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  • 5.3 Terminology Services

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Add section on relevant terminology services for supporting the implementation and described use cases



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:

FHIR element

Corresponding ECL

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|


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

<<716186003 |No known allergy|


AllergyIntolerance. reaction.substance

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

AllergyIntolerance. reaction.manifestation

<<404684003 |Clinical finding|

AllergyIntolerance. reaction.exposureRoute

<<284009009 |Route of administration value|

Since the SNOMED CT value sets in this category usually include a large number of concepts, implementers often ask for lists of most frequently used concepts to facilitate implementation (e.g., building picklists to assist data entry). These frequently-used subsets are sometimes called “starter sets”. Examples of starter sets are: