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This page is part of the FHIR Specification (v1.0.2: DSTU 2). The current version which supercedes this version is

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . For a full list of available versions, see the Directory of published versions . Page versions: . Page versions: R4B R4 R3 R2

1.25.1.1 1.30.1.1 Using SNOMED CT with FHIR Using SNOMED CT with FHIR

Vocabulary Vocabulary Work Group Work Group Maturity Level : N/A Maturity Level : N/A Ballot Status : DSTU 2 Ballot Status : DSTU 2

1.25.1.1.1 1.30.1.1.1 Summary Summary

Note: The IHTSDO glossary
Source SNOMED CT is made managed by IHTSDO SNOMED CT is made managed by IHTSDO . IHTSDO is an international standards organization with multiple different countries as members, each of which distribute their own variant of SNOMED CT . IHTSDO is an international standards organization with multiple different countries as members, each of which distribute their own variant of SNOMED CT
System The URI http://snomed.info/sct The URI http://snomed.info/sct identifies the SNOMED CT code system identifies the SNOMED CT code system
Version Where a version is used, it should be a full URI that represents the specific distribution, following the SNOMED CT URI Specification Where a version is used, it should be a full URI that represents the specific distribution, following the SNOMED CT URI Specification (see note below) (see note below)
Code The following SNOMED CT artifacts are valid in the The following SNOMED CT artifacts are valid in the code element for the http://snomed.info/sct namespace: Concept IDs element for the http://snomed.info/sct namespace: Concept IDs , Expressions , Expressions ( ( grammar grammar ) and SNOMED Legacy codes ) and SNOMED Legacy codes .
Description Ids are not valid, nor are other concepts associated with SNOMED CT Concepts using the RF2 identifier infrastructure. Expressions SHOULD NOT contain terms, only concept IDs
Description Ids are not valid, nor are other concepts associated with SNOMED CT Concepts using the RF2 identifier infrastructure. Expressions SHOULD NOT contain terms, only concept IDs
Display The correct display for a SNOMED CT concept is one of the preferred terms for the concept. Preferred terms are case sensitive. The Fully Specified Name is not an appropriate choice. The source of preferred name comes from a Language Reference Set. SNOMED CT does not define displays for expressions; if no display has been associated with the expression through a value set or other mechanism, the full expression syntax with preferred terms embedded may be used The correct display for a SNOMED CT concept is one of the preferred terms for the concept. Preferred terms are case sensitive. The Fully Specified Name is not an appropriate choice. The source of preferred name comes from a Language Reference Set. SNOMED CT does not define displays for expressions; if no display has been associated with the expression through a value set or other mechanism, the full expression syntax with preferred terms embedded may be used
Filter Properties Filter Properties Several properties are defined as described below Several properties are defined as described below

Note: The IHTSDO glossary explains some of these SNOMED CT specific terms. explains some of these SNOMED CT specific terms.

1.25.1.1.2 1.30.1.1.2 Version Issues Version Issues There is no single distribution that contains all defined SNOMED CT codes in all contexts of use; instead, each national office distributes a set of version of a particular distribution. In addition, other release authorities may be designated. The SNOMED CT URI Specification

There is no single distribution that contains all defined SNOMED CT codes in all contexts of use; instead, each national office distributes a set of version of a particular distribution. In addition, other release authorities may be designated. The SNOMED CT URI Specification describes how to unambiguously reference a particular version of a distribution: describes how to unambiguously reference a particular version of a distribution: 

  http://snomed.info/sct/[sctid]/version/[YYYYMMDD] 
where
[sctid]
is
the
concept
id
of
the
SNOMED
CT
distribution
(e.g.
32506021000036107
for
Australia),
and
the
tail
is
the
date
of
release
(by
custom,
this
is
usually
the
last
day
of
the
month).
Note
that
many
implementations
are
in
the
habit
of
simple
using
the
date
of
release
in
the
form
YYYYMMDD
(e.g.
"20140531"),
and
assuming
that
the
distribution
is
known.
However
this
is
not
always
safe,
so
implementations
that
populate
the

where [sctid] is the concept id of the SNOMED CT distribution (e.g. 32506021000036107 for Australia), and the tail is the date of release (by custom, this is usually the last day of the month). Note that many implementations are in the habit of simple using the date of release in the form YYYYMMDD (e.g. "20140531"), and assuming that the distribution is known. However this is not always safe, so implementations that populate the version element SHOULD use the full URI form. element SHOULD use the full URI form.

1.25.1.1.3 1.30.1.1.3 Copyright/License Issues Copyright/License Issues The use of SNOMED CT codes, display names and value sets in this specification is subject to (basis to be confirmed) . This does not convey the right to use SNOMED CT to any users of this specification; implementers must acquire a license to use SNOMED CT in their own right (from their national SNOMED CT authority, or elsewhere). Note that the US distribution of SNOMED CT is currently used as the underlying system for the FHIR specification.

