FHIR based terminology server at NewYork-Presbyterian Hospital, NY, NY

NewYork-Presbyterian Hospital has a robust terminology service that maintains clinical concepts in a large semantic data network.  Active since the 1980s, the terminology repository originated at Columbia as the Medical Entities Dictionary (“the MED”), and is one of the first distinct terminology systems to be integrated with an EHR.  Historically, terminology from the MED is served via C programs that provide direct shared memory access or via a web browser.  In this proof-of-concept project, we provide FHIR capabilities to the MED to allow FHIR based queries for code translations.

The FHIR MED proof of concepts provides several FHIR enabled URLs. This is proprietary information so we cannot provide direct links to the actual data. The examples below are taken from our FHIR enabled server.

FHIR ValueSet and Code

Using the FHIR VauteSet API and passing a Med Code will return the matching Med Code.

http:/<internal-uri>/qrymed/fhir/ValueSet/147

This result is being rendered in HTML for easy viewing. You may access this content as Raw JSON or Raw XML, or view this content in HTML JSON or HTML XML. Response generated in 92ms.

<ValueSet xmlns="http://hl7.org/fhir">
 <id value="147"/>
 <url value="/fhir/ValueSet/147"/>
 <name value="SPECIAL CHEMISTRY WHOLE BLOOD SPECIMEN"/>
 <status value="active"/>
 <publisher value="New York Presbytarian"/>
 <description value="SPECIAL CHEMISTRY WHOLE BLOOD SPECIMEN"/>
</ValueSet>
 

FHIR ValueSet and Description

Using the FHIR VauteSet and the description parameter with the value ‘blood’ will return all Med Codes that find the value “blood” in any of the slots.

http://<internal-uri>/qrymed/fhir/ValueSet?description=blood

<Bundle xmlns="http://hl7.org/fhir">

<id value="92b818ea-1f56-4b37-8b5e-121eede038f2"/>

<meta>

<lastUpdated value="2017-09-28T13:38:02.016-04:00"/>

</meta>

<type value="searchset"/>

<total value="2631"/>

<link>

<relation value="self"/>

<url value="http://pasteur.nyp.org:8080/qrymed/fhir/ValueSet?description=blood"/>

</link>

<entry>

<fullUrl value="http://pasteur.nyp.org:8080/qrymed/fhir/ValueSet/147"/>

<resource>

<ValueSet xmlns="http://hl7.org/fhir">

<id value="147"/>

<url value="/fhir/ValueSet/147"/>

<name value=" SPECIAL CHEMISTRY WHOLE BLOOD SPECIMEN"/>

<status value="active"/>

<publisher value="New York Presbytarian"/>

<description value="147 - SPECIAL CHEMISTRY WHOLE BLOOD SPECIMEN"/>

</ValueSet>

</resource>

</entry>

<entry>

<fullUrl value="http://pasteur.nyp.org:8080/qrymed/fhir/ValueSet/154"/>

<resource>

<ValueSet xmlns="http://hl7.org/fhir">

<id value="154"/>

<url value="/fhir/ValueSet/154"/>

<name value=" CLINICAL PATHOLOGY WHOLE BLOOD SPECIMEN"/>

<status value="active"/>

<publisher value="New York Presbytarian"/>

<description value="154 - CLINICAL PATHOLOGY WHOLE BLOOD SPECIMEN"/>

</ValueSet>

</resource>

</entry>

<…snip..>

</Bundle>

FHIR $Translate

Returns either the LOINC code or the SNOWMED code if the MED code being passed has an associated LOINC or SNOMED slot populated.

http://<internal-uri>/qrymed/fhir/ConceptMap/99975/$translate

<Parameters xmlns="http://hl7.org/fhir">
 <text>
 <div xmlns="http://www.w3.org/1999/xhtml">The Med Code translated to SNOMED or LOINC</div>
 </text>
 <parameter>
 <name value="LOINC - 62318-1"/>
 </parameter>
</Parameters>
 
 

Return the SNOMED code or the ICD10 code if an ICD10 Code is passed

http://<internal-uri>/qrymed/fhir/ConceptMap/B18.2/$translate

<Parameters xmlns="http://hl7.org/fhir">
 <text>
 <div xmlns="http://www.w3.org/1999/xhtml">The Med Code translated to SNOMED or LOINC</div>
 </text>
 <parameter>
 <name value="SNOMED - 128302006"/>
 </parameter>
</Parameters>