SlideShare a Scribd company logo
1 of 12
FINDING WITH FHIR
HL7NZ Standards Workshop– June27, 2016
Accessing SNOMED CT With
FHIR Terminology Services
PeterJordanMScLLBMCPD
Vice-ChairHL7NewZealand
Page 2 • HL7 New Zealand
The SNOMED CT Landscape in NZ
• Comprehensive Terminology > 300,000 active concepts…each with
multiple descriptions & relationships.
• Endorsed by MoH for EHR clinical content coding at point of care.
• Replacing Read Codes in primary care.
• Numerous implementation options…
 A code system – store information
 An interface Terminology – capture & display
 An indexing system - retrieve
 A common terminology – meaningful communication & integration
 A dictionary – query, analyse & report; link health records to
knowledge resources
• 2016 SNOMED CT Expo: Oct 27-28 Wellington
Page 3 • HL7 New Zealand
The Problem
• Terminology is HARD: very few – if any – existing
systems do it well.
• Consistency required for clinical safety and
downstream uses (analytics, research, etc.).
• Friendly & efficient UIs (controls or text + Natural
Language Processing?)
• HIE issues are common to ALL systems
• Risks of individual implementation approach
– Inconsistent implementations – e.g. pre or post coordination?
– Version Lags if Facility/Vendor based deployment
– Duplicate/Overlapping Reference Sets
– Inconsistent Mapping to Read (NZ variations)
Page 4 • HL7 New Zealand
Mitigation
• Sector-wide implementation
• National Release Centre – single source
• National Reference Sets
• Single set of NZ Read to SCT maps
• Terminology Services
• Common standards-based APIs
Page 5 • HL7 New Zealand
Terminology Services
• Repository of coded clinical concepts, descriptions &
relationships plus tools for maintenance of vocabulary
resources, but…
• There’s a lot of complexity here:
o Code Systems / Ref Sets / Value Sets / Bindings
o Value Sets are complex (intensional, extensional, implicit)
o Underlying terminology logic much more complex (expressions)
• Most applications much simpler
o List of codes and displays in some table structure
o This is a known problem – in many countries
Page 6 • HL7 New Zealand
Terminology Services API
• Bridge the Gap: delegate all this complexity to
specialist software
• Provide a set of services that do what
applications need
• It becomes easy to write applications that do
terminology well
• FHIR – a framework well-suited to building these
APIs.
Page 7 • HL7 New Zealand
Application Needs
• Give me a list of codes (filtered
by term, super type, expression)
• How do I display this code?
• Is this code valid?
• Translate this code to a different
code system
• Integrate terminology search
into my application (including
client-side caching)
Page 8 • HL7 New Zealand
Application Needs API Gives
• Give me a list of codes (filtered
by term, super type, expression)
• How do I display this code?
• Is this code valid?
• Translate this code to a different
code system
• Integrate terminology search
into my application (including
client-side caching)
• $expand
• $lookup
• $validate-code
• $translate
• $closure
Page 9 • HL7 New Zealand
FHIR Terminology Resources
• Code System – defines a set of codes with meanings, e.g.
URL, version, description, key properties, filters
• Value Set – selects a set of codes from one, or more, Code
Systems constructed from…
 Inline code system or..
 Set of codes defined in other code systems, e.g. SNOMED CT by listing
the codes (extensional) and/or providing selection criteria
(intensional)
 Can be expanded – turned into a simple collection of enumerated
codes & descriptions, ready to use for data entry or validation.
• Concept Map – mappings between Code Systems
Page 10 • HL7 New Zealand
Using SNOMED CT With FHIR Value Sets
• Implicit Value Sets
o defined as part of each request
o provide a interface to distinct subsets
o basis for $expansion operations [base]/ValueSet/$expand
o URLs with base identifier
?identifier=http://snomed.info/sct/ 900000000000207008 /version/20160131
…plus a query portion defining scope…
o All concepts in the edition/version /fhir_vs
...but maybe add a text filter! /fhir_vs&filter=midlife
o All concepts subsumed by (descendants of) another concept
/fhir_vs=isa/38341003
o All concepts in specified reference set /fhir_vs=refset/450970008
Page 11 • HL7 New Zealand
NZ Implementation Example
• Patients First Terminology Server
http://its.patientsfirst.org.nz/RestService.svc/Terminz
NB: Display preferred terms, rather than fully specified names.
Page 12 • HL7 New Zealand
Questions and Comments?
Next steps…beta testing!
Test Page: http://itp.patientsfirst.org.nz/Home/Terminology
Feedback to peter.jordan@patientsfirst.org.nz

