Stream: implementers
Topic: SNOMED CT post co-ordination
Dave Barnet (Feb 22 2018 at 15:53):
Is anyone sending SNOMED CT post co-ordinated expressions in FHIR resources? If so what do you do with the "slots" that would have had data when not using post co-ordination. For example in a Procedure resource, if the Procedure.code was post co-ordinated as a "Change of dressing (procedure)" post co-ordinated with "left cheek" - what would go into Procedure.bodySite?
I'd be interested in hearing from any members who do use post co-ordinated SNOMED expressions within FHIR, and whether there are advantages or disadvantages of this approach over using the FHIR information model.
Lloyd McKenzie (Feb 22 2018 at 16:17):
@Rob Hausam
Daniel Karlsson (Feb 22 2018 at 18:05):
This is not only relevant for post-coordinated SNOMED CT expressions. The pre-coordinated ones have Finding Sites etc. as well. This and other things are being discussed in the SNOMED on FHIR meetings: https://confluence.ihtsdotools.org/display/FHIR/SNOMED+on+FHIR
Rob Hausam (Feb 22 2018 at 18:42):
Yes, I was also going to refer to the SNOMED on FHIR discussions - but Daniel beat me to it. We are working on providing guidance for exactly these sorts of questions.
Grahame Grieve (Feb 22 2018 at 22:24):
where we know about this in pre-coordinated systems, we discuss this on the elements - particularly on observation
Grahame Grieve (Feb 22 2018 at 22:25):
more generally, at the spec level, our advice is that if you populate both, they shall not disagree
Grahame Grieve (Feb 22 2018 at 22:26):
we have left making further rules to implementation guides. However.... my advice is duplication is better than not duplicating; systems that understand the code will have to choose which to use, but others that don't are not left in the dark
Finnie Flores (Feb 23 2018 at 15:14):
I'd be also interested to know how to deal with codes that are not post-coordinated. For example, where to put the laterality of the body site. Also, where to place the type of procedure/surgery (e.g. whether primary, revision). Would really appreciate help on these two. Thanks.
Lloyd McKenzie (Feb 23 2018 at 15:51):
You can use the approach and target body structure extensions to point to BodyStructure when you want a more fine-grained description of what the procedure is doing. (You can use a contained resource or a distinct resource depending on whether you want to track the site over time.)
Lloyd McKenzie (Feb 23 2018 at 15:52):
Primary vs. revision would need to be an extension I think. @Michelle (Moseman) Miller ?
Last updated: Apr 12 2022 at 19:14 UTC
