Peter G. Williams

Recording, notes & attendance.

Peter G. Williams

India NRC - Manisha MantriSayali Pophalkar Gaurav Vaishnav Using SNOMED with LOINC and ICD-10.  FHIR recommended nationally as a standard.   Looking to build FHIR compliant TS at National Level, especially for lookup and validate & expand.

Australia - N/A

Belgium - Marie-Alexandra Lambot Anne Nerenhausen  multi-discipline data exchange programme for care-sets, FHIR objects codified in SNOMED CT (firstly allergy intollerance)

Estonia - Rutt Lindström switching to FHIR Nationally, preferring international terminologies.  No National TS yet, currently capturing requirements.

Hong Kong - Karissa Hung Maggie LauHave own terminology table, mapped to other terminologies including SNOMED CT.  Looking to learn more about using 

Netherlands - Pim Volkert

Norway - Oskar Hurtig

New Zealand - Peter Jordan (HL7)  National Terminology Server for NZ currently under development.  Peter's own implementation "Terminz".   FHIR Release 5 underway eg changes to Concept Map.

Sweden - Daniel KarlssonNo clear decision made yet on using FHIR with SNOMED but there are a number of projects underway eg with HL7 Sweden.  Some competition in this space for Terminologies but 

United Kingdom - Andrew Perry(NHS) Various FHIR profiles in use for moving data between primary and secondary care incorporating SNOMED.   National Terminology Server procured (not publicly available - constrained by copyright eg non UK access).  Programme of implementations which use the National Server underway.  See https://digital.nhs.uk/services/terminology-servers

SNOMED International - Linda Bird Alejandro Lopez Osornio Kai Kewley Peter G. Williams

Peter G. Williams

Recent events:

HL7 Jan 2022 Virtual meeting: Aim for testing ConceptMap on the Connectathon (Jan 10-12). Set up an independent Connectathon after the Jan meeting?  HL7 May 2022 Dallas     590 attendees. Discussion on improving test suite (driven by need to create a group of trusted terminology servers for federation.  Also interest in IPS (International Patient Summary)).   Interest in LOINC, less so for ICD-11.    Another Australasia event hopefully planned for this year due to travel restrictions.

Upcoming events:

10:00 UTC from Wednesday 19 January 2022 every 4 weeks (the "off" week from this call). TB & TS.

HL7 May 2022 Dallas - virtual.  

HL7 September Baltimore, meeting and connectathon.

Sayali Pophalkar

Manisha Mantri

20

Marie-Alexandra Lambot

Implementation Guide for Use of SNOMED CT in Documentation of Allergy, Non-allergic Hypersensitivity and Intolerance" 

DK - suggests a dedicated meeting on this work.   Are there specific questions on this?  MAL - Too long to spend time in a meeting reading, would like feedback.

Request that SI make the GPS ValueSet available as an extensional definition.

SI are (I think - PWI) in agreement to do this.

•  Peter G. Williamsticket and progress.   MAINT-1740 Target October 15 into production (need SearchAfter functionality for Refset Members).   Also check date for next GPS publication.

16 Nov Update:   "Search After" functionality will be available in Prod 1 Dec.

Daniel Karlsson

Jeremy Rogers

Best Links for Terminology Binding:

Resource bindings

Free SNOMED CT set for FHIR

Collecting topics for TB stream here, with a view to having a call when there's sufficient material

FamilyMemberHistory - how is "no family history of X" best represented?   

19 Jan 2022 Example issue with 160444004 |Family history with explicit context pertaining to brother (situation)| using "Brother of subject" rather than "Brother" which - following that pattern - reduces the scope of family members compared to straight "relationship" eg "Brother" of which there are many more.  Do we need "Brother of Subject", but regardless what should be bound to? 

FreshDesk ticket question on Allergy substance cross field validation.  DK: Mappings to other information models, is that helpful?

20 April:   Topic for discussion - new Resources introduced in R4B.    Also (Linn Brandt) Use case: Registries need nullFlavor-concepts in their value sets. Which code system to use?  Consider "Long COVID no longer present" as a topical example.  4 May DK: This is more of a negation issue than null flavour, also probability.   JL Distinction between unknown and uncertain.

Oct 5 Request for input from nutrition CRG.

Mechanisms for working with Languages

Designation extension

24 August DK Added pull request to Snowstorm  here

Implementation by ML using existing fields and specifying LangRefset in displayLanguage parameter with "preferredForLanguage" code and wildcard  Eg https://r4.ontoserver.csiro.au/fhir/ValueSet/$expand?displayLanguage=*-x-sctlang-20581000-087109&_format=json&url=http://snomed.info/sct/20611000087101?fhir_vs=ecl/160303001&includeDesignations=true

Oct 5 Release of Ontoserver 6.5.0 which includes support for language reference sets as above.

Peter G. Williams

Implementation Guide for using SNOMED CT with FHIR.

IG Documentation: http://build.fhir.org/ig/FHIR/ig-guidance/index.html

Also look at the sample IG https://github.com/fhir/sample-ig see build http://build.fhir.org/ig/FHIR/sample-ig/

•  Rob Hausam to speak to Lloyd about extending the base template as per http://build.fhir.org/ig/FHIR/ig-guidance/template.html Update 24 March: Documentation on this is "TODO"
•  Peter G. Williams FHIR core content to be copied over to Snowstorm instance.

TODOS 

• Check build issues http://build.fhir.org/ig/IHTSDO/snomed-ig/qa.html
• Rerun with latest tooling (also sushi)
• Run with local snowstorm provided as Tx
• See Mark Kramer presentation 
• CONTENT!  (PWI speak to PTB)
• Merge in DUC branch (Designation Use Context) with a view to implementing in a branch of Snowstorm and making available via connectathon.ihtsdotools.org
• Clean up other branches
• Check templates are up to date - should now be self updating, see https://github.com/FHIR/sample-ig (fsh may ask to update this structure).   Sushi sending out information about new format (PJ says leading whitespace is now significant).
• ReadMe should provide links for Publisher tooling
• Add discussion on Refset / IN (see above)
• Provide link to it in http://build.fhir.org/snomedct.html and discuss further socializing.
• TerminologyCapabilities caching is overly aggressive.

Discussion on * version wildcard. (relates to a Zulip discussion on expanding a ValueSet against multiple editions to give a superset?)  DK How could we specify the latest version of multiple modules.   Answer http://snomed.info/sct/*   (ie not specifying the version) or http://snomed.info/sct/*/version/*  to include concepts from previous versions.

For use in the module / version URI.   Existing workaround is to use multiple include elements for each version.

7 Sept ML Sticking point - what do we do with incompatible properties eg active/inactive between two different versions - the most recent?

Use case - primarily being able to validate codes that might exist in different editions.   Secondarily, being able to validate code received in a historical record ie where codes were valid at time of data entry.

Rob Hausam (primarily Vocab WG)