More Related Content

What's hot

What's hot (20)

FHIR® Profiling Using Forge and Simplifier.net
FHIR® Profiling Using Forge and Simplifier.netFHIR® Profiling Using Forge and Simplifier.net
FHIR® Profiling Using Forge and Simplifier.net
 
FHIR Documents by Lloyd McKenzie
FHIR Documents by Lloyd McKenzieFHIR Documents by Lloyd McKenzie
FHIR Documents by Lloyd McKenzie
 
Terminology, value-sets, codesystems by Lloyd McKenzie
Terminology, value-sets, codesystems by Lloyd McKenzieTerminology, value-sets, codesystems by Lloyd McKenzie
Terminology, value-sets, codesystems by Lloyd McKenzie
 
Discover the new face of HL7 FHIR v4 - Ideas2IT
Discover the new face of  HL7 FHIR v4 - Ideas2ITDiscover the new face of  HL7 FHIR v4 - Ideas2IT
Discover the new face of HL7 FHIR v4 - Ideas2IT
 
Vitalis 2016 FHIR App Development
Vitalis 2016 FHIR App DevelopmentVitalis 2016 FHIR App Development
Vitalis 2016 FHIR App Development
 
HL7 FHIR Adoption In New Zealand
HL7 FHIR Adoption In New ZealandHL7 FHIR Adoption In New Zealand
HL7 FHIR Adoption In New Zealand
 
Getting started with FHIR by Ewout Kramer
Getting started with FHIR by Ewout KramerGetting started with FHIR by Ewout Kramer
Getting started with FHIR by Ewout Kramer
 
FHIR Profiles
FHIR ProfilesFHIR Profiles
FHIR Profiles
 
FHIR tutorial - Afternoon
FHIR tutorial - AfternoonFHIR tutorial - Afternoon
FHIR tutorial - Afternoon
 
FHIR Profiling tutorial
FHIR Profiling tutorialFHIR Profiling tutorial
FHIR Profiling tutorial
 
FHIR API for Java programmers by James Agnew
FHIR API for Java programmers by James AgnewFHIR API for Java programmers by James Agnew
FHIR API for Java programmers by James Agnew
 
FHIR Search for server developers by Martijn Harthoorn
FHIR Search for server developers by Martijn HarthoornFHIR Search for server developers by Martijn Harthoorn
FHIR Search for server developers by Martijn Harthoorn
 
FHIR and DICOM by Marten Smits
FHIR and DICOM by Marten SmitsFHIR and DICOM by Marten Smits
FHIR and DICOM by Marten Smits
 
Authoring profiles by Michel Rutten
Authoring profiles by Michel RuttenAuthoring profiles by Michel Rutten
Authoring profiles by Michel Rutten
 
FHIR Tutorial - Morning
FHIR Tutorial - MorningFHIR Tutorial - Morning
FHIR Tutorial - Morning
 
Profile and validation by Grahame Grieve
Profile and validation by Grahame GrieveProfile and validation by Grahame Grieve
Profile and validation by Grahame Grieve
 
FHIR DevDays 2015 - introduction to FHIR
FHIR DevDays 2015 - introduction to FHIRFHIR DevDays 2015 - introduction to FHIR
FHIR DevDays 2015 - introduction to FHIR
 
Route from CCDA to FHIR by Grahame Grieve
Route from CCDA to FHIR by Grahame GrieveRoute from CCDA to FHIR by Grahame Grieve
Route from CCDA to FHIR by Grahame Grieve
 
Introduction to HL7 FHIR
Introduction to HL7 FHIRIntroduction to HL7 FHIR
Introduction to HL7 FHIR
 
FHIR for implementers in New Zealand
FHIR for implementers in New ZealandFHIR for implementers in New Zealand
FHIR for implementers in New Zealand
 

Viewers also liked

Viewers also liked (16)

SMART on FHIR by Scot Post van der Burg
SMART on FHIR by Scot Post van der BurgSMART on FHIR by Scot Post van der Burg
SMART on FHIR by Scot Post van der Burg
 
FHIR architecture overview for non-programmers by René Spronk
FHIR architecture overview for non-programmers by René SpronkFHIR architecture overview for non-programmers by René Spronk
FHIR architecture overview for non-programmers by René Spronk
 
Rolling out FHIR - architecture and implementation considerations by Lloyd Mc...
Rolling out FHIR - architecture and implementation considerations by Lloyd Mc...Rolling out FHIR - architecture and implementation considerations by Lloyd Mc...
Rolling out FHIR - architecture and implementation considerations by Lloyd Mc...
 
