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Use Cases and Requirements:

Almost every clinical application leverages (coded) concepts from both standard, national and local terminology systems. 
The ability to look up concepts in a terminology system, to resolve the relationships between two or more concepts, the
expansion of a valueset definition, their maintenance across versions over time are but some of the basic operations that  
would be beneficial to the components and services supporting an application.

...

  • Terminology system curation tools
  • Knowledge artifact authoring tools (e.g. rules, quality measures, etc..)
  • (Synthetic) Data curation tools
  • Data repositories implementing "semantic" queries (e.g. FHIR servers)
  • Knowledge execution runtime (e.g. CDS engines)
  • Data validation and conformance implementations (e.g. FHIR validation based on profiles)
  • Data Aggregation systems e.g. supporting dashboard-like applications
  • Data normalization / alignment / transreption, both offline and online 

 

The goals of this task force are manifold

  • Harmonize the FHIR Terminology Service (TS) specification with the OMG CTS-2 standard, under some assumptions:
    • The scope of the FHIR server is narrower, and more runtime and application oriented
    • The scope of CTS-2 is to cover a full terminology management and runtime service
    • The FHIR server specification can be implemented on top of a CTS-2 one
  • Critique the underlying CTS-2 spec, furthering its next generation
  • Making recommendations to the FHIR community
  • Identify candidate implementations 

 

Current action items / decisions

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High level functional requirements for a terminology service include:

  • Resolving codes into concept (descriptions)
  • Resolving subsumption and other "semantic" queries between concepts
  • Resolving and expanding valuesets, supporting operations between them
  • Maintaining terminology systems, with provenance and versioning
  • Supporting mappings between terminology systems

From an integration perspective, several patterns have emerged as desirable, which
result in a variety of non-functional requirements:

  • Terminology resolution as a centralized (web) service in a SOA
  • Terminology as a component in a tightly coupled architecture
  • Terminology as an in-memory application feature
  • Hybrid combinations of the above

  • High-throughput online systems, mostly focused on resolving relationships
    between coded concepts and valuesets (e.g. to support semantic queries or CDS)
  • Low-throughput online systems, mostly focused on lookups (e.g. to support CDS authoring tools)
  • Low-throughput offline systems, mostly focused on maintenance (e.g. to support maintenance tools)

Current action items

 

Specifications
  • Alignment of FHIR TS and CTS-2 APIsany 
     
  • Evaluate, provide feedback and assist with the evolution of the candidate specifications
    • CTS-2 consolidation roadmap
       
  • Define a test framework to validate the functionality of a candidate implementation for the purpose of use by an application
Specifications

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