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Attendance can be found Here

Co-Chair and Key Participant information can be found on the Agenda found Here

Discussion items

9:00HousekeepingRob Mfill in attendance sheet, get speakerphone for remote attendees. We will be in the same room all day today. Elections for cochair are open. Voting is eleyronically now. Many will have received the email from NLM to renew their annual license; there are many questions to be answered relate to the access to and use of VSAC; please answer the questions and make sure you fill out the form and submit it (or you will be locked out of the UMLS and VSAC. We went round the room with introductions. Two folks have dialed in on the phone, as we are showing Rob's screen on FCC Vocab.
9:12SNOMED on FHIR updateRob HausamProject is all about how SNOMED CT and FHIR work together. There is one stream on Terminology Binding, and one stream on Terminology Services. Each of these tracks have a call every other week (so the project has call every week). The Using Snomed CT in FHIR page ( is a start of the comprehensive material being developed by the project. Rob M noted that the knowledge especially in the services area needs to be in a consumable form for VSAC and others in the community that do not participate on the calls. Rob H moves that a PSS for the joint SNOMED on FHIR work between HL7 and Snomed International be created, with Vocabulary being primary sponsor and a request to FHIR-I if they wish to cosponsor. Carmela seconds. Some discussion about the governance process ensued. Vote: 12/0/0 motion carries unanimously.
9:30TermInfo updateRob HausamDiscussion about overlaps between the FHIR and SNOMED concept models that affect mapping using ConceptMap. This is part of the update on the TermInfo project. TermInfo was republished as a DSTU specific to CDA R2, and it is now again expired. It was reballoted last September and passed with a few comments and negatives, but no further work has occurred since the ballot. We need to decide what to be done next. The negatives resolution and proceeding to publication hopefully this week. We will see if we can use some of the Thursday Q2 Binding time for this if possible.
9:40Concept Map topicRob Hausam

There was work done in the past cycle on the open Tracker Items, focus on the issues around the value set for equivalence values. This could not get resolved in time for R4 and was deferred to R5, so we are not going back to working on it. Rob showed some slides on the work underway and moving forward. Carmela documented all the existing tracker items and use cases that will need to be evaluated in our discussion.

Group discussed the differences between ConceptMap and Code System Supplements:

1) ConceptMap allows for transitive closure and imbued with a significant functionality in the content of creating expansions, whereas CodeSystem Supplements do not inherently.

2) ConceptMap is only intended to represent equivalence between two concepts and is generally understood to be contextual. Code System Supplements are generally understood to be true in ALL contexts

Note that a supplement is such a thing that is referenced as such by another code system. A code system that is a supplement is identified as such in the code system resource.

We went through the slides in detail.

Conclusions: if a change to do more things than just equivalence we need to change the name of the element from 'equivalence' to 'relationship'. Add the new types of relationships to the code set for the element. The current definition is:

relatedto | equivalent | equal | wider | subsumes | narrower | specializes | inexact | unmatched | disjoint
ConceptMapEquivalence (Required)

Also change the name of the value set but keep the binding and datatype (Required, code)

Michael Lawley describes some uses he has for ConceptMap that have been really useful. These include aggregation relationships to do summary reporting, where 'broader-than' is very useful.

There are existing uses of supplements, and it is infeasible to get rid of supplements in favor of using ConceptMap for all these related things. That leaves the requirement that we improve the documentation and guidance to make it more clear for implementers which to use (ConceptMap or Supplement) for various kinds of requirements.

Ted brought up the concrete example of ISO 3166-1 Country, as this has 3 equivalent codes inside the code system for each country. If we have 2 value sets one of the numeric set and one of the 3-alpha set, is this a Concept Map only? A supplement? Either? Both? We need to find time for further discussion on this and suggest we use this example to hit on any rules or guidance we develop to see if it holds water. We will have another half hour on this discussion in Q3 later today.

10:31AdjournRob MAdjourned for break

Concept Map Slide Set:

Action items

  • Robert Hausam to create the PSS with the Snomed on FHIR group and bring it forward.

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