Security in FHIR with OAuth by Grahame Grieve
Security in FHIR with OAuth by Grahame GrieveSecurity in FHIR with OAuth by Grahame Grieve
Security in FHIR with OAuth by Grahame Grieve
 
Introduction to FHIR™
Introduction to FHIR™Introduction to FHIR™
Introduction to FHIR™
 
Patients First Terminology Services: A Brief Introduction for Developers
Patients First Terminology Services: A Brief Introduction for DevelopersPatients First Terminology Services: A Brief Introduction for Developers
Patients First Terminology Services: A Brief Introduction for Developers
 
FHIR REST API
FHIR REST APIFHIR REST API
FHIR REST API
 
Vitalis 2016 FHIR Introduction
Vitalis 2016 FHIR IntroductionVitalis 2016 FHIR Introduction
Vitalis 2016 FHIR Introduction
 
CCDs or QRDAs for eCQM Reporting
CCDs or QRDAs for eCQM ReportingCCDs or QRDAs for eCQM Reporting
CCDs or QRDAs for eCQM Reporting
 
Authoring FHIR Profiles - extended version
Authoring FHIR Profiles - extended versionAuthoring FHIR Profiles - extended version
Authoring FHIR Profiles - extended version
 
Cda
CdaCda
Cda
 
Integration in the Age of Value-Based Care: Webinar Slides
Integration in the Age of Value-Based Care: Webinar SlidesIntegration in the Age of Value-Based Care: Webinar Slides
Integration in the Age of Value-Based Care: Webinar Slides
 
Route from CCDA to FHIR by Grahame Grieve
Route from CCDA to FHIR by Grahame GrieveRoute from CCDA to FHIR by Grahame Grieve
Route from CCDA to FHIR by Grahame Grieve
 
Redox Enterprise
Redox EnterpriseRedox Enterprise
Redox Enterprise
 
HL7 Clinical Document Architecture: Overview and Applications
HL7 Clinical Document Architecture: Overview and ApplicationsHL7 Clinical Document Architecture: Overview and Applications
HL7 Clinical Document Architecture: Overview and Applications
 
Fundamentals of HL7 CDA & Implementing HL7 CDA
Fundamentals of HL7 CDA & Implementing HL7 CDAFundamentals of HL7 CDA & Implementing HL7 CDA
Fundamentals of HL7 CDA & Implementing HL7 CDA
 

Similar to Accessing SNOMED CT With FHIR Terminology Services

Hl7 common terminology services
Hl7 common terminology servicesHl7 common terminology services
Hl7 common terminology services
Syed Ali Raza
 
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
Nawanan Theera-Ampornpunt
 
The Logical Model Designer - Binding Information Models to Terminology
The Logical Model Designer - Binding Information Models to TerminologyThe Logical Model Designer - Binding Information Models to Terminology
The Logical Model Designer - Binding Information Models to Terminology
Snow Owl
 

Similar to Accessing SNOMED CT With FHIR Terminology Services (20)

Fhir seminar hinz 2015
Fhir seminar hinz 2015Fhir seminar hinz 2015
Fhir seminar hinz 2015
 
Hl7 common terminology services
Hl7 common terminology servicesHl7 common terminology services
Hl7 common terminology services
 
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...
 
FHIR intro and background at HL7 Germany 2014
FHIR intro and background at HL7 Germany 2014FHIR intro and background at HL7 Germany 2014
FHIR intro and background at HL7 Germany 2014
 
The Logical Model Designer - Binding Information Models to Terminology
The Logical Model Designer - Binding Information Models to TerminologyThe Logical Model Designer - Binding Information Models to Terminology
The Logical Model Designer - Binding Information Models to Terminology
 
Hl7 Standards
Hl7 StandardsHl7 Standards
Hl7 Standards
 
Hl7 Standards
Hl7 StandardsHl7 Standards
Hl7 Standards
 
Hl7 Standards (September 15, 2016)
Hl7 Standards (September 15, 2016)Hl7 Standards (September 15, 2016)
Hl7 Standards (September 15, 2016)
 
