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).

Breakout Sessions 

"Ask the Expert" Office Hours 

An open, unstructured discussion of HL7 FHIR Terminology current events, resources, and implementation "tips and tricks."  Pull up a chair and bring your Connectathon comments, discoveries and unresolved terminology issues to the table.  All are welcome.

HL7 Vocabulary Office Hours – Rob McClure       Monday January 10 2-3pm CST
Dr. Rob McClure, MD, FAMIA is a Vocabulary Working Group co-Chair, the Terminology Services Management Group representative to the Technical Steering Committee, and currently co-leads the Gender Harmony project.  Rob has a strong clinical background practicing in Pediatrics and Internal Medicine for 10 years, before focusing on informatics, where he has worked for over 30 years.  Rob had a pivotal role in launching the National Library of Medicine’s Value Set Authority Center and served on the National Quality Forum Value Set Harmonization Committee. He has supported the development of terminology-focused work at HL7; including the Value Set Expansion (VSE) Project, Vocabulary Binding Semantics (VBS) Project, the Characteristics of a Value Set Definition (VSD) Project, development of the Unified Terminology Governance process and the Terminology at HL7 resource infrastructure. 

Rob will be bringing his considerable experience and expertise to this Office Hours session to answer your policy process and general questions about HL7 Vocabulary and its utilization within FHIR

FHIR Terminology Server Implementation Office Hours – Peter Jordan               Tuesday, January 11 3-4pm CST
Peter Jordan is an Affiliate Director on the HL7 International Board; Co-Chair of the HL7 International Council; a Co-Chair of the SNOMED on FHIR Terminology Services Group; chairperson HL7 New Zealand and member of the Terminology Services Working Group. Peter has over 3 decades of IT experience, with emphasis in in healthcare information modelling, exchange and security. He contracts, as a Solutions Architect, with various organizations, to provide implementation expertise on standards and architecture in support of the NZ Digital Health Work Program – including HL7® FHIR® Terminology Services. 

Peter will bring his hands-on implementation of FHIR Terminology Services expertise to this Office Hours Session to answer your need for pragmatic Terminology Server implementation guidance.

Internal Code System Management Office Hours – Carmela Couderc                  Wednesday, January 12 10-11a CST
Carmela Couderc is a Vocabulary Working Group Co-Chair contributing to the Core Principles, Characteristics of a Value Set Definition, Release 1, FHIR and Common Terminology Services ballots. She is the Branch Chief of Terminology and Content Delivery at the US Office of the National Coordinator for Health Information technology (ONCHIT), co-inventor of two patents related to clinical logical models and have co-authored material related to clinical terminology mapping and physician order entry knowledge representation. In her role as a Vocabulary WG co-chair, Carmela leads the group that resolves vocabulary issues identified in the FHIR specification and has contributed to development of the Unified Terminology Governance process and the Terminology at HL7 resource infrastructure.

Carmela will bring her knowledge of the freshly minted THO resource this Office Hours Session to answer your questions about internal code system management and their appropriate designation within the FHIR standard and IG development.

System Roles

FHIR Terminology Server

For service providers, implement the following operations from

Support additional capabilities:

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 ( Other servers (see the list above) will support several of these operations and capabilities.


1 - Testing Proposed ConceptMap R5 Changes 

For FHIR R5 significant changes have been made to the ConceptMap resource, including:

  1. Replace the previous 'equivalence' element with a new 'relationship' element.
  2. Revise the concept-map-relationship (previously concept-map-equivalence) code system and value set so that the codes are easier and simpler to understand and choose and so that the mapping relationship direction is clearly specified.
  3. Related changes to the $translate and $closure operations based on the above code changes. 
  4. Updates to and

Connectathon testing and implementation experience is needed to progress the revised ConceptMap resource through the maturity levels toward normative status.  

2 - Formal Testing of Terminology - Participants with FHIR experience

This scenario introduces a more formalized testing approach for those participants that have been working the FHIR Terminology specification and wish to move beyond basic testing and may have systems that are in active development, deployed or soon to be deployed into a production environment. Automated testing tooling is significantly leveraged for both automated terminology server testing (testing tool to FHIR terminology server) and surveillance of peer-to-peer testing (external FHIR client to external FHIR server).

Pre-connectathon testing is highly encouraged in order to be better prepared for the actual Connectathon event and to become familiar with the public testing platforms that will be used for the formal testing.

Testing and test reporting will be done using the public testing platforms which will provide test results via the new FHIR TestReport resource type as well as any specific reporting capabilities of those testing platforms. These reports will provide qualitative and quantitative analysis of the system under test and its conformance to the FHIR specification.

4 - NamingSystem $translate-id proposed operation testing (R5)

Executing the use of the NamingSystem resource in and with FHIR terminology services and its applications in profiles and IGs, testing the $translate-id operation functionality


This track includes formal testing and reporting of test results utilizing a defined set of test scripts.
[Note:  The test scripts and repository location will be updated for Virtual Connectathon 29.]

AEGIS Touchstone TestScripts will be available for Connectathon 29.  Please email for any questions about using Touchstone.

The AEGIS Touchstone testing tool has test scripts available for tracks to test their implementations. See to sign in our register if you are a new user.
Below, you will find a link to the tests specific to this HL7 track. Please send questions or issues to and a team member will be glad to assist you.

Terminology Tests for Connectathon 29 will be found here:   Terminology Tests in Touchstone

Security and Privacy Considerations

Most FHIR terminology terminology service endpoints are open (at present).  This may change in the future as adoption and implementation experience increases in order to more directly manage external (non-HL7) terminology licensing considerations.  Some servers do allow or require authentication (e.g. Apelon - see above).