Stream: terminology
Topic: HL7 FHIR Table Column Headings and Contents
Andrew Gledhill (Jul 12 2018 at 11:07):
I would like to suggest a standard column heading format for all HL7 FHIR Tables:
FHIR Description (Display) | FHIR Abbreviation | FHIR Code | SNOMED CT Code
e.g. Oral | PO | PO | 12345678
Currently there seems to be some confusion between 'FHIR Abbreviation' and 'FHIR Code', sometimes they may be the same and sometimes they are different, hence the suggestion for an additional data column. I also think the FHIR tables should include 'FHIR' in their heading to distinguish from 'v2' tables.
Any thoughts?
Lloyd McKenzie (Jul 12 2018 at 14:45):
We're actually trying to move away from code systems that are specific to v2/v3/FHIR and starting to maintain a single collection of terminologies that can be used for any.
Not sure what you mean by "FHIR Abbreviation"?
Andrew Gledhill (Jul 12 2018 at 16:23):
Thanks Lloyd
So, in future, each terminology table will contain 3 'generic' HL7 columns with the following headings?
HL7 description / HL7 code / SNOMED CT code
Oral / PO / 123456789
twice a day / BID / 987654321
Yunwei Wang (Jul 12 2018 at 16:39):
Why the sct code is there?
Lloyd McKenzie (Jul 12 2018 at 17:20):
SNOMED is no more important than any other terminology. And quite often there won't be mappings to SNOMED. (One additional challenge with SNOMED is that the mappings can potentially be different for different national editions.) Something that might be worth a change request is to add links to the HL7 International-published concept maps that exist for a particular value set or code system.
Lloyd McKenzie (Jul 12 2018 at 17:21):
If you want to provide additional mappings for codes that don't yet have one, you're welcome to submit change requests for that too.
Andrew Gledhill (Jul 13 2018 at 11:06):
Thanks Lloyd
Wouldn't it make sense if HL7 International were to commit to SNOMED CT International as the terminology 'of choice'? I'm not sure why 'local/national' versions of SNOMED CT have been allowed to be created as this will create 'a chaotic mess' for future terminology development.
Getting back to HL7 table column headings an 'international EMR/EHR' database design might go for:
HL7_Description | HL7_Code | SCT_International_Code
In the medium/long term I predict that the SCT_International_Code will replace the HL7_Code which should minimize mapping requirements.
Michael Lawley (Jul 13 2018 at 11:10):
I'd like to understand why there would be different mappings for different Snomed Editions. If there's content overlap then it should just be promoted to the International edition. The best thing for everyone is that national extensions are as small as possible
Russ Hamm (Jul 13 2018 at 14:58):
Not all countries who participate in HL7 are licensed to use SNOMED unfortunately.
Lloyd McKenzie (Jul 13 2018 at 17:21):
Snomed can't be a preferred terminology because there are significant financial barriers to its use in many countries. As an international SDO, we can't identify something as preferred that isn't equally accessible to all.
Grahame Grieve (Jul 16 2018 at 00:15):
'FHIR Abbreviation' and 'FHIR Code', sometimes they may be the same and sometimes they are different
Grahame Grieve (Jul 16 2018 at 00:15):
uh? can you explain what you mean?
Andrew Gledhill (Jul 16 2018 at 10:29):
So, countries which are not members of the SCT-International organisation might configure their coded clinical data tables (EMR/EHR column headings) as:
Local_Description | Local_Code | HL7_FHIR_Description | HL7_FHIR_Code
It is obviously important to distinguish between HL7_FHIR, HL7_V3 and HL7_V2 data sets/data tables.
One of the advantages of this database table structure would be that language translation wouldn't be necessary between the indigenous language and the HL7 FHIR English language description.
Last updated: Apr 12 2022 at 19:14 UTC