Hl7 Standards
Hl7 StandardsHl7 Standards
Hl7 Standards
 
Health Information Exchange Standards - Compliance via Integration Testing
Health Information Exchange Standards  -  Compliance via Integration TestingHealth Information Exchange Standards  -  Compliance via Integration Testing
Health Information Exchange Standards - Compliance via Integration Testing
 
Interoperability, the rise of HL7 and FHIR
Interoperability, the rise of HL7 and FHIRInteroperability, the rise of HL7 and FHIR
Interoperability, the rise of HL7 and FHIR
 
Snow Owl Platform. Unlocking the meaning from healthcare data.
Snow Owl Platform. Unlocking the meaning from healthcare data. Snow Owl Platform. Unlocking the meaning from healthcare data.
Snow Owl Platform. Unlocking the meaning from healthcare data.
 
HL7 Standards (March 21, 2018)
HL7 Standards (March 21, 2018)HL7 Standards (March 21, 2018)
HL7 Standards (March 21, 2018)
 
Intro_To_FHIR.pptx
Intro_To_FHIR.pptxIntro_To_FHIR.pptx
Intro_To_FHIR.pptx
 
Towards the Implementation of an openEHR-based Open Source EHR Platform (a vi...
Towards the Implementation of an openEHR-based Open Source EHR Platform (a vi...Towards the Implementation of an openEHR-based Open Source EHR Platform (a vi...
Towards the Implementation of an openEHR-based Open Source EHR Platform (a vi...
 
Strategic Directions for Health Informatics Content Interoperability in NZ
Strategic Directions for Health Informatics Content Interoperability in NZStrategic Directions for Health Informatics Content Interoperability in NZ
Strategic Directions for Health Informatics Content Interoperability in NZ
 
WEBINAR: The Yosemite Project: An RDF Roadmap for Healthcare Information Inte...
WEBINAR: The Yosemite Project: An RDF Roadmap for Healthcare Information Inte...WEBINAR: The Yosemite Project: An RDF Roadmap for Healthcare Information Inte...
WEBINAR: The Yosemite Project: An RDF Roadmap for Healthcare Information Inte...
 
Zdravković Milan, Trajanović Miroslav. Semantic interoperability of Supply Ch...
Zdravković Milan, Trajanović Miroslav. Semantic interoperability of Supply Ch...Zdravković Milan, Trajanović Miroslav. Semantic interoperability of Supply Ch...
Zdravković Milan, Trajanović Miroslav. Semantic interoperability of Supply Ch...
 
Devdays 2017 implementation guide authoring - ardon toonstra
Devdays 2017  implementation guide authoring - ardon toonstraDevdays 2017  implementation guide authoring - ardon toonstra
Devdays 2017 implementation guide authoring - ardon toonstra
 
Open Platforms for Healthcare Applications
Open Platforms for Healthcare ApplicationsOpen Platforms for Healthcare Applications
Open Platforms for Healthcare Applications
 

More from Peter Jordan

SNOMED_CT_Implementation_Course_Certificate_Grade_A
SNOMED_CT_Implementation_Course_Certificate_Grade_ASNOMED_CT_Implementation_Course_Certificate_Grade_A
SNOMED_CT_Implementation_Course_Certificate_Grade_A
Peter Jordan
 
Foundation_Course-Foundation_Course_Certificate_94
Foundation_Course-Foundation_Course_Certificate_94Foundation_Course-Foundation_Course_Certificate_94
Foundation_Course-Foundation_Course_Certificate_94
Peter Jordan
 
MS_Learning_Transcript.PDF
MS_Learning_Transcript.PDFMS_Learning_Transcript.PDF
MS_Learning_Transcript.PDF
Peter Jordan
 
NZ Primary Healthcare IT Integration: May 2014
NZ Primary Healthcare IT Integration: May 2014NZ Primary Healthcare IT Integration: May 2014
NZ Primary Healthcare IT Integration: May 2014
Peter Jordan
 
HL7 FHIR: Potential Uses in New Zealand
HL7 FHIR: Potential Uses in New ZealandHL7 FHIR: Potential Uses in New Zealand
HL7 FHIR: Potential Uses in New Zealand
Peter Jordan
 

More from Peter Jordan (13)

HL7 FHIR FoundationTopics for Non-Developers
HL7 FHIR FoundationTopics for Non-DevelopersHL7 FHIR FoundationTopics for Non-Developers
HL7 FHIR FoundationTopics for Non-Developers
 
