Skip to end of metadata
Go to start of metadata

You are viewing an old version of this page. View the current version.

Compare with Current View Page History

« Previous Version 11 Next »

Reference Material for Discussion

FHIR JIRA ticket - US Core binding:   FHIR-29563 - Getting issue details... STATUS

Binding strength: https://build.fhir.org/codesystem-binding-strength.html

CodeDisplayDefinitionUsage NoteIssue
requiredRequiredTo be conformant, the concept in this element SHALL be from the specified value set.

extensibleExtensibleTo be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.

Added  

Parts of the definition that contribute to possible confusion:

  1. can apply
  2. does not cover
  3. instead

Do we know the original intent of this binding strength? Does it matter?

Do the education materials consistently/accurately reflect the original intent? Does it matter?

Example 1:

Clinician selects: Heart Attack Type A

Bound value set expansion does not include Heart Attack Type A, however it does include Heart Attack.

Core issue:

Which is the expectation of the sender?

  1. Sender must provide 2 
    1. Heart Attack Type A
    2. Heart Attack
  2. Sender provides
    1. Heart Attack Type A  (from a code system not referenced in the bound value set)
      1. Note: this is the same as preferred binding strength
  3. Sender provides
    1. Heart Attack

Example 2:

Clinician selects: Heart Attack Type A

Bound value set expansion does not include Heart Attack Type A, nor Heart Attack.

Core issue:

Which is the expectation of the sender?

  1. Sender provides
    1. Heart Attack Type A  (from a code system not referenced in the bound value set)

DataType has an impact on the usage of this binding strength. 


NOTE: due to the ambiguous wording, implementations have interpreted the existing definition different ways. 


preferredPreferredInstances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant.

exampleExampleInstances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.

Terminology Binding Examples: http://build.fhir.org/terminologies-binding-examples.html

Health Intersections examples: http://www.healthintersections.com.au/?p=2810

Vocab Working Definition

CodeDisplayDefinitionUsage Note
requiredRequiredTo be conformant, the concept in this element SHALL be from the specified value set.
extensibleExtensible

For reference (rejected, simple definition):  

Concepts may be drawn from a value set other than the one bound to the element.

  • Very general, could apply to preferred and example. 

Note: CC removed the "to be conformant" part of the sentence for the definition. 

The concept in this element SHALL be from the specified value set if any of the codes within the value set match or acceptably generalize the concept being communicated. If the value set expansion does not include a concept that matches or acceptably generalizes cover the concept (based on human review), the concept in this element MAY be drawn from a different value set (or, data type allowing, text) may be included instead.

11/16/2020 discussion/adjustments:

The concept in this element SHALL be from the specified value set if any of the codes within the value set exactly represent or are a more general representation of the concept being communicated. If the value set expansion does not include a concept that exactly represents or is a more general representation of the concept (based on human review), the concept in this element MAY be drawn from a different value set (or, data type allowing, text) may be included instead.

Next steps consider changing the wording to include:  (draft below)

Semantically aligned vs: exactly represent 

Meaning of the concept 

The concept in this element SHALL be from the specified value set if any of the codes within the value set is semantically aligned or is a more general representation of the concept being communicated. If the value set expansion does not include a concept that semantically aligns or is a more general representation of the concept (based on human review), the concept in this element MAY be drawn from a different value set (or, data type allowing, text) may be included instead.

A concept that would be considered is conformant when it exists in the expansion of the bound value set that is more general and as an acceptable representation of the information to be exchanged. What constitutes "acceptable" must be defined as part of the implementation guidance. If the value set expansion does not include a concept that matches or acceptably generalizes of sufficient specificity (based on human review), one or more alternate codings (or, data type allowing, text) may be the only coding sent. 



preferredPreferredInstances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant.
exampleExampleInstances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.

Usage Note(s):

  • No labels