Welcome and introductions

2

@Peter Williams

@Rob Hausam

Recording, notes & attendance.

Summary of previous week and previous fortnight

10

@Peter Williams

@Rob Hausam

• 2019-05-28 - SNOMED on FHIR Meeting (TB)

• 2019-05-21 - SNOMED on FHIR Meeting (TS & TB)

Note Daniel away for 3 weeks after the 11th so keen to have meeting despite overlap with FHIR Dev Days (FYI @Jeremy Rogers )

Jane also away on the 11th

Other Meetings

10

@Peter Williams

Redmond June 10 - 12 Redmond

SNOMED Expo Oct 31 - Nov 1 Kuala Lumpur

Thursday half hour session. Title of session: "SNOMED on FHIR" Content: Profiles (eg Allergy Intolerance), Free Set, Implementation Guide, discussing and sharing.

Publication of FHIR Free Set

2

@Jane Millar

Free SNOMED CT set for FHIR

Green - Grahame to provide feedback for next week

Amber - documents going to Patient Care Group (meeting next week)

Update 23 April: Terminology Binding group moving on to remaining Valuesets.

SNOMED FHIR Implementation Guide

60

@Peter Williams

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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.

Mechanism for working with Languages.

15

@Reuben Daniels

Mechanisms for working with Languages

@michael lawley has raised ticket about the "use" field being limited to FSN/Synonym. Elsewhere in FHIR there is a "display" code that can be used to indicate other languages See 22490. Also 19960 - additional term for "Consumer Terms" ready for implementation R5 (Q4 2020 at the earliest).

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 agenda item with @Reuben Daniels : Proposed changes to ConceptMap resource

Clarification of the reverse flag in ConceptMap $translate

Follow up discussion on finding all refsets that a particular concept is a member of (relates to both $expand $lookup and ECL)

^( << languages refsets)