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  1. FHIR Specification Feedback
  2. FHIR-33652

Only use SNOMED for qualitative lab result coding

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • SMART Health Cards: Vaccination and Testing (FHIR)
    • 0.6.2
    • Public Health
    • Qualitative lab result findings [deprecated]
    • 16.20.1
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      SNOMED GPS provides all of the codes needed to describe qualitative lab test results currently, and there is a path to adding new codes to SNOMED GPS if needed, which we can describe in the IG. We have a community-maintained ValueSet at https://terminology.smarthealth.cards/ValueSet-qualitative-lab-test-result-value-set.html that allows for rapid updates.

      We will update the IG to only allow SNOMED codes from this ValueSet to be used. This will simplify the requirements for Verifiers to support SMART Health Cards. We will limit to qualitative lab results in the current version of the IG, but could add a new profile later for other types of lab results if there is demand.

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      SNOMED GPS provides all of the codes needed to describe qualitative lab test results currently, and there is a path to adding new codes to SNOMED GPS if needed, which we can describe in the IG. We have a community-maintained ValueSet at https://terminology.smarthealth.cards/ValueSet-qualitative-lab-test-result-value-set.html that allows for rapid updates. We will update the IG to only allow SNOMED codes from this ValueSet to be used. This will simplify the requirements for Verifiers to support SMART Health Cards. We will limit to qualitative lab results in the current version of the IG, but could add a new profile later for other types of lab results if there is demand.
    • Max Mesnick/Craig Newman: 27-0-2
    • Enhancement
    • Non-compatible

    Description

      Qualitative lab results can be coded in either LOINC or SNOMED, with a virtually identical set of codes for either system. For ease of use, especially on the verifier side, we should pick one.

      The LOINC codes are free to use internationally. The SNOMED codes in the value set are released as part of GPS, so there should also be no licensing issues prohibiting the use of SNOMED internationally. It has been suggested that IIS in the US already use SNOMED for qualitative lab result reporting, therefore I'm suggesting we normalize on SNOMED. An alternative would be to favor LOINC.

      Some discussion here: https://chat.fhir.org/#narrow/stream/284830-smart.2Fhealth-cards/topic/Lab.20Results.20Value.20Set

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            pascal Pascal Pfiffner
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