Rob Hausam

Peter G. Williams

Recording + Notes.

Rob Hausam

Peter G. Williams

• 2020-06-30 - SNOMED on FHIR Meeting (TS)
• 2020-06-23 - SNOMED on FHIR Meeting (TB)

Rob Hausam

Peter G. Williams

HL7 Baltimore September 18 - 25 Fully Virtual. Connectathon 9 -11 Sept

SI Business + Expo October. Confirmed fully virtual.

• Peter G. Williams Submit abstract

Daniel Karlsson

Michael Lawley

Daniel Karlsson

Jeremy Rogers

Discuss: Requirements for publishing - quality criteria, technical , maintenance plan needed before we commit to publish?

Investigate use of query Refset as a way to avoid coding ECL into Profiles. Could we detect a change in expansion membership. JR suggests mapping between FHIR XPath (identifying location in profile) and Query.

Option for "use at your own risk / best efforts for maintenance" / STU / Maturity Level (traditionally two named implementers are required). "Aim for best practice"

• Peter G. Williams Discuss internally (FYI Jim Case Linda Bird Rory Davidson ), also with TS group. How are other non-computable artefacts maintained. Confluence gives us some publishing mechanism, as does FHIR. But the responsibility for this must be allocated - and accepted - for ongoing care.
  

2020-06-23: Internal discussion to be held.

Specimen binding. Update from HL7 Specimen Project Group by Ulrike Merrick (and offer to review this group's work!)

DK Both FHIR and SNOMED have reasonably elaborate models for dealing with these which creates "interesting" opportunities for binding discussions.

Discussion on why Specimen (which - as an industry - has been around forever) is only at maturity level 2. Perhaps there's a lack of production implementations. DK: Specimen is a potential candidate for a SOF Published Profile.

Peter G. Williams

The Implementation Guide is now building fine. Please everyone have a look and share comments. http://build.fhir.org/ig/IHTSDO/snomed-ig/index.html

http://hl7.org/fhir/us/mcode/2019Sep/StructureDefinition-onco-core-CancerDiseaseStatus.html

http://hl7.org/fhir/us/mcode/2019Sep/ValueSet-obf-datatype-ConditionStatusTrendVS.html

• Peter G. Williams Fill in current values and parents

Query about qualifier values used. Would it be better to use < 418138009 |Patient condition finding (finding)| ? (JR suggested immediate children ie "<!" rather than descendants)

See also 373117000 |Pathology examination findings indeterminate (finding)| (child of 250537006 |Histopathology finding (finding)|)

Update 31 March 2020 - PWI: links above no longer work. I was unable to find obvious alternative via http://hl7.org/fhir/us/mcode/

Daniel Karlsson

Jeremy Rogers

Publishing Profiles

• Wrapped by implementation guide - in this case https://github.com/IHTSDO/snomed-ig
• Value set publish to a live SI hosted Snowstorm instance. Alternatively Michael Lawley has offered to host.
• Additional hosting on Simplifier (STU3, not yet R4 - January?)
• Suggestion to review work already done to ensure R4 compatibility
• Would value sets also be published as reference sets? Maintain via Refset tool and published in MLDS. Note: UK experienced substantial 'getting off the ground' effort in this area. Sweden have worked through ~10 (will request promotion of content to International Edition where appropriate).
• HL7 FHIR Registry?
• Option to have multiple profiles available at the same time using slicing.
• Chance to do some technical work at HL7 San Antonio

• Peter G. Williams discuss Rory Davidson
• Peter G. Williams re-run tooling to include existing profiles in appropriate hierarchy.

Options for Profile discussion:

Notes 26 Feb: UK working on pathology reporting - diagnostic / observation.

Suggestion that we try out two types of profile, both of which avoid issues of conflict between fields within the information model:

1. Where we only use the code field for clinical content (plus the administrative fields)
2. Where we restrict the code field to atomic values and all other resource fields should also be populated. Note that this does not solve the role group problem.

28 May: Plan to publish profile for the October conference (8 sessions + working between meetings. Completion for review Tues 14 October (or earlier since we'll need time to complete the IG?)

• Build implementation guide
• Setup FHIR server with relevant valusets

Tooling for profiles: Forge (.NET) is now R4

14 Jan 2020: Update from Rob on his progress with a new FHIR Template infrastructure. Required migrating/juggling what we had already built on older infrastructure. Sits under our implementation guide materials at build.fhir.org/ig/IHTSDO/snomed-ig/branches/new-template/ as Option 6: SNOMED Specific Profiles

Differential Table view shows the difference between the parent resource and our SNOMED-specific further profiling of it.

Discussion around practicalities of handling bindings where the ECL isn't very pretty, but the enumerated membership list could change very frequently e.g. a list of codes for vaccine preparations (or procedures) that are specifically relevant to some national childhood immunisation programme, and which can therefore change monthly as new vaccine preparations become available. Preferred implementation solution would be for suppliers to be able to consume ECL, however complex.

Discussion about what kind of separation should exist between the Implementation Guide (which should list things we think everybody should be doing in some certain way) and any more discursive musings that have have not reached that level of consensus or experience.

Thoughts on whether the IG should be balloted, and how to assess the maturity of any of it? Should each SNOMEDonFHIR published profile have its own (1-5) maturity metric stated?

• Daniel Karlsson to try loading existing Allergy Intolerance profiles into Forge R4. The STU3 profiles loaded fine in Forge R4 as just STU3 profiles. There are almost no changes between STU3 and R4 for AllergyIntolerance, so by manually changing the XML files from "3.0.1" to "4.0.0" the files showed as R4 profiles with no errors displayed. Files uploaded to profile page.
  
• Rob Hausam to take Observation questions to OO group, see Observation binding
  

RH: Suggestion that "published" valuesets would be read-only.

• Peter G. Williams Create confluence page for the profile work

21 July 2020.