New Zealand on FHIR - HiNZ 2019
New Zealand on FHIR - HiNZ 2019New Zealand on FHIR - HiNZ 2019
New Zealand on FHIR - HiNZ 2019
 
FHIR Validate-Code Operations: SNOMED on FHIR Meeting, Vancouver Oct 2018
FHIR Validate-Code Operations: SNOMED on FHIR Meeting, Vancouver Oct 2018FHIR Validate-Code Operations: SNOMED on FHIR Meeting, Vancouver Oct 2018
FHIR Validate-Code Operations: SNOMED on FHIR Meeting, Vancouver Oct 2018
 
Hl7 fhir proficiency_certificate
Hl7 fhir proficiency_certificateHl7 fhir proficiency_certificate
Hl7 fhir proficiency_certificate
 
Why HL7 FHIR is Hot & SNOMED CT Is Cool - For Healthcare CIOs
Why HL7 FHIR is Hot & SNOMED CT Is Cool - For Healthcare CIOsWhy HL7 FHIR is Hot & SNOMED CT Is Cool - For Healthcare CIOs
Why HL7 FHIR is Hot & SNOMED CT Is Cool - For Healthcare CIOs
 
Igniting Interoperability: HL7NZ Seminar, May 2017
Igniting Interoperability: HL7NZ Seminar, May 2017Igniting Interoperability: HL7NZ Seminar, May 2017
Igniting Interoperability: HL7NZ Seminar, May 2017
 
Interoperability In Practice: HL7NZ Seminar, May 2017
Interoperability In Practice: HL7NZ Seminar, May 2017Interoperability In Practice: HL7NZ Seminar, May 2017
Interoperability In Practice: HL7NZ Seminar, May 2017
 
SNOMED_CT_Implementation_Course_Certificate_Grade_A
SNOMED_CT_Implementation_Course_Certificate_Grade_ASNOMED_CT_Implementation_Course_Certificate_Grade_A
SNOMED_CT_Implementation_Course_Certificate_Grade_A
 
Foundation_Course-Foundation_Course_Certificate_94
Foundation_Course-Foundation_Course_Certificate_94Foundation_Course-Foundation_Course_Certificate_94
Foundation_Course-Foundation_Course_Certificate_94
 
MS_Learning_Transcript.PDF
MS_Learning_Transcript.PDFMS_Learning_Transcript.PDF
MS_Learning_Transcript.PDF
 
GP2GP In Action - Transferring Patient Records Around New Zealand, Electronic...
GP2GP In Action - Transferring Patient Records Around New Zealand, Electronic...GP2GP In Action - Transferring Patient Records Around New Zealand, Electronic...
GP2GP In Action - Transferring Patient Records Around New Zealand, Electronic...
 
NZ Primary Healthcare IT Integration: May 2014
NZ Primary Healthcare IT Integration: May 2014NZ Primary Healthcare IT Integration: May 2014
NZ Primary Healthcare IT Integration: May 2014
 
HL7 FHIR: Potential Uses in New Zealand
HL7 FHIR: Potential Uses in New ZealandHL7 FHIR: Potential Uses in New Zealand
HL7 FHIR: Potential Uses in New Zealand
 

Recently uploaded

“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
Muhammad Subhan
 

Recently uploaded (20)

“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
“Iamnobody89757” Understanding the Mysterious of Digital Identity.pdf
 
Linux Foundation Edge _ Overview of FDO Software Components _ Randy at Intel.pdf
Linux Foundation Edge _ Overview of FDO Software Components _ Randy at Intel.pdfLinux Foundation Edge _ Overview of FDO Software Components _ Randy at Intel.pdf
Linux Foundation Edge _ Overview of FDO Software Components _ Randy at Intel.pdf
 
Working together SRE & Platform Engineering
Working together SRE & Platform EngineeringWorking together SRE & Platform Engineering
Working together SRE & Platform Engineering
 
Introduction to FDO and How It works Applications _ Richard at FIDO Alliance.pdf
Introduction to FDO and How It works Applications _ Richard at FIDO Alliance.pdfIntroduction to FDO and How It works Applications _ Richard at FIDO Alliance.pdf
Introduction to FDO and How It works Applications _ Richard at FIDO Alliance.pdf
 
Event-Driven Architecture Masterclass: Engineering a Robust, High-performance...
Event-Driven Architecture Masterclass: Engineering a Robust, High-performance...Event-Driven Architecture Masterclass: Engineering a Robust, High-performance...
Event-Driven Architecture Masterclass: Engineering a Robust, High-performance...
 
