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Introduction

The SNOMED on FHIR working group (Terminology Binding Stream) have spent some time on trying to identify an equivalence mapping from SNOMED CT for a selection of FHIR Valueset codes, as identified by Grahame Grieve.  The group, consisting of a mixture of SNOMED and HL7 FHIR expertise, have achieved a range of results, which have been classified Red, Amber or Green according to the group's confidence level for each mapping.  See Free SNOMED CT set for FHIR for a more detailed background and notes on each Valueset.  In presenting some provisional work, the mappings are being addressed as follows:

RedDiscussion with SNOMED International (SI) Head of Terminology to consider either inclusion of additional concepts into SNOMED CT, or, confirmation that content should be considered out of scope
AmberDiscussion with appropriate working groups in HL7
GreenForwarding to Grahame Grieve for a first pass review


The following sections list the "Green" mappings in which the working group have a reasonable level of confidence and would like to receive feedback from Grahame Grieve on the work done to date.

DetectedIssue.Severity

AdverseEvent.Severity 

AllergyIntolerance.Reaction.Severity

The group's suggested approach for these three Valuesets is to use concepts taken from << 272141005 |Severities (qualifier value)|.

Mapping to qualifier values means that there is little context being supplied from SNOMED CT.  That context would need to be supplied through the particular element being bound, before meaningful reasoning could be performed.

HL7 Value

Suggested SNOMED CT concept

High

24484000 |Severe (severity modifier) (qualifier value)|

Moderate

6736007 |Moderate (severity modifier) (qualifier value)|

Low

255604002 |Mild (qualifier value)|

AllergyIntolerance.Type

The group's suggested approach here is to use concepts taken from << 420134006 |Propensity to adverse reaction (finding)|.

HL7 Value

Suggested SNOMED CT concept

Allergy609328004 |Allergic disposition (finding)|
Intolerance782197009 |Intolerance to substance (finding)|



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