RE: Minutes of last week's (Dec 2) HL7 ITS RDF Subgroup / W3C HCLS COI call -- Review of FHIR ontology approaches (cont.)

SNOMED can not and should not map to FHIR resources.  This is the 
difference between clinical models that capture who, when where and why 
with the medical terminologies like SNOMED that are only the what.
In HL7 V3, the information model has the entities in roles that 
participate in acts.  That is perfectly what should be in a clinical 
model. Then the "what" part of the clinical model may go only as far as 
say it is an "observation".
SNOMED does not, and should not ever deal with who when where or why.  It 
only deals with what.

The medical terminology such as SNOMED supplies the "value" of the 
Observation.  Which might be "diabetes".

There is no one to one between a FHIR observation and a SNOMED concept. 
They don't overlap. The FHIR, just like the HL7 V3 tells you who when 
where why but the what stops at "observation". The medical terminology 
which is linked to that observation resource then can be SNOMED diabetes. 
You would not make a FHIR resource for Diabetes. You use the FHIR 
observation and then code it with a SNOMED value.

The FHIR Observation does not get subclassed to Diabetes.  It is only ever 
Observaiton.  The specific "value" of the Observation is the medical 
terminology part supplied for example by SNOMED.

So I would never see it being appropriate to create any SNOMED terms to 
represent FHIR resources.

Thanks







NOTICE TO RECIPIENT:  If you are not the intended recipient of this 
e-mail, you are prohibited from sharing, copying, or otherwise using or 
disclosing its contents.  If you have received this e-mail in error, 
please notify the sender immediately by reply e-mail and permanently 
delete this e-mail and any attachments without reading, forwarding or 
saving them.  Thank you.






From:   "Vipul Kashyap" <kashyap.vipul@gmail.com>
To:     "'Grahame Grieve'" <grahame@healthintersections.com.au>, "'Lloyd 
McKenzie'" <lloyd@lmckenzie.com>
Cc:     "'David Booth'" <david@dbooth.org>, "'w3c semweb HCLS'" 
<public-semweb-lifesci@w3.org>, "'HL7 ITS'" <its@lists.hl7.org>
Date:   12/13/2014 10:41 AM
Subject:        RE: Minutes of last week's (Dec 2) HL7 ITS RDF Subgroup / 
W3C HCLS COI call -- Review of FHIR ontology approaches (cont.)



 
If every FHIR element was mapped to a snomed term, then you could 
represent that in RDF no problems.
 
VK> Would propose that FHIR could be the hub – and we could leverage 
RDF/OWL constructs to map FHIR elements to Snomed, MedDRA, ICD11, RxNorm, 
etc.?
 
However the problem with this is that we already have a slot for mapping 
an element to it's snomed code, but there are hardly any snomed codes that 
are appropriate. 
 
VK> Not sure if I understand this – If no Snomed codes are appropriate for 
a particular FHIR element – then we can request the IHTSDO folks to create 
a new one, no?
        Also, if the RDF/OWL metamodel gives us the language to express 
more general relationships – we may not want to use a specific slot for a 
Snomed code? Or we can perhaps
       Create an axiom linking the values of the snomed code based on the 
sameAs/subClassOf relationship for a particular terminology, e.g., Snomed?
 
Thanks,
 
---Vipul