Stream: smart/health-cards
Topic: FHIR IG: int'l code systems
Max Masnick (May 06 2021 at 13:37):
Implementers from outside the US: please take a look at these changes to our Immunization profile.
This adds support for using the following code systems to identify vaccines: GTIN, AIR (Australia), SNOMED-CT (universal; includes SNOMED GPS codes with a more permissive license), ICD-11, and ATC/DDD.
Some of these code systems only identify the vaccine's disease target or the general type of vaccine. In these cases, manufacturer MUST be specified as well. We support using GTIN, GLN (a part of GTIN), or MVX for this. GTIN is the preferred approach.
This also adds LOINC answers for lab test results (in addition to the SNOMED codes we were previously using).
If there are any other code systems you would like to see support for or any other comments, please let us know before our content freeze on Saturday, May 8.
Please leave comemnts on this topic or on the GitHub pull request. Thanks!
Paul Denning (May 06 2021 at 13:41):
According to Derick Ritz on IPS Cross-SDO call, GTIN is at the product packaging level, not at the "product" level (e.g. different GTINs for 50 caps, 100 caps and 500 caps of the exact same product). Is this a concern?
Max Masnick (May 06 2021 at 13:45):
According to Derick Ritz on IPS Cross-SDO call, GTIN is at the product packaging level, not at the "product" level (e.g. different GTINs for 50 caps, 100 caps and 500 caps of the exact same product). Is this a concern?
I don't think so. For US GTINs, the product can be extracted by ignoring digits on the right-hand slide of the GTIN, and we're told by GS1 that the GTINs for COVID vaccines are the same everywhere.
Presumbly the product can also be identified by doing some sort of GTIN lookup, though I couldn't figure out how to do this myself with the public lookup tools I found.
I have a list of questions for the GS1 folks, so I added this to that. We'll plan on providing more context on GTIN inside the IG once we talk with GS1.
Paul Denning (May 06 2021 at 13:46):
THO has GTIN https://terminology.hl7.org/CodeSystem-gtin.html but i don't see GLN there.
Max Masnick (May 06 2021 at 13:46):
In the US, the GTINs for 50 caps, 100 caps, etc. of the same product would just differ by a few trailing digits + the check digit. We will want to confirm this is also true outside the US, but if not I still don't think it's a deal-breaker as long as there's a way to do a lookup on the GTIN.
Max Masnick (May 06 2021 at 13:47):
GLN is just the manufacturer prefix from the GTIN with some padding.
Paul Denning (May 06 2021 at 16:46):
Edited:
Should probably use the NamingSystem for MVX in the identifier.system https://terminology.hl7.org/NamingSystem-MVX.html
Apparently, the value used for identifier.system is taken from NamingSystem.uniqueId
So for MXV see
https://terminology.hl7.org/NamingSystem-MVX.json
which has NamingSystem.uniqueId[1].value = http://terminology.hl7.org/CodeSystem/MVX
(which may be wrong, but still following up on that ...)
We should work with UTG/HTA/THO to add GLN as a NamingSystem; they should approve the use of https://www.gs1.org/gln (after coordinating with GS1)
Carmela Couderc (May 06 2021 at 18:42):
https://jira.hl7.org/browse/HTA-40 entered to request a CodeSystem identifier for GLN. MVX and CVX code system identifiers in THO are not correct and the issue is being addressed by the UTG and HTA teams. The CodeSystem identifers to user are http://hl7.org/fhir/sid/mvx and http://hl7.org/fhir/sid/cvx (as documented on the HTA pages: https://confluence.hl7.org/display/TA/Manufacturers+of+Vaccines+%28MVX%29+--+DRAFT )
Max Masnick (May 06 2021 at 18:56):
Carmela Couderc said:
https://jira.hl7.org/browse/HTA-40 entered to request a CodeSystem identifier for GLN. MVX and CVX code system identifiers in THO are not correct and the issue is being addressed by the UTG and HTA teams. The CodeSystem identifers to user are http://hl7.org/fhir/sid/mvx and http://hl7.org/fhir/sid/cvx (as documented on the HTA pages: https://confluence.hl7.org/display/TA/Manufacturers+of+Vaccines+%28MVX%29+--+DRAFT )
:face_palm: I should know to look at the HTA page by now.
FYSA there are 2 other MVX URIs floating around: http://terminology.hl7.org/CodeSystem/v2-0227 and http://terminology.hl7.org/CodeSystem/MVX.
I'll switch to http://hl7.org/fhir/sid/mvx in the IG. Thanks!!!
Max Masnick (May 11 2021 at 10:48):
Please get us any final comments on #132 Vaccine product and manufacturer terminology improvements by 5pm EDT today (May 11).
The latest version of this PR adds AD and DM profiles specifically for United States COVID-19 implementations (/cc @Josh Mandel). We will consider adding profiles for other geographies as requested.
Last updated: Apr 12 2022 at 19:14 UTC
