Terminology

Last updated 4 months ago

Overview

FHIR defines terminology service to simplify usage of terminologies.

A terminology service is a service that lets healthcare applications make use of codes and value sets without having to become experts in the fine details of code system, value set, and concept map resources, and the underlying code systems and terminological principles.

Code System is a set of codes with meanings (also known as enumeration, dictionary, terminology, classification, and/or ontology; you probably know ICD-10, RxNorm, SNOMED, LOINC).

In FHIR, many resource elements are represented as coded values. For example, to encode Lab Tests in Observation resource you may want to use LOINC, or RxNorm for medication prescriptions. FHIR has special data types for coded values:

  • code — code as string strictly bound to predefined ValueSet (usually used for fixed codes defined by standard such as Encounter.status or Patient.gender)

  • Coding — complex type with system & code attributes; system refers to specific Code System

  • CodeableConcept — complex type which may contain many Codings — so it can be coded using multiple Code Systems (for example, Lab Tests can be coded by proprietary internal code system and by LOINC).

To specify what codes can be assigned to specific element, FHIR defines binding of element definition to ValueSet. ValueSet selects a set of codes from those defined by one or more code systems.

In Aidbox, all terminology services are built around non-FHIR Concept resource type. Concept resource behaves like other FHIR resources — you can CRUD & Search it. Concept structure essentially follows structure of Coding data type with some additional attributes.

Terminology service can be logically split into two parts:

  • terminology service for your app to lookup and validate existing codes;

  • terminology management — to upload new code systems and create new value sets.

Operations

CodeSystem

FHIR specification

Status

Documentation and samples

$lookup

supported

CodeSystem Concept Lookup

$subsumes

supported

CodeSystem Subsumption testing

$compose

supported

CodeSystem Code composition

ValueSet

FHIR specification

Status

Documentation and samples

$expand

supported

ValueSet Expansion

$validate-code

supported

ValueSet Code validation

ConceptMap

FHIR specification

Status

Documentation and samples

$translate

not supported

WIP ConceptMap Translation

$closure

not supported

WIP ConceptMap Closure Table