Trends in Terminology Servers: Standardization and Implementation in the FHIR Ecosystem
Terminologieserver
Summary
Multiple international initiatives, including HL7 FHIR and ART-DECOR, highlight the necessity of unified terminology services for comprehensive clinical data, such as end-of-life care. These efforts aim to integrate major code systems like SNOMED CT and LOINC into the FHIR ecosystem to improve data interoperability.
Details
This document outlines various solutions for standardized terminology management and provision in electronic health records. Specifically, it details how Terminology is published to the HL7 FHIR Ecosystem and provides examples of using Value Sets (VS) and Concept Models (CM), such as those shown by ART-DECOR. Major code systems like SNOMED CT are accessible via dedicated Terminologieser through FHIR format, ensuring interoperability in both data structure and terminology definition. Furthermore, regional efforts from countries/organizations like ELGA (Austria) and MII-AG demonstrate that a unified terminology service based on FHIR is becoming an international standard. Technically, the FHIR Terminology Service offers advanced functions beyond mere code list provision, including management of data structures (VS, CS) and definitions (CM). Existing massive vocabulary systems like LOINC and UMLS are also recommended for FHIR access, ensuring conceptual consistency across different healthcare information systems. In the context of Japanese healthcare IT, a critical challenge is how to utilize international standards such as SNOMED CT and LOINC and integrate them comprehensively using FHIR as the common language. This document provides technical guidelines and concrete implementation examples for achieving this goal.
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