Welcome and introductions

5

@Peter Williams

@Rob Hausam

Recording, notes & attendance.

Summary of previous week and previous fortnight

5

@Peter Williams

@Rob Hausam

• 2019-03-05 - SNOMED on FHIR Meeting (TS)

• 2019-03-12 - SNOMED on FHIR Meeting (TB)

Mentioned at last meeting

5

@Rob Hausam

Rob provided link to IG re Genomics: https://github.com/HL7/genomics-reporting

Advertising new HL7 Vocab group project: https://confluence.hl7.org/display/VOC/The+Gender+Harmony+Project

Other Meetings

15

@Peter Williams

SNOMED on FHIR Sunday 7 April 13:30 - 17:00 BST Hilton Waldorf, London

Conference Schedule

Agenda: 2019-04-07 - SNOMED on FHIR Meeting (TS & TB)

Publication of FHIR Free Set

20

@Peter Williams

@Jane Millar

@Rob Hausam

Free SNOMED CT set for FHIR

JM 29 Jan: Call with Wayne and Karen - suggestion to document current work with TB stream leads.

Update from Rob re Amber mappings almost all going to Patient Care working group.

SNOMED FHIR Implementation Guide

10

@Peter Williams

Progressing the SNOMED Implementation Guide and specific guidance of "Best Practice" of using SNOMED with FHIR. Can we include tests for 'correctness' - using existing FHIR Testing platforms?

https://github.com/IHTSDO/snomed-ig with the built view hosted by GitHub at https://ihtsdo.github.io/snomed-ig/

Tooling: Current tooling appears to be solely command line based. See also Snapper for value set editing (currently STU3).

What is the scope of content for the guide? Targeting "Best Practice" for FHIR Implementers using SNOMED CT. Possible layered approach and potentially strict (for internal record keeping and communication) vs permissive profiles when . General guidance for bindings or specific details on each resource.

Audiences - Developer vs User of implemented services. ML Suggests single entry point document with multiple paths through the documentation.

8 January 2019 Update:

Tooling: Forge (doesn't support R4)

What do we want to say about how SNOMED should be used in FHIR? Eg On the Terminology Services side, start with a narrative and head towards a test script where a particular query is expected (formally) to return a given set of results. Then on the resource side, talking about what particular value sets should be used for specific resources - condition code being a high value. Will we insist that these are SNOMED code or could they be proxy codes eg where a medication is given on a problem list and - in it's presence - indicates the underlying condition but without specifying that explicitly.

Start with a Confluence page for collaborative work and once that's reached some stage of maturity it can be moved into the GitHub repository in a more structured form.

Are we looking at one implementation guide or two? Terminology Server vs Terminology Binding and Profiles.

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Mechanism for working with Languages.

15

@Reuben Daniels

HL7 Vocab Item: https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=15806

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?

Update 11 September: Do we need a parameter for the expand operation for this - Reuben looking into this currently.

Update 11 Dec: HTTP Headers RFC 5646 (Tags for identifying languages). Suggestion that where dialects are to be referenced which do no have a standard code, one could be constructed, either using new letters or the language reference set id directly eg en-nz-x-12345601 Note also that requested language/dialect could be an ordered list for gradual fallback where descriptions may or may not be available.

Can also be passed in the language parameter passed to an expansion operation.

Language reference set could be an implicit code system supplement.

Update 8 Jan: Note that SNOMED CT Language Reference sets do not indicate if they relate to a dialect, language or context of use. GG suggested FHIR could address that more directly than using a reference set SCTID to supply that desired context. Include someone in a non-English speaking country!

Update 5 March: Reuben suggesting plan of action to ensure we have a solid proposal to take to the Montreal Connectathon (4-5 May 2019). Languages working group code for "consumer friendly terms" - Rob says that a harmonization proposal is in the pipeline

Open

Ongoing items

10

@Peter Jordan

@michael lawley

• SNOMED CT Canonical CodeSystem resource

  • Outstanding question of whether this is the Canonical CodeSystem for the International Edition, or some base set of properties for all Editions.

  • How is this distinct from the Terminology Capabilities Resource?

  • Review and attempt to resolve detail questions

  • Update 28 Aug: Official endpoint should be hosted somewhere (SI?)

  • Update 13 Nov: (ML) We should publish as part of the IG - possibly two - a) International and b) a template as guidance for implementers. In the event of a choice of versions, suggest the default is to return the most recent available.

• 4.2.1.0 Using SNOMED CT with FHIR

Collaborative Work

On Hold / Maintenance

Any other business

Next Meeting: Tuesday 2 April 2019

Advertising new HL7 Vocab group project: https://confluence.hl7.org/display/VOC/The+Gender+Harmony+Project