Stream: implementers
Topic: Mapping of various coding systems
Pranitha Sruthi (Dec 07 2017 at 10:39):
Hi all, if I create a Medication profile using the Rxnorm code system and also want to refer to other code system, where can I store the other system in the profile? For instance, if I create a profile for a drug using the Rxnorm code, the drug may also have a different code in other system (SNOMED CT, NDC etc) . Where can I store the other coding system? Thank you
John Moehrke (Dec 07 2017 at 13:29):
are you asking about recording the same concept using different coding systems? then see http://build.fhir.org/datatypes.html#CodeableConcept
Pranitha Sruthi (Dec 07 2017 at 13:31):
How can I do that? Shall I create an extension?
John Moehrke (Dec 07 2017 at 13:33):
you just use the existing elements. The datatype CodeableConcept is specifically designed to support the need.
John Moehrke (Dec 07 2017 at 13:34):
If you are trying to define a mapping, then see http://build.fhir.org/terminologies.html
Pranitha Sruthi (Dec 07 2017 at 13:37):
Shall I create a value set of all the coding systems or how can I use an element in the resource? Please let me know
Jose Costa Teixeira (Dec 07 2017 at 15:09):
in the catalog, which seems to be the concept you are looking for
Yunwei Wang (Dec 07 2017 at 15:25):
Here is an example. The content may NOT be accurate.
Yunwei Wang (Dec 07 2017 at 15:25):
{
"resourceType": "Medication",
...
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "387160004",
"display": "Captopril (substance)"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1998",
"display": "Captopril"
}
]
},
...
}
Jose Costa Teixeira (Dec 07 2017 at 15:26):
this works until you have different granularities, and then you have to choose: do you put different granularities in the resource? I wouldn't, because I assume that this info will come from the catalog
Yunwei Wang (Dec 07 2017 at 15:31):
I thought the question from @Pranitha Sruthi is about how to put codes from different coding system in a resource. It is not dealing with where the codes are stored and maintained
Lloyd McKenzie (Dec 07 2017 at 16:01):
@Jose Costa Teixeira I don't think catalog is relevant here. The question is how to require multiple codes be present in the Medication instance - there may be no intention to support catalog at all.
Lloyd McKenzie (Dec 07 2017 at 16:02):
@Pranitha Sruthi You would define a profile that slices Medication.code.coding (or MedicationRequest.medication.coding or wherever you need multiple codes). For each slice you'd bind to a value set for the code you want included. You can use the cardinality for that slice to determine whether a code from that code system must be present or is optional.
Jose Costa Teixeira (Dec 07 2017 at 16:14):
@Lloyd McKenzie possibly Catalog is not needed and perhaps i was mixing the subjects with another thread (too many threads on how to add different codes to medications).
Jose Costa Teixeira (Dec 07 2017 at 16:14):
the thing is that ATC is a classification, not a code.
Jose Costa Teixeira (Dec 07 2017 at 16:15):
there is no uniqueness in that code, some products have no ATC, some products have more than one. So it is not really a code itself.
Jose Costa Teixeira (Dec 07 2017 at 16:15):
we can definitely put several codes in a medication, and include different granularities like putting the code for Acetaminophen in Tyelnol.
Jose Costa Teixeira (Dec 07 2017 at 16:18):
But it really depends on what we want to do with it. If it is to group medications in a medication list, then we should see the impact of doing that on prescription and dispense.
Pranitha Sruthi (Dec 08 2017 at 12:01):
@Lloyd McKenzie Ok. But the code element has cardinality 0..1. Can I still add multiple slices?
Yunwei Wang (Dec 08 2017 at 15:02):
What Lloyd suggested is to slice Medication.code.coding not Medication.code
Last updated: Apr 12 2022 at 19:14 UTC
