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20:00 UTC on Tuesday 11 September 2018 - 90 minutes.


  • FHIR Terminology Services and Resources

Discussion items



OwnerNotes & Actions
1Welcome and introductions5

Recording, notes & attendance.

SNOMED on FHIR meeting planned during the business meeting - closed session (observers space dependent).


October Business Meeting/

Expo - Vancouver


Suggestions for additional agenda items.

3Summary of previous week5
4Work suggestions from last meeting40

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.

Options for validate code - mapping between various data issue scenarios and true/false result flag.

  • 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.

5SNOMED with FHIR30Rob Hausam

Revisit Using SNOMED CT with FHIR

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

  • Section 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.
6Main item for discussion30SNOMED 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?)

7Current items10
  • 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) :

8Mechanism for working with Languages.15Reuben Daniels

HL7 Vocab Item:

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!
9Valuesets / Refsets5

Any other business

Next Meeting: Tuesday 25 September

Actions for next week:

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