Terminology - general discussion

[niquola]

[niquola]

Health Samurai FTR protocol can be used for terminology distribution - https://docs.aidbox.app/terminology/fhir-terminology-repository/ftr-specification.

[johngrimes]

I don't think that people should generally be encouraged to import terminologies into their databases. This is very difficult to do well.

A better way is to integrate your ETL with the FHIR Terminology Services API to cleanse / augment the data.

[vadi2]

Cleanse / augment / and store separately?

[EvanMachusak]

95% of quality measurement is two things: presence of code in value set and date range checking. A primary concern for that use case is determining a resource's primary code's membership in 1 or more value sets. That needs to be as fast as possible.

I'm not sure how else you would accomplish that except to store valueset expansions in a table you could join on.

Another thing to keep in mind is that intensional value sets expressed as a collection of concepts from to be expanded by a terminology service is something we at NCQA wouldn't even allow by policy. We are doing national benchmarking of quality scores. If plan A uses a terminology server that expands our intensional value sets differently than plan B's terminology server, it's not an apples-to-apples comparison.

Therefore, by policy, we only allow our measures to be computed against a fixed set of fully expanded value sets, which we provide.

I think value set expansions need to be in the database, unless someone can think of a more clever way to do this.