WIP SNOMED CT Implementation Guide for Allergy, Hypersensitivity and Intolerance

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  • 5.3 Terminology Services
  

The recommended approach for implementing SNOMED CT in clinical systems is using standard Terminology Services. HL7 FHIR provides the CodeSystem, Valuesets, and ConceptMaps resources and their corresponding operations to support access to terminologies using a standardized approach. 

These are some examples of how FHIR Terminology services can be used to resolve the terminology bindings described in this guide. using a demo FHIR terminology server:

FHIR element

FHIR Terminology Services Expand Operation

AllergyIntolerance.code




If recording is based on substances and products and specifies the type of reaction in "type":

<<105590001 | Substance (substance) | OR <<373873005 | Pharmaceutical / biologic product (product) |

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C105590001%20%7C%20Substance%20%28substance%29%20%7C%20OR%20%3C%3C373873005%20%7C%20Pharmaceutical%20%2F%20biologic%20product%20%28product%29%20%7C

If recording is based on finding concepts precoordinating the type of reaction :

<<418038007 |Propensity to adverse reactions to substance|

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C418038007%20%7CPropensity%20to%20adverse%20reactions%20to%20substance%7C

When using precoordianted Situation concepts to represent the absence of an allergic propensity

<<716186003 |No known allergy|

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C716186003%20%7CNo%20known%20allergy%7C

AllergyIntolerance. reaction.substance

<<105590001 | Substance (substance) | OR <<373873005 | Pharmaceutical / biologic product (product) |

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C105590001%20%7C%20Substance%20%28substance%29%20%7C%20OR%20%3C%3C373873005%20%7C%20Pharmaceutical%20%2F%20biologic%20product%20%28product%29%20%7C

AllergyIntolerance. reaction.manifestation

<<404684003 |Clinical finding|

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C404684003%20%7CClinical%20finding%7C

AllergyIntolerance. reaction.exposureRoute

<<284009009 |Route of administration value|

https://snowstorm.snomedtools.org/fhir/ValueSet/$expand?url=http://snomed.info/sct?fhir_vs=ecl/%3C%3C284009009%20%7CRoute%20of%20administration%20value%7C

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