Section 4.2.3 Data Entry Context, noted that the environment or use case in which data is entered may:
- Determine the range of concepts that can rationally be entered
- For example, limiting the range of concepts that can be used for diagnoses to subtypes of 64572001 |Disease (disorder)|.
- Significantly affect the interpretation of concepts and other data entered
- For example, entry of a subtype of 64572001 |Disease (disorder)| in a "Family History" section should be interpreted as a family history of that disorder, rather than a diagnosis suffered by the subject of the record.
Terminology bindings are links between terminology components and information model artifacts, such as EHR structures and data entry contexts. There are two types of terminology bindings, value set bindings and meaning bindings. Table 5.1-1 summarizes the characteristics of these two types of terminology binding.
Table 5.1-1: Summary of the Characteristics of Different Types of Terminology Binding
| Value Set Binding | Meaning Binding | ||
| Definition | A terminology binding that represents the set of permitted values that can be used to populate a coded data item. | A terminology binding that represents the clinical meaning of a data item or collection of data items. | |
Practical use when applied to a data entry context | To constrain the range of concepts (or expressions) that can be entered in a particular data entry context. | To specify how the meaning of a concept or expression is affected by the data entry context in which it is entered. | |
| Example | To constrain the values entered in a field labeled "Surgical operation" to concepts that represent subtypes of surgical procedures. | To specify that when a "disorder" concept is entered in a family history data entry form, this represents a "family history" of this disorder. | |
| Representation | Each SNOMED CT value set binding should be represented using an expression constraint as specified in the Expression Constraint Language - Specification and Guide. | Each SNOMED CT meaning binding could be represented using a single SNOMED concept. | |
| Example | The expression constraint below only matches concepts that are subtypes of . 387713003 | Surgical procedure (procedure)| . A data entry context to which this constraint is applied would only permit the entry of concepts representing surgical procedures. If a user searches for terms matching "append" surgical procedure concepts such as 80146002 | Excision of appendix (procedure)| , 174036004 | Emergency appendectomy| , and 6025007 | Laparoscopic appendectomy (procedure)| should be available for selection. However, other concepts with matching terms such as 74400008 | Appendicitis (disorder)| , 47693006 | Rupture of appendix (disorder)| , and 66754008 | Appendix structure (body structure)| should not be available in this data entry context. | The expression template below indicates that when a subtype of the concept 64572001 | Disease (disorder)| is entered used in the family history data entry context, it should be treated as the value of the 246090004 | Associated finding (attribute)| attribute. If the concept 44054006 | Diabetes mellitus type 2 (disorder)| is entered in this data entry context, that concept becomes the value of the associated finding attribute as shown in the following expression. The resulting expression is equivalent to the definition of the concept 430679000 | Family history of diabetes mellitus type 2 (situation)| 2. | |
The following subsections describe ways in which each of these types of terminology binding can be used to represent data entry contexts.
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