2026-04-02: DEUSG Virtual

Summary

Dose Form Modeling Attributes Discussion

An update was presented for discussion on dose form modeling, focusing on intended site versus route administration attributes. It was explained that while the intended site and route administration have distinct attributes in the modeling, many values are nearly identical when the route description is removed. As a follow on to previous options, two considerations were proposed: either consolidate and unify the common values between the hierarchies or create a mapping table to connect concepts. He suggested inactivating 30 intended sites and replacing them with corresponding existing route values to achieve a single code representation.

Oral Dose Form vs Administration

During the discussion the semantic differences between "oral dose form" and "oral route of administration," were highlighted - they represent distinct concepts rather than synonyms. Members provided implementation perspective, noting that current drug dictionary structures already require mapping between dose forms and administration routes, and suggested extending the route of administration hierarchy rather than merging the concepts, to maintain reusability across different countries' needs.

Route Administration Mapping Concerns

Group members expressed concerns about the mapping between "route of administration" and "intended site" terms, highlighting they are not synonymous and questioning the clinical value of such mapping. It was highlighted that there are practical limitations in programmatically mapping certain routes like parenteral and oral mucosal, and emphasized that clinical decisions require specific knowledge about medicines rather than just dose forms. The use of information in medication administration messages in FHIR resources was also highlighted, but these would also require specific knowledge of the scenario.

Medication Route Modeling Challenges

The group discussed challenges with modeling medication routes of administration and dose forms in SNOMED International. It was emphasized that decision support systems need to consider a triad of medication, route, and dose form rather than binary options. It was highlighted that maintaining semantic consistency is important, even if it requires abstraction and judgment calls in modeling complex concepts like enteral administration. It was suggested implementing a qualified voting mechanism for controversial topics, where only National Release Candidates (NRCs) with direct implementation interests should have voting rights. The group agreed to continue discussions in Vienna.

SNOMED team shared a draft drug model implementation guide for review and noted the Agenda for Vienna would be posted on forums for user input and requests for topics.