Terminology, and the proper use of it, is fundamental for everything that we do in FHIR. The purpose of this track is to test and enhance the capabilities of FHIR Terminology Services and promote their use throughout the FHIR implementation community.
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. We expect and hope to achieve: (1) improved capabilities of terminology servers measured by testing performance, (2) improved and more extensive terminology service testing, (3) implementation and implementer experience with aspects of the terminology services specifications, including experience with newer and previously lesser used terminology service operations and operation capabilities, (4) identify potential improvements as well as deficiencies and possibly errors in the FHIR terminology service specifications based on implementation and testing experience, and (5) increased awareness and utilization of terminology services by other Connectathon tracks.
Wednesday, January 13
Thursday, January 14
Friday, January 15
Test the design of a Resource/set of Resources/Service
Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group
Proposed Track Lead
Rob Hausam, email@example.com
Peter Jordan, firstname.lastname@example.org
R4, Current build (Connectathon build)
Specification(s) this track uses
http://hl7.org/fhir/terminology-service.html (R4 Terminology Services)
http://build.fhir.org/conceptmap.html (proposed R5 changes to ConceptMap)
Artifacts of focus
Clinical input requested (if any)
Clinician involvement and input is certainly welcome. We generally do have leadership and regular participants in the track who have backgrounds with significant clinical experience.
Patient input requested (if any)
No specific request.
Likely the following:
Some of the expected attendees (please feel free to add your name or let us know if you will be participating):
https://chat.fhir.org/#narrow/stream/179207-connectathon-mgmt/topic/Terminology.20Services.20Track (Connectathon Terminology Services track topic)
https://chat.fhir.org/#narrow/stream/179202-terminology (Terminology stream - multiple topics)
Track Orientation Date
To be determined.
Track Orientation Details
The track orientation webinar materials (from the January 2018 WGM in New Orleans) are here:
Also consider joining and participating in the SNOMED on FHIR project Terminology Services (TS) calls here.
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).
Detailed list of sessions to be determined.
Expected and suggested topics (to be scheduled during Kickoff session):
Previous breakout sessions (Connectathon 25):
FHIR Terminology Server
For service providers, implement the following operations from http://hl7.org/fhir/terminology-service.html:
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:
At least one server supports all of these operations and capabilities (http://test.fhir.org/r4). Other servers (see the list above) will support several of these operations and capabilities.
1 - Introduction to Terminology
This has been and will remain a primary purpose of this track and provides a 'friendly introduction' for those new to Terminology Track in FHIR. Attendees participate in this track using a simple scenario that can be met with limited domain knowledge. It is quite feasible to complete the client side terminology interaction of the track within a day with only knowledge of a development environment and some previous FHIR knowledge (such as Patient). If creating a server, advanced preparation will be required.
Pre-connectathon testing is encouraged, but not required, where the participants can utilize the publicly available FHIR Terminology Servers listed above.
Testing and test reporting at the Connectathon event will be self-attested using ConMan and primarily involves peer-to-peer execution between known FHIR clients and/or servers.
2 - ConceptMap R5 Changes
For FHIR R5 significant changes have been made to the ConceptMap resource, including:
Connectathon testing and implementation experience is needed to progress the revised ConceptMap resource through the maturity levels toward normative status.
3 - NamingSystem R5 Changes and $translate-id operation
We want to explore and clarify the role and use of the NamingSystem resource in and with FHIR terminology services and its applications in profiles and IGs. Explore the proposed new $translate-id operation.
4 - Federated Terminology Servers
We need to obtain Connectathon and implementation experience in this important area. In order to practically implement full terminology service capabilities and utilization, a single terminology server may not be capable of handling all needed requests, but it is clearly desirable for clients to be able to point to a single terminology services endpoint for application needs. Some initial work has been done in implementing federated networks composed of multiple FHIR terminology servers for responding to terminology service queries, and this needs to be tested and expanded in the Connectathon.
5 - Coronavirus/COVID-19 ValueSets
Multiple standard terminologies, including SNOMED CT, LOINC, CPT and other have developed and released (or pre-released) new Coronavirus/COVID-19 terminology content in response to the ongoing COVID-19 pandemic. This is obviously a very timely topic for further testing in the Connectathon.
6 - 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.
7 - TerminologyCapabilities resource
Further testing of this resource. working toward increasing the maturity level (beyond draft status).
8 - Returning context-specific designations in $expand and $lookup
9 - NamingSystem $translate-id proposed operation testing (R5)
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: https://github.com/FHIR/documents/tree/master/connectathons/VirtualJan2021.
Available Test Script Sets
The test scripts listed below will be updated for Connectathon 26 and scripts for additional tests may be added.
Test Scripts - Supported Formats
Test Scripts - ValueSet Expand - $expand
Test Scripts - CodeSystem Lookup - $lookup
Test Scripts - CodeSystem Subsumes - $subsumes
Test Scripts - CodeSystem Translate - $translate
Test Scripts - CodeSystem Validate Code - $validate-code
Test Scripts - ValueSet Validate Code - $validate-code
Test Scripts - NamingSystem Preferred ID - $preferred-id
The AEGIS Touchstone testing tool has test scripts available for tracks to test their implementations. See www.touchstone.com to sign in our register if you are a new user.
Terminology Tests for Connectathon 26 are 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).