19. Connectathon could be arranged remotely if face-to-face cancelled)

PJ: R5 may have to wait for San Antonio in May 2020. Suggested breakout session for working with languages (DK expressed interest in dial in for that session). PJ only available on the Sunday.

PCE Issue with "compose (findMatches)" GG apparently looking to get SI and ICD-11 in a room to look at common methods. PWI not planning on going to San Antonio. GG rumour also other commitments.

ML suggested adding in client focus items eg SNOMED UI Demo

FHIR DevDays - June 16-18, 2020 Cleveland, OH (Update 10 March: RD: Go/No Go decision 10 May. DK: US expected to peak late April)

SI Business + Expo October

4Behaviour on Lookup10

What properties are returned?

Discussion: Both Ontoserver and Snowstorm are returning EffectiveTime which is not listed here (unlike other SNOMED specifics):

Point of interest: Grahame's server returns a copyright property.

5Language Reference Sets in FHIR45AllDesignation extension
6Searching for ValueSets

Could we take a look at ? Actually I'll make a page for it here: Working with ValueSets#ValueSet+Search

I thought I should be able to search all ValueSets for a specific code like:|195967001&_format=json but that gives me an HTTP 400. I'm planning on responding to this will "Too Expensive" for the Snowstorm implementation.

Question: If the compose element specifies the URL for the edition/version and we also pass one through as a GET/POST parameter, does the passed in parameter override the compose value? Answer: URL is not defined for an instance level expansion (however, this is not evident in the spec)

We make the distinction between what language you're searching in and what language the results should be in. Is that even relevant in FHIR? What did we decide between returning results with no descriptions, english descriptions (by default - which is a problem for Patient Friendly) or not returning results. Answer: DK thought that returning the English as a fallback was useful behaviour and the client could filter that out if it didn't want it. ML said that in building a UI, a code without a description is not useful. Answer: in FHIR Language header displayLanguage is for the output. Header content-language could be used to specify the language of the filter.

7Behaviour when specifying system-version

If the compose contains ECL with a code that doesn't exist for the version requested, do we return nothing, or return an error?

OntoServer responds to$expand?system-version= but it also gives the same response for 19990731.

I thought HAPI checked for unknown parameters eg http://localhost:8080/fhir/ValueSet/chronic-diseases/$expand?foos= doesn't notice there's a problem?

Are there rules around expanding a ValueSet that's defined using Compose, but also with a "url" parameter?

8Concept Map - Mapping Relationship15

See ConceptMap

Update 26 Nov: HL7 close to concluding change. Codes that have a meaning change will have value changed to make the direction clearer. PJ: Will any changes be included in the reference libraries in time for the Sydney meeting?

Update 10 Dec: Topic being decided at the workgroup level for inclusion in R5. New values already in place. Narrower → "Broader than" so we'll now read source to target. ML suggested either "source" or "target" should be included to avoid assumption of direction being necessary and that "Narrower than target" would avoid reversing the words used.

Update 11 Feb: FHIR does not allow ICD-10 map 'rules' to be included, say as annotations.

Relevant tracker:

See also

Note Vocab WG meet every 2 weeks, alternating with FHIR Tracker calls.

9Licence conditions of GPS5Daniel Karlsson

Are translations of GPS available? SR: Not official ones, see

Point made that SI have rights to use extension content as they see fit.

Users of GPS are free to translate as they see fit (it is free to use!) however this will not be endorsed by SI. We could have a discussion about publishing a translation where an member edition already exists.

Spanish and German (being developed by Switzerland and Austria) possible cases for a desirable.

  • Peter G. Williams try out GPS expansion when GPS loaded on MAIN, in other languages.

    TODO: Sufficiently covered for next agenda.
10SNOMED FHIR Implementation Guide60

Implementation Guide for using SNOMED CT with FHIR.

Update 10 Dec: DK - main problem is URI/Ls which publisher has fixed ideas about. Publisher does not examine all folders - looks in profiles but not subfolders and doesn't seem to look in ValueSet folder.

Update 21 Jan: DK and RH have merged commits and these can be seen in the HL7 server build: and build errors here:

Update 11 Feb: Grahame said that he'd show us how to set the URI so that it doesn't have to follow the base URI. Next person to try that can we fire a Zulip off to ask about it?

IG Documentation:

Also look at the sample IG see build

11Mechanism for working with Languages.15Reuben Daniels

Any other business

Next meeting 24 March 2020.

Potential Items for Discussion

OwnerNotes & Actions
API for FHIR Resource ↔ Post coordinated expression mapping

API for FHIR Resource to SNOMED Expression

  • Daniel Karlsson Thought there might be some documentation from CIMI on this. Also notes from DMarkwell about constructor bindings.
  • Peter G. Williams Pull these notes into confluence - can we mention it in the IG?
Looking up an SCTID in an unknown module

Problems when dependencies do not align. Multiple code system resources represent multiple editions / versions.

ML: See code parameter to code system search. Should return code systems (ie versions) where that code is defined. International concepts would appear in every edition known to the server.

eg /CodeSystem?system=htp://


See Discussion on Global Patient Set (GPS)
FHIR Shorthand
Michael Lawley


$lookup operation - properties returned
Peter Jordan

Using  I noticed that both Ontoserver and SnowStorm return a SNOMED CT $lookup property for effectiveTime, which I don't see listed, as one of the SNOMED CT properties in the FHIR R4 specification at Should we create a Jira TIcket to add this?

Completed -

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