Collecting & Temporal Analysis of Behavioral Web Data - Tales From The Inside
Collecting & Temporal Analysis of Behavioral Web Data - Tales From The InsideCollecting & Temporal Analysis of Behavioral Web Data - Tales From The Inside
Collecting & Temporal Analysis of Behavioral Web Data - Tales From The Inside
 
Extensible Python: Robustness through Addition - PyCon 2024
Extensible Python: Robustness through Addition - PyCon 2024Extensible Python: Robustness through Addition - PyCon 2024
Extensible Python: Robustness through Addition - PyCon 2024
 
Vector Search @ sw2con for slideshare.pptx
Vector Search @ sw2con for slideshare.pptxVector Search @ sw2con for slideshare.pptx
Vector Search @ sw2con for slideshare.pptx
 
WebAssembly is Key to Better LLM Performance
WebAssembly is Key to Better LLM PerformanceWebAssembly is Key to Better LLM Performance
WebAssembly is Key to Better LLM Performance
 
Event-Driven Architecture Masterclass: Integrating Distributed Data Stores Ac...
Event-Driven Architecture Masterclass: Integrating Distributed Data Stores Ac...Event-Driven Architecture Masterclass: Integrating Distributed Data Stores Ac...
Event-Driven Architecture Masterclass: Integrating Distributed Data Stores Ac...
 
Continuing Bonds Through AI: A Hermeneutic Reflection on Thanabots
Continuing Bonds Through AI: A Hermeneutic Reflection on ThanabotsContinuing Bonds Through AI: A Hermeneutic Reflection on Thanabots
Continuing Bonds Through AI: A Hermeneutic Reflection on Thanabots
 
Observability Concepts EVERY Developer Should Know (DevOpsDays Seattle)
Observability Concepts EVERY Developer Should Know (DevOpsDays Seattle)Observability Concepts EVERY Developer Should Know (DevOpsDays Seattle)
Observability Concepts EVERY Developer Should Know (DevOpsDays Seattle)
 
Generative AI Use Cases and Applications.pdf
Generative AI Use Cases and Applications.pdfGenerative AI Use Cases and Applications.pdf
Generative AI Use Cases and Applications.pdf
 
AI mind or machine power point presentation
AI mind or machine power point presentationAI mind or machine power point presentation
AI mind or machine power point presentation
 
ADP Passwordless Journey Case Study.pptx
ADP Passwordless Journey Case Study.pptxADP Passwordless Journey Case Study.pptx
ADP Passwordless Journey Case Study.pptx
 
Human Expert Website Manual WCAG 2.0 2.1 2.2 Audit - Digital Accessibility Au...
Human Expert Website Manual WCAG 2.0 2.1 2.2 Audit - Digital Accessibility Au...Human Expert Website Manual WCAG 2.0 2.1 2.2 Audit - Digital Accessibility Au...
Human Expert Website Manual WCAG 2.0 2.1 2.2 Audit - Digital Accessibility Au...
 
Portal Kombat : extension du réseau de propagande russe
Portal Kombat : extension du réseau de propagande russePortal Kombat : extension du réseau de propagande russe
Portal Kombat : extension du réseau de propagande russe
 
Design Guidelines for Passkeys 2024.pptx
Design Guidelines for Passkeys 2024.pptxDesign Guidelines for Passkeys 2024.pptx
Design Guidelines for Passkeys 2024.pptx
 
Using IESVE for Room Loads Analysis - UK & Ireland
Using IESVE for Room Loads Analysis - UK & IrelandUsing IESVE for Room Loads Analysis - UK & Ireland
Using IESVE for Room Loads Analysis - UK & Ireland
 
Overview of Hyperledger Foundation
Overview of Hyperledger FoundationOverview of Hyperledger Foundation
Overview of Hyperledger Foundation
 