The use of SNOMED CT codes, display names and value sets in this specification is subject to (basis to be confirmed) . This does not convey the right to use SNOMED CT to any users of this specification; implementers must acquire a license to use SNOMED CT in their own right (from their national SNOMED CT authority, or elsewhere).

Note that the US distribution of SNOMED CT is currently used as the underlying system for the FHIR specification.

1.25.1.1.4 1.30.1.1.4 RDF SNOMED CT Filter Properties

The IHTSDO URI specifications uses the namespace http://snomed.info/sct for the code system, and the URI http://snomed.info/id for the individual concepts in the code system. This means that when a SNOMED CT concept is converted from the system::code pair, where the system is http://snomed.info/sct, to the RDF ontological form , the representation is http://snomed.info/id/[concept-id]. Expressions are represented the same way, except that for this use, expressions SHALL not contain whitespace, terms, or comments.

1.30.1.1.5 SNOMED CT Filter Properties This section documents the property filters that can be used with the SNOMED CT code system in value set composition statements. For implementer convenience, some of the property filters are documented in terms of the SNOMED CT Query Language

This section documents the property filters that can be used with the SNOMED CT code system in value set composition statements.

For implementer convenience, some of the property filters are documented in terms of the SNOMED CT Query Language , but this does not imply that its use is required. To Do: what's the correct link for this> , but this does not imply that its use is required. To Do: what's the correct link for this>

1.25.1.1.4.1 1.30.1.1.5.1 By Subsumption By Subsumption

Description Select a set of concepts based on subsumption testing Select a set of concepts based on subsumption testing
Property Name Property Name concept
Operations Allowed Operations Allowed is-a
Values Allowed Values Allowed [concept id] [concept id]
Comments Includes all concept ids that have a transitive is-a relationship with the concept Id provided as the value Includes all concept ids that have a transitive is-a relationship with the concept Id provided as the value
Example Administation Methods Administation Methods
SCT QL SCT QL 
DescendentsAndSelf([concept])

1.25.1.1.4.2 1.30.1.1.5.2 By Reference Set By Reference Set

Description Select a set of concepts based on their membership of a SNOMED CT reference set Select a set of concepts based on their membership of a SNOMED CT reference set
Property Name Property Name concept
Operations Allowed Operations Allowed in
Values Allowed Values Allowed [concept id] [concept id]
Comments Includes all concept ids that are active members of the reference set identified by the concept Id provided as the value Includes all concept ids that are active members of the reference set identified by the concept Id provided as the value
SCT QL SCT QL 
MembersOf([concept])

1.25.1.1.4.3 1.30.1.1.5.3 By Snomed Query Expression By Snomed Query Expression

Description Select a set of concepts based on a formal expression statement Select a set of concepts based on a formal expression statement
Property Name Property Name expression
Operations Allowed Operations Allowed =
Values Allowed Values Allowed [expression]
Comments The result of the filter is the result of executing the given SNOMED CT expression. note: the query statement is under current development The result of the filter is the result of executing the given SNOMED CT expression. note: the query statement is under current development

1.25.1.1.4.4 1.30.1.1.5.4 By whether post-coordination is allowed By whether post-coordination is allowed

Description Specify whether post-coordinations is allowed or not Specify whether post-coordinations is allowed or not
Property Name Property Name expressions
Operations Allowed Operations Allowed =
Values Allowed Values Allowed true or false true or false
Comments Expressions, if allowed, are subject to the same rules as pre-coordinated concepts. Note: reference sets do not include expressions. Expressions, if allowed, are subject to the same rules as pre-coordinated concepts. Note: reference sets do not include expressions.
Example Administation Methods Administation Methods
SCT QL SCT QL 
n/a

1.25.1.1.5 Implicit Value Sets 1.30.1.1.6 Implicit Value Sets Implicit value sets are those whose specification can be predicted based on the grammar of the underlying code system, and the known structure of the URL that identifies them. SNOMED CT has two sets of implicit value sets: By Subsumption, and By Reference Set. If any value set resources exist with an identifier that conforms to the URL patterns specified below, the content of the resource must conform to the template provided. Profiles and other value set references are allowed to reference these value sets directly (by reference as a URI, rather than by a value set reference, which is a literal reference). A SNOMED CT implicit value set URL has two parts: the base URL is either "http://snomed.info/sct", or the URI for the edition version, in the format specified by the IHTSDO the SNOMED CT URI Specification

Implicit value sets are those whose specification can be predicted based on the grammar of the underlying code system, and the known structure of the URL that identifies them. SNOMED CT has two sets of implicit value sets: By Subsumption, and By Reference Set.

