201901 Terminology Services

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Terminology Services

Submitting WG/Project/Implementer Group

Vocabulary WG/FMG

Justification

The FHIR specification includes support for the provision of a terminology service - that is, a service that lets healthcare applications make use of codes and value sets without having to become experts in the fine details of the value sets and underlying code systems and their related resources. The management and proper use of terminology is fundamental to effective, interoperable data exchange, so this is an important capability to provide and test in the Connectathons.

David Hay's blog post on Terminology Services

Proposed Track Lead

See Connectathon_Track_Lead_Responsibilities Rob Hausam, Peter Jordan

Track Administration

Connectathon Management Tool: ConMan: WGM San Antonio January 2019

Messaging & Communications: Zulip Chat Stream

Test Support: Richard Ettema

Orientation Slides: Terminology Services Track Orientation Slides

Orientation Recording: Click here to play recording

Expected participants

• Health Intersections - FHIR Server
• AEGIS - Touchstone tool and test scripts
• Apelon (Terminology Service): http://fhir.ext.apelon.com:7080/dts/fhir/ and Demo Page at http://fhir.ext.apelon.com:7080/DtsOnFhirDemo/logon/Logon.action
  • Through a collaboration with the American Medical Association, the Current Procedural Terminology (CPT®) is now available for use in FHIR development efforts through the Apelon DTS on FHIR® service. Authentication is required. Please send an email to support@apelon.com (or on-site to cmacumber@apelon.com) for a user/pass. Please note that use of CPT® for production or commercial purposes through this service is prohibited.*
• Lantana - FHIR services on Trifolia
• CSIRO Australia - Ontoserver
• NLM - FHIR services on VSAC
• IMO - FHIR services on FHIR R4
• Patients First NZ Terminology Server
• Health Language FHIR terminology services
• Hausam Consulting test server
• PHAST Standard Terminology Services

• Additional servers and clients

Roles

Please include information here regarding how much advance preparation will be required if creating a client and/or server.

FHIR Terminology Server

For service providers, implement the following operations from http://hl7.org/fhir/2018Sep/terminology-service.html:

• $expand - Value Set Expansion
• $validate-code - Value Set Validation
• $lookup - Concept Lookup
• $validate-code - Code System Validation
• $subsumes - Subsumption Testing
• $translate - Concept Translation
• $closure - Maintaining a Closure Table

Support additional capabilities:

• Capability Statement Produce a Terminology Service Capability Statement
• SNOMED CT and LOINC implicit value sets - using SNOMED CT with FHIR and using LOINC with FHIR
• $find-matches - Finding codes based on supplied properties (experimental)

Service providers are not required to implement all of this functionality - it's a lot to do. For new implementers, start at the top and work down (generally).

FHIR Terminology Client Consumer

Implement any one or more of:

• Do a value set expansion of one of the value sets in the spec
• Validate a code using the spec against a FHIR value set, a v2 value set, LOINC or SNOMED CT
• Validate a code using the spec against a code system such as LOINC or SNOMED CT
• Look up a display for a code (most appropriate for v2/FHIR conversion)
• Translate a code from one value set to another, based on the existing value set and ConceptMap resources, and/or other additional knowledge available to the server
• Maintain a client-side closure table based on server-side terminological logic
• References to SNOMED CT and LOINC implicit value sets
• Create (POST, PUT) ValueSet resources referencing in-line and/or external code systems

At least one server supports all of these operations and capabilities (http://test.fhir.org/r4). Other servers, including the Apelon server (http://fhir.ext.apelon.com/dtsserverws/fhir) and the others listed above will support several of these operations and capabilities. For a list of functions supported by the Apelon Server, see the demo web app (http://fhir.ext.apelon.com/DtsOnFhirDemo, uid/pwd dtsadminuser/dtsadmin).

Pre-Requisites

For all levels of testing the required pre-requisite is the fundamental requirement that all FHIR servers SHALL support the capabilities interaction.

The FHIR Terminology Servers under test are expected to have already downloaded and installed the required resources (Code Systems, Value Sets & Concept Maps).

Test Scripts

This track includes formal testing and reporting of test results utilizing a defined set of test scripts.

The TestScript and terminology content resources will be committed to the FHIR documents Github repository at: FHIR/documents/tree/master/connectathons Please contact Grahame Grieve if you require commit privileges to this repository; otherwise, you may forward your TestScripts and related artifacts to Richard Ettema who will get them committed.

Additional Resources:

• Terminology Test Definition Spreadsheet - Example proposals for Terminology tests (positive and negative) from the Connectathon 16 event held in San Diego

Scenarios

Scenario Step 1 Name

Action:

Precondition:

Success Criteria:

Bonus point: