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

From: Vipul Kashyap <kashyap.vipul@gmail.com>
Date: Sat, 20 Dec 2014 17:06:49 -0500
To: <Peter.Hendler@kp.org>
Cc: <david@dbooth.org>, <grahame@healthintersections.com.au>, <its@lists.hl7.org>, <lloyd@lmckenzie.com>, <public-semweb-lifesci@w3.org>, "'Vipul Kashyap'" <kashyap.vipul@gmail.com>
Message-ID: <02d401d01ca1$4170faa0$c452efe0$@gmail.com>
Hi Peter,


Thanks for your email below – If I may summarize:


Clinical Models capture the “who, when, where, why”

Snomed/Medical Terminogies – capture the “what”


Agree with your suggestion that Snomed should not be used for the former – 

The underlying motivation for my suggestion – as has been suggested by other medical informatics researchers is to 

“combine” both information models and terminologies is a common “model/ontology” and leverage the semantic expressiveness of OWL

for the purpose.


I think that primary reason divergence appears to be whether Snomed is viewed as a set of codes which can be used as “tags” or “values”

or Snomed is a full fledged ontology with classes, properties, relationships and instances of those classes. Based on the perspective taken,

Of course there are pros and cons of these approaches and can lead us to different choices of how we model clinical information and knowledge.






From: Peter.Hendler@kp.org [mailto:Peter.Hendler@kp.org] 
Sent: Saturday, December 13, 2014 5:31 PM
To: kashyap.vipul@gmail.com
Cc: david@dbooth.org; grahame@healthintersections.com.au; its@lists.hl7.org; lloyd@lmckenzie.com; public-semweb-lifesci@w3.org
Subject: 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. 


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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? 

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Received on Saturday, 20 December 2014 22:07:21 UTC

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