Stream: IG creation
Topic: Updated CVX codes for value set expansion
Max Masnick (Mar 17 2021 at 18:16):
I'm trying to define a value set with all the current CVX codes (which identify vaccinations). If I use http://hl7.org/fhir/sid/cvx, it doesn't look like recent additions show up in the value set expansion and cause errors with validation.
This is the value set from the IG I'm working on: http://build.fhir.org/ig/dvci/vaccine-credential-ig/branches/main/ValueSet-vaccine-credential-vaccine-value-set.html. It doesn't show 207, which is listed on the CDC website.
My question: what can I say, if anything, that will give me all CVX codes on the CDC website in a value set -- like * include codes from system urn:oid:2.16.840.1.114222.4.11.934 (but that doesn't expand at all).
Max Masnick (Mar 18 2021 at 10:18):
I found this message explaining how to use PHINVads value sets, but that doesn't really help me in this case because http://fhir.org/packages/us.cdc.phinvads would presumably need to be updated when the CDC releases new CVX codes.
Max Masnick (Mar 18 2021 at 10:27):
My question: Is there a way to have a value set such that when validating a resource, the validator will pull in the latest CVX codes directly from CDC?
In other words, how do I tell the FHIR validator to go out to CDC to get the latest CVX codes, vs. relying on http://hl7.org/fhir/sid/cvx, which may be out of date (as it is now)?
With the potential for new CVX codes to be released frequently with new COVID vaccines (or modified booster vaccines to cover variants), I'd like to avoid having updates elsewhere in the critical path for validating a CVX code.
/cc @Josh Mandel
Lloyd McKenzie (Mar 18 2021 at 13:33):
The expectation with value sets is (unless you lock to a specific code system version) to always use the latest codes that the terminology server has available. The process of updating a terminology server to the 'latest' varies from code system to code system and often requires manual intervention. With a production level terminology service, there would generally be service level agreements in place as to how frequently updates must be brought across. tx.fhir.org is managed by volunteers, so updates tend to happen on an "as time allows" and/or "when someone hollers" basis.
Max Masnick (Mar 18 2021 at 13:58):
Thanks, @Lloyd McKenzie. Is there someone specifically I can politely holler at to get tx.fhir.org updated to return the CVX codes for current COVID vaccines? This is to support https://vaccinationcredential.org/ so it's somewhat time sensitive -- we're actively trying to facilitate implementers validating their resources.
Lloyd McKenzie (Mar 18 2021 at 14:13):
@Rob Hausam
Rob Hausam (Mar 18 2021 at 14:46):
@Max Masnick, @Lloyd McKenzie pointed at the right person to holler at. :) I've also discussed this today with @Carmela Couderc, and it appears that it's definitely time to give this some attention (which certainly makes sense with the COVID-19 vaccinations). I'll put this on the queue to update the code system content from the PHINVADS page that you linked (actually the related CVX code system page). Hopefully I can get that done by later today or tomorrow - but I need to also give the caveat that once I've updated the content there is another manual step that Grahame needs to do, so I'm not entirely sure when the updated content will be visible on tx.fhir.org.
Max Masnick (Mar 18 2021 at 15:06):
@Rob Hausam thank you! To make sure I understand: are you updating the CVX codes listed in http://hl7.org/fhir/sid/cvx, or somewhere else?
Rob Hausam (Mar 18 2021 at 15:38):
@Max Masnick I will be updating the set of codes that are available on tx.fhir.org for the http://hl7.org/fhir/sid/cvx code system.
Max Masnick (Jul 30 2021 at 00:41):
@Rob Hausam looks like some additional CVX codes have been assigned for non-US vaccines. This is potentially quite useful for SMART Health Cards as there are some vaccines that aren't clearly represented in other code systems, but are in these additional 500-series CVX codes.
https://www.cdc.gov/vaccines/programs/iis/COVID-19-related-codes.html (scroll down to the 2nd table)
These are marked as "preview posting" -- is this final enough to make it into http://tx.fhir.org/r4/CodeSystem/cvx?
Rob Hausam (Jul 30 2021 at 06:59):
That makes sense and is very good to know, @Max Masnick. It's always a little difficult when we are dealing with "pre-release" codes like this. But looking at these updates, my inclination is that it would probably be reasonable to go ahead and add them. I'm adding this to the queue, and I think I should be able to get that done soon (24-48 hours). Getting the code system updates loaded on the server could take a little longer - but hopefully not too much.
Max Masnick (Jul 30 2021 at 13:38):
Thank you Rob!!!!!
Last updated: Apr 12 2022 at 19:14 UTC