Accessing SNOMED CT With FHIR Terminology Services

  • 1. FINDING WITH FHIR HL7NZ Standards Workshop– June27, 2016 Accessing SNOMED CT With FHIR Terminology Services PeterJordanMScLLBMCPD Vice-ChairHL7NewZealand
  • 2. Page 2 • HL7 New Zealand The SNOMED CT Landscape in NZ • Comprehensive Terminology > 300,000 active concepts…each with multiple descriptions & relationships. • Endorsed by MoH for EHR clinical content coding at point of care. • Replacing Read Codes in primary care. • Numerous implementation options…  A code system – store information  An interface Terminology – capture & display  An indexing system - retrieve  A common terminology – meaningful communication & integration  A dictionary – query, analyse & report; link health records to knowledge resources • 2016 SNOMED CT Expo: Oct 27-28 Wellington
  • 3. Page 3 • HL7 New Zealand The Problem • Terminology is HARD: very few – if any – existing systems do it well. • Consistency required for clinical safety and downstream uses (analytics, research, etc.). • Friendly & efficient UIs (controls or text + Natural Language Processing?) • HIE issues are common to ALL systems • Risks of individual implementation approach – Inconsistent implementations – e.g. pre or post coordination? – Version Lags if Facility/Vendor based deployment – Duplicate/Overlapping Reference Sets – Inconsistent Mapping to Read (NZ variations)
  • 4. Page 4 • HL7 New Zealand Mitigation • Sector-wide implementation • National Release Centre – single source • National Reference Sets • Single set of NZ Read to SCT maps • Terminology Services • Common standards-based APIs
  • 5. Page 5 • HL7 New Zealand Terminology Services • Repository of coded clinical concepts, descriptions & relationships plus tools for maintenance of vocabulary resources, but… • There’s a lot of complexity here: o Code Systems / Ref Sets / Value Sets / Bindings o Value Sets are complex (intensional, extensional, implicit) o Underlying terminology logic much more complex (expressions) • Most applications much simpler o List of codes and displays in some table structure o This is a known problem – in many countries
  • 6. Page 6 • HL7 New Zealand Terminology Services API • Bridge the Gap: delegate all this complexity to specialist software • Provide a set of services that do what applications need • It becomes easy to write applications that do terminology well • FHIR – a framework well-suited to building these APIs.
  • 7. Page 7 • HL7 New Zealand Application Needs • Give me a list of codes (filtered by term, super type, expression) • How do I display this code? • Is this code valid? • Translate this code to a different code system • Integrate terminology search into my application (including client-side caching)
  • 8. Page 8 • HL7 New Zealand Application Needs API Gives • Give me a list of codes (filtered by term, super type, expression) • How do I display this code? • Is this code valid? • Translate this code to a different code system • Integrate terminology search into my application (including client-side caching) • $expand • $lookup • $validate-code • $translate • $closure
  • 9. Page 9 • HL7 New Zealand FHIR Terminology Resources • Code System – defines a set of codes with meanings, e.g. URL, version, description, key properties, filters • Value Set – selects a set of codes from one, or more, Code Systems constructed from…  Inline code system or..  Set of codes defined in other code systems, e.g. SNOMED CT by listing the codes (extensional) and/or providing selection criteria (intensional)  Can be expanded – turned into a simple collection of enumerated codes & descriptions, ready to use for data entry or validation. • Concept Map – mappings between Code Systems
  • 10. Page 10 • HL7 New Zealand Using SNOMED CT With FHIR Value Sets • Implicit Value Sets o defined as part of each request o provide a interface to distinct subsets o basis for $expansion operations [base]/ValueSet/$expand o URLs with base identifier ?identifier=http://snomed.info/sct/ 900000000000207008 /version/20160131 …plus a query portion defining scope… o All concepts in the edition/version /fhir_vs ...but maybe add a text filter! /fhir_vs&filter=midlife o All concepts subsumed by (descendants of) another concept /fhir_vs=isa/38341003 o All concepts in specified reference set /fhir_vs=refset/450970008
  • 11. Page 11 • HL7 New Zealand NZ Implementation Example • Patients First Terminology Server http://its.patientsfirst.org.nz/RestService.svc/Terminz NB: Display preferred terms, rather than fully specified names.
  • 12. Page 12 • HL7 New Zealand Questions and Comments? Next steps…beta testing! Test Page: http://itp.patientsfirst.org.nz/Home/Terminology Feedback to peter.jordan@patientsfirst.org.nz

Editor's Notes

  1. SNOMED CT is a standarised, multilingual vocabulary of scientifically-validated clinical terms that enables the consistent, processable, representation of clinical content in electronic health records.
  2. Inline code system – a small, simple and inclusive set of codes (e.g. New Zealand Regions).
  3. Implicit value sets are those whose specification can be predicted based on the grammar of the underlying code system and the known structure of the URL that identifies them.