Stream: snomed
Topic: Exemplar value sets that point to multiple hierarchies
Melva Peters (Jul 30 2018 at 21:43):
During the Snomed on FHIR calls, a concern was raised with Pharmacy about one of our value sets that points to different hierarchies. No solution was proposed about what the valuet set should look like. Can anyone provide any guidance or suggest who we should reach out to that was part of this work to get some input. The value set was http://build.fhir.org/valueset-reason-medication-not-given-codes.html
Robert McClure (Jul 31 2018 at 19:55):
What was the concern? If this works, why not use it?
Melva Peters (Jul 31 2018 at 20:34):
I'm not sure. On a Snomed on FHIR call, the group raised a concern. Unfortunately I don't think any guidance was given. None of the Pharmacy co-chairs were on the call. I'm not sure what the scope of those meetings are. Pharmacy is trying to determine if anything needs to be done about this
Rob Hausam (Jul 31 2018 at 21:28):
You may be referring to this bit that was documented (apparently from July 3)?
MedicationAdministration
Refusal reason is a wrong binding. Those codes in SNOMED relate to the actual medication that was refused. Perhaps better option to use << 182895007 |Drug declined by patient (situation)|Note that 242990004 |Drug not available for administration (event)| is another item in that valueset, but it is concerning that we're picking from different sub-hierarchies here.
We'll have another SNOMED on FHIR Terminology Binding call next Tuesday (but, of course, that's after the FHIR freeze of that matters). We can further discuss it here in the meantime.
Robert McClure (Aug 01 2018 at 00:49):
Ok, so they are noting that there are concepts from two different semantic types - situation and event. I do not find the distinction concerning. If the concepts work, you have a green light from me.
Melva Peters (Aug 01 2018 at 01:23):
Thanks Rob. I'm not sure what the intent of these meetings are, but if you have any input into the conversation and outcome, it would be good if they came up with solutions and not just issues!
Rob Hausam (Aug 01 2018 at 14:02):
I think that "Perhaps better option to use << 182895007 |Drug declined by patient (situation)|" is an attempt at suggesting a solution? Further discussion and input is certainly welcomed. And it's really essential to have sufficient engagement with the relevant parts of the FHIR community (e.g. Pharmacy) in order to provide useful guidance.
Melva Peters (Aug 01 2018 at 16:38):
Unfortunately that doesn't cover all of the reasons why a medication was not administered. We included the following hierarchies to try to cover them: Include codes from http://snomed.info/sct where concept is-a 406149000 (Medication refused)
Include codes from http://snomed.info/sct where concept is-a 371900001 (Medication not administered)
Include codes from http://snomed.info/sct where concept is-a 242990004 (Drug not available for administration)
Melva Peters (Aug 01 2018 at 16:38):
I'd be happy to try to join a call to discuss if you can let me know when it can be on the agenda.
Rob Hausam (Aug 01 2018 at 16:47):
That sounds good. Here is the planned meeting agenda and invite for next week. I can check with Jeremy Rogers about adding this to the agenda if you think that might work for you.
Michael Lawley (Aug 03 2018 at 03:33):
I've run this past our terminologists and they see no problem with this particular use of codes from multiple hierarchies
Rob Hausam (Aug 03 2018 at 14:51):
I don't really recall much more than a fairly brief mention of this on the July 3 or any of the calls. I think it was more of a comment from a overview rather than a product of significant discussion and analysis by the group, as I recall. It certainly can be revisited - and this is an example binding. I agree that it doesn't seem likely to be a significant issue.
Melva Peters (Aug 03 2018 at 15:22):
I can make it August 14th if that is the date
Rob Hausam (Aug 03 2018 at 15:42):
the terminology binding call is actually next week on August 7th and then every other week following
Melva Peters (Aug 03 2018 at 15:45):
@Rob Hausam I'm away for the next couple of weeks. I'll see if another Co-chair can join. Can you send me the dial in info?
Rob Hausam (Aug 03 2018 at 15:51):
Here are the details for the call next week. If you would like to wait and join to discuss this on the 21st, that should work, too.
Last updated: Apr 12 2022 at 19:14 UTC
