HL7 Project Insight # 1623

Link to STK project PSS

TINKAR Milestones and Deadlines

Link to Published HL7 Logical Model: Standardized Terminology Knowledgebase, Release 1

Current Status

The Guidelines for a Standardized Terminology Knowledgebase project published the logical model specification in August 2021. This project remains active with a focus on future ballot work, implementation of the Terminology Knowledge Architecture (TINKAR), and participation in Connectathons.


This project begins the work to describe a flexible self-describing standard logical model for format and distribution of terminology knowledge bases.

The work will be executed in two phases:
Phase I - Creation of the logical model and analysis to map the requirements to existing standards, including FHIR
Phase II - If necessary, definition of a syntax for sharing the terminology artifacts (may be new or an extension to existing standards, including FHIR).

Phase I is covered in this project and further described below. Phase II, if necessary, will be covered in a separate Vocabulary project:
The logical model will include the ability to represent structures/collections like value sets, refsets, etc.
The resulting logical model is aimed to standardize representation of machine-processable semantics, consistent representation of language and dialect, and change over time.
References and previous standards that will be considered include:
- The Data Management Requirement re: reference data (DMBOK 2019)
- Existing ISO Standards including https://www.iso.org/standard/32881.html, https://www.iso.org/standard/61979.html

- Metadata Repository standards that may be used for implementation include ISO/IEC 11179.

- Existing HL7 standards including CTS2, MIF and FHIR

Specifically, the scope includes 1) outlining how the standardized terminology knowledge base can support FHIR resource generation, perhaps closing gaps that are currently covered as extensions 2) a gap analysis of CTS2 logical model, including an evaluation of why it may be considered a unsuccessful attempt to provide a single logical model, so that those pitfalls may be avoided with this attempt.
This project is a first step of defining a logical architecture, based on concepts & requirements that come from existing FHIR terminology services, and the terminologies themselves, such as SNOMED, LOINC, RxNorm, and so forth, and then we can make use of existing—or possibly revised—FHIR resources as a physical representation.

Standard terminologies provide some interesting challenges, such as reconciliation of differing models of modularity and change over time. RxNorm for example, has the need for representing concrete domains, in addition to the current "concepts for numbers" approach that SNOMED is currently taking, and also makes use of cardinality restrictions on role restrictions. There are other things to consider such as how stated and inferred views are represented, how does FHIR terminology services support classification, support for class-based queries (aka kind-of queries).
The terminologies also having differing models of language, dialect, and usage (aka something like a "nursing dialect"), and fitting them all into a consistent logical architecture is part of the effort.
Our goal is to define the logical architecture (i.e. implementation neutral) and then take inventory of the FHIR resources (e.g. CodeSystem, ValueSet, ConceptMap, Basic) and FHIR terminology services to support the implementation of standard-based, integrated terminology knowledge bases, master files, domain specific mapping files, etc. Based on that inventory, this project may develop formal requirements for Phase II and result in FHIR implementation guides to support standard-based terminology knowledge bases.


Vocab Facilitator: Caroline Macumber

Subject Matter Expert: Keith E. Campbell

Meeting Info

Note Calls, starting Friday October 2nd 2020 at 2 pm ET for 60 min

Every other Friday, for details, see the call information in HL7 Conference Call Center information Here

Meeting Documents and Agendas Here

Call Info

Participation Information

+1 646 558 8656 US (New York) or find your local number: https://zoom.us/u/aciVC9RrJ6

Or use the built-in VOIP of Zoom

Web Meeting Info

Web Meeting Info:
Join Zoom Meeting - https://zoom.us/j/7183806281?pwd=WHVnUUlkWWhhcnRaYk9sWWQyOEkvUT09 | Meeting ID: 718 380 6281  Password: 370553 |

Relevant links

FHIR Terminology

Artifact Repositories

Artifacts related to this project will be managed in either confluence (project documentation) or Github (versioned logical model information). Links are shown below

Github Repository

Project Document Repository (below)

Final Informative Ballot Document: 

Tinkar Model:


  File Modified
Microsoft Powerpoint Presentation Tinkar Project Summary - Sept WGM.pptx Sep 28, 2020 by Ioana Singureanu
Microsoft Word Document Terminology Knowledge Architecture (TINKAR).docx Sep 28, 2020 by Ioana Singureanu
File TINKAR.eap Sep 28, 2020 by Ioana Singureanu
Multimedia File 20201204_Recording.mp4 Dec 04, 2020 by Caroline Macumber
Microsoft Word Document Vocab WG_Tinkar Comms Plan.docx Feb 26, 2021 by Jessica Bota
Multimedia File Tinkar Deep Dive 03-26-2021.mp4 Mar 26, 2021 by Jessica Bota
ZIP Archive HL7_LM_TERM_KB_R1_I1_2021MAY.zip May 19, 2021 by Caroline Macumber
PDF File HL7_LM_TERM_KB_R1_I1_2021MAY.pdf May 24, 2021 by Jessica Bota
PDF File HL7_LM_TERM_KB_R1_I1_2021MAY_FINAL.pdf Jul 16, 2021 by Jessica Bota
PDF File HL7_LM_TERM_KB_R1_INFORM_2021AUG_FINAL.pdf Aug 25, 2021 by Raja Cholan

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1 Comment

  1. Minor correction - SNOMED is not doing "concepts for numbers", but rather proper DL concrete domains.  The "concepts for numbers" was a (misguided?) interim approach.