If any value set resources exist with an identifier that conforms to the URL patterns specified below, the content of the resource must conform to the template provided. Profiles and other value set references are allowed to reference these value sets directly (by reference as a URI, rather than by a value set reference, which is a literal reference).

A SNOMED CT implicit value set URL has two parts:

  • the base URL is either "http://snomed.info/sct", or the URI for the edition version, in the format specified by the IHTSDO the SNOMED CT URI Specification a query portion that specifies the scope of the content "http://snomed.info/sct" should be understood to mean an unspecified edition/version. This defines an incomplete value set whose actual membership will depend on the particular edition used when it is expanded. For the second part of the URL (the query part), the 3 possible values are: ?fhir_vs - all Concept IDs in the edition/version. If the base URI is http://snomed.info/sct, this means all possible SNOMED CT concepts ?fhir_vs=isa/[sctid] - all concept IDs that are subsumed by the specified Concept. ?fhir_vs=refset/[sctid] - all concept IDs in the specified reference set A value set with an identifier that follows the pattern "[edition/version]?fhir_vs=isa/[sctid]" in the identifier follows this template:
  • a query portion that specifies the scope of the content

"http://snomed.info/sct" should be understood to mean an unspecified edition/version. This defines an incomplete value set whose actual membership will depend on the particular edition used when it is expanded.

For the second part of the URL (the query part), the 4 possible values are:

  • ?fhir_vs - all Concept IDs in the edition/version. If the base URI is http://snomed.info/sct, this means all possible SNOMED CT concepts
  • ?fhir_vs=isa/[sctid] - all concept IDs that are subsumed by the specified Concept.
  • ?fhir_vs=refset - all concept ids that correspond to real references sets defined in the specified SNOMED CT edition
  • ?fhir_vs=refset/[sctid] - all concept IDs in the specified reference set

A value set with a URL that follows the pattern "[edition/version]?fhir_vs=isa/[sctid]" follows this template: 

<ValueSet xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
     [Some HTML that describes this value set as all concepts subsumed by conceptid]
    </div>
  </text>
  <identifier value="[edition/version]?fhir_vs=isa/[sctid]"/>

  <url value="[edition/version]?fhir_vs=isa/[sctid]"/>

  <version value="[edition/version]"/>
  <name value="SNOMED CT Concept [conceptid] and descendents"/>
  <description value="All SNOMED CT concepts for [concept id or preferred description]"/>
  <copyright value="This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement"/>
  <status value="active"/>
  <compose>
    <include>
      <system value="http://snomed.info/sct"/>
      <filter>
        <property value="concept"/>
        <op value="is-a"/>
        <value value="[sctid]"/>
      </filter>
    </include>
  </compose>
</ValueSet>
A
value
set
with
an
identifier
that
follows
the
pattern
"[edition/version]?fhir_vs=refset/[sctid]"
in
the
identifier
follows
this
template:

The value set with a url that follows the pattern "[edition/version]?fhir_vs=refset" follows this template: 

<ValueSet xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
     [Some HTML that describes this value set as all concepts with associated reference sets]
    </div>
  </text>
  <url value="[edition/version]?fhir_vs=refset"/>
  <version value="[edition/version]"/>
  <name value="SNOMED CT Reference Sets"/>
  <description value="All SNOMED CT concepts associated with a reference set"/>
  <copyright value="This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement"/>
  <status value="active"/>
  <compose>
    <include>
      <system value="http://snomed.info/sct"/>
      <!-- repeat: one concept element with a code for each concept that has an associated reference set -->
      <concept>
        <code value="[concept]"/>
      </concept>
      <-- end repeat -->
    </include>
  </compose>
</ValueSet>

For each concept that is associated with a reference set, there will be one concept element with a contained code that contains the concept id.

A value set with a url that follows the pattern "[edition/version]?fhir_vs=refset/[sctid]" follows this template: 

<ValueSet xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
     [Some HTML that describes this value set as all concepts in the reference set identified by conceptid]
    </div>
  </text>
  <identifier value="[edition/version]?fhir_vs=refset/[sctid]"/>

  <url value="[edition/version]?fhir_vs=refset/[sctid]"/>

  <version value="[edition/version]"/>
  <name value="SNOMED CT Reference Set [conceptid]"/>
  <description value="All SNOMED CT concepts in the reference set [concept id or preferred description]"/>
  <copyright value="This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement"/>
  <status value="active"/>
  <compose>
    <include>
      <system value="http://snomed.info/sct"/>
      <filter>
        <property value="concept"/>
        <op value="in"/>
        <value value="[conceptid]"/>
      </filter>
    </include>
  </compose>
</ValueSet>
©
HL7.org
2011+.
FHIR
DSTU2
(v1.0.2-7202)
generated
on
Sat,
Oct
24,
2015
07:44+1100.
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