If it does not, a new concept would be created (e.g. with mapping ICD/2014).
This means that old encounters that reference LOINC/2013 would still be linked to LOINC/2013.
In the end we’d have two concepts for malaria, this which might not be “efficient”, but it does remove any ambiguity about which code the original sender used
···
On 18 December 2013 17:51, Suranga Kasthurirathne surangakas@gmail.com wrote:
Hi Ryan,
My apologies, I’m with you when you write of CDA instead of hl7. Unfortunately, my coke supply has been cut off, and I was drowsy at the time of writing.
I need to ask a stupid question based on your comment that a concept can’t be edited.
So assuming that message A created a concept named “MALARIA” with LOINC/2013 as a mapping, and message B is also for “MALARIA” but tagged with ICD-10/2014, will the previous concept on the SHR be edited to include the new mapping, or will it result in a totally new concept being created ?
–
Hannes Venter
Software Developer, Jembi Health Systems | SOUTH AFRICA
Mobile: +27 73 276 2848 | Office: +27 21 701 0939 | Skype: venter.johannes
E-mail: hannes@jembi.org
On Wed, Dec 18, 2013 at 4:39 AM, Ryan Crichton ryan@jembi.org wrote:
Hey Suranga,
Don’t always assume that the message that the SHR will receive will be HL7 messages. We are looking to use CDA messages for the newer version of the SHR.
To your questions, the messages will not likely contain the mappings to concepts but rather we could create concepts based on the code and code system specified in the message. The message will be validated and normalized in the IL using the TS to check if the codes are valid and this could also be able to convert codes to a code systems that the SHR supports. There won’t likely need to be updates to the concepts as we will be using standardised code systems such as LOINC or ICD-10. I don’t think codes can be changed or removed from these so we should be safe with the SHR. If they do change we would have to run a script to clean these up. What do you think about this?
Cheers,
Ryan
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Best Regards,
Suranga
On Wed, Dec 18, 2013 at 1:52 AM, Suranga Kasthurirathne surangakas@gmail.com wrote:
Hi Ryan,
I’m quite in favor of your proposal, but if we create concepts on the fly, how will we manage updates/edits to existing concepts ? I’m assuming that for this process, the hl7 message sent to the SHR will contain concepts with all concept mappings included, and that the SHR will go through each of these and validate them, creating/editing ones that are missing/incorrect.
Does this match what you had in mind ? perhaps we can discuss a path forward on how to continue with this ?
–
Ryan Crichton
Software Developer, Jembi Health Systems | SOUTH AFRICA
Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org
On Tue, Dec 17, 2013 at 3:06 AM, Ryan Crichton ryan@jembi.org wrote:
Hi all,
I just wanted to add that previously we have discussed that perhaps we don’t need to have a pre-specified concept dictionary for the SHR. We could create the concepts that we need on the fly depending on what needs to be stored (This will be previously validated by the IL so we won’t just store anything). In this way we don’t have to manage a specific concept dictionary for the SHR. I’m not sure if this is the approach we want to take but it is another option.
Cheers,
Ryan
Suranga
–
Best Regards,
On Tue, Dec 17, 2013 at 9:59 AM, Hannes Venter hannes@jembi.org wrote:
Yes you’re correct Suranga, we don’t currently store mappings for local clinic code sets to standard terminologies.
but this is an important use case and I think we should definitely take it into account.
We currently don’t have any web services available for retrieving code sets (we only do validation atm)
but it might be a good idea for us to start looking at CTS2 for doing these transactions.
There were email threads in the architecture list regarding this, and it’s sounding like we’re reaching consensus on using CTS2.
I also just wanted to mention that there is work going on within the TS community in defining these types of use cases.
See the documentation here https://wiki.ohie.org/display/SUB/Integration+of+TS+Use+Case+Examples and feel free to take part in the community 
Cheers
Hannes
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Ryan Crichton
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On 17 December 2013 07:05, Suranga Kasthurirathne surangakas@gmail.com wrote:
Hmm… I’m sorry Mark, but you kind of lost me when you started talking about Hospital X’s code etc.
Basically, what you mean to say is that the SHR should be able to download all the latest LOINC/ICD10 etc. mappings which were updated as of the last date that a SYNC occurred ?
I don’t think that the Terminology Service currently uses mapping tables for users who don’t send standard codes. Perhaps the second part of your response is a bit too ahead of our times just yet ?
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Hannes Venter
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Mobile: +27 73 276 2848 | Office: +27 21 701 0939 | Skype: venter.johannes
E-mail: hannes@jembi.org
On Mon, Dec 16, 2013 at 10:59 PM, Tucker, Mark mtucker2@regenstrief.org wrote:
With code sets, you would ask: Download the current copy of code set ICD-10 (including the code + meta-data about the code)
With code mappings, you would say:
Download the mapping from Hospital X’s code set XYLAB to Loinc.
Such a mapping would define things like X12^^XYLAB maps to 1234-5^^LOINC.
These mapping tables exist for senders that do not send standard codes. Such mappings are usually created by and stored in terminology servers.
From: Suranga Kasthurirathne [mailto:surangakas@gmail.com]
Sent: Monday, December 16, 2013 6:11 PM
To: Tucker, Mark
Cc: openhie-shr
Subject: Re: Syncing of the SHR + POC against the Terminology Registry
Hi,
@Mark, when you say code-set xyz, are you referring to something like ICD-10 or LOINC, or something specific like LOINC term 0001 ?
If its the second one, i’m afraid that I don’t understand the context in which we can have a dump for code-set XYZ.
Hmm… I’m happy to work with the 'look for updates daily / weekly, as opposed to whenever an unknown code is encountered.
However, i’m wondering what the HIM guys think of the two different options. Are you happy querying and retrieving a single code at a time (whenever an unknown one is encountered), or do you want to go with what Mark suggested ? is the
TR capable of keeping track of when a code-set was last updated ?
On Mon, Dec 16, 2013 at 5:21 PM, Tucker, Mark mtucker2@regenstrief.org wrote:
I like to break this problem into stages.
[1] Allow the SHR to ask TR (What is the last update time on code set XYZ?)
[2] TR, please give me a dump of codeset XYZ.
Then, the SHR could ask for codesetup updates whenever it wants.
At Regenstrief, our “policy” is to look for updates once a day, and not whenever an unknown code
is encountered.
We have nightly jobs that sync the SHR codes with TR codes, and restart jobs that have cached other
tables.
From:
openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com]
On Behalf Of Suranga Kasthurirathne
Sent: Monday, December 16, 2013 10:49 AM
To: openhie-shr
Subject: Syncing of the SHR + POC against the Terminology Registry
Hi,
I want to discuss the possibility of writing a module which allows you to sync the concepts/mappings on the SHR and the POC against those in the Terminology service.
I’m thinking of a module which kicks into action when you receive a POST encounter request with a mapping which doesn’t tally with the concept mappings you already have in the SHR.
I’m quite sure that this feature will be very beneficial, the alternative being that any new change to the TR has to be manually replicated across multiple POC’s and the SHR.
@Ryan, Hannes, does the TR have a url which allows us to check whether a given term/mapping exists, and return the full content / mappings for that term to us as a restful response?
I’m pretty sure that there used to be something like this, but unfortunately I cant seem to find the url 
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Best Regards,
Suranga
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Best Regards,
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Best Regards,
Suranga