# IHTSDO meeting - term binding presentation available **Category:** [Clinical (archive)](https://discourse.openehr.org/c/clinical-archive/153) **Created:** 2010-05-03 21:58 UTC **Views:** 1 **Replies:** 16 **URL:** https://discourse.openehr.org/t/ihtsdo-meeting-term-binding-presentation-available/14985 --- ## Post #1 by @thomas.beale I attended the IHTSDO meeting just finished in Copenhagen. Things look pretty good for where SNOMED CT is going generally - the RF2 technical infrastructure seems relatively well designed. There is a lot of activity in content modeling, the IHTSDO workbench and many other areas relevant to openEHR. Converely, I believe openEHR will be very important to make SNOMED CT work in many places, since it will be via archetypes, templates and associated ref sets that information systems will be able to connect to terminology in a disciplined way. I believe that ref sets are the future of SNOMED CT (and any terminology for that matter) in use in real systems. I was asked to present a view from openEHR about 'terminology binding', i.e. connecting terminology and information models. My presentation is on this page [http://www.openehr.org/wiki/display/term/Terminology+Binding](http://www.openehr.org/wiki/display/term/Terminology+Binding) or see the following direct links: - PDF - [http://www.openehr.org/wiki/download/attachments/5997267/openEHR_term_binding_IHTSDO_april_2010.pdf](http://www.openehr.org/wiki/download/attachments/5997267/openEHR_term_binding_IHTSDO_april_2010.pdf) - PPTX - [http://www.openehr.org/wiki/download/attachments/5997267/openEHR_term_binding_IHTSDO_april_2010.pptx](http://www.openehr.org/wiki/download/attachments/5997267/openEHR_term_binding_IHTSDO_april_2010.pptx) I hope this is useful. I will continue to document IHTSDO-related thoughts on the openEHR wiki, and I encourage others to do the same. - thomas beale --- ## Post #2 by @tonyshannon Thanks for this Tom, Good to see this exploration looking at healthy blend of archetypes & terminology together\. I agree ref set approach seems best\.\.interested if anyone has another view\.\. Regards, Tony Thomas Beale wrote: --- ## Post #3 by @system Hi Thomas, do you know if there is a formal way of how RefSets (=the resulting Snomed CT codes etc.) and the RefSet query (=the query on Snomed CT to get to the RefSet) are expressed and shared? Similar to what is described here but based on RefSets: [http://www.openehr.org/wiki/display/term/Ocean+Terminology+Query+Language+%28TQL%29](http://www.openehr.org/wiki/display/term/Ocean+Terminology+Query+Language+%28TQL%29) I agree that RefSets are a good way forward, but they need to be available, reusable and sharable, etc. Sebastian Thomas Beale wrote: --- ## Post #4 by @thomas.beale > Hi Thomas, > > do you know if there is a formal way of how RefSets (=the resulting Snomed CT codes etc.) and the RefSet query (=the query on Snomed CT to get to the RefSet) are expressed and shared? the ref set results are defined by Snomed RF2 ref set specs, now in draft. I don't know whether they are allowed to be shared outside IHTSDO, but will find out. The query language is still an open question. > Similar to what is described here but based on RefSets: [http://www.openehr.org/wiki/display/term/Ocean+Terminology+Query+Language+%28TQL%29](http://www.openehr.org/wiki/display/term/Ocean+Terminology+Query+Language+%28TQL%29) > > I agree that RefSets are a good way forward, but they need to be available, reusable and sharable, etc. they do. The current IHTSDO thinking is that ref sets will mainly be defined by national release centres and maintained in the national extensions, with some major refsets being in the international release. I think this is far too restrictive a view, and that in future they will be defined and maintained in health care facilities, regional information centres and anywhere else that needs them. The IHTSDO representation and extension mechanism should be usable at all these levels. How it could be used for openEHR I have yet to find out, but am making enquiries as a member of the IHTSDO Technical Committee). - thomas --- ## Post #5 by @Eric_Browne Hi Sebastian, If I can give my own perspective on this, having been peripherally involved for some time\.\. 1\. Unfortunately, the IHTSDO \(www\.ihtsdo\.org\), who is responsible for the ongoing management and development of SNOMED CT, is still a somewhat closed and traditional standards development organisation\. It has no publicly accessible wiki of resources à la openEHR\. It does, however, have a substantial community of individuals from member countries and affiliate organisations and several collaborative websites and mailing lists where ideas, contributions, new specifications etc\. are documented and evolve\. I would guess that the majority of participants are either active in other standards development organisations, or staff/affiliates of member nation health informatics programs such as the UK's NHS Connecting for Health Program, Canada's Infoway, Australia's National E\-Health Transition Authority, etc\. 2\. For many years prior to IHTSDO taking over SNOMED CT from the College of American Pathologists, SNOMED CT embraced a mechanism and format for producing "subsets" of SNOMED CT\. About 18 months ago, proposals for a new SNOMED release format and a new Reference Set format \(to replace the old subset mechanism\) emerged and evolved\. These two proposals morphed into a single umbrella specification called Release Format 2, which has now reached Draft for Trial Use status within the IHTSDO\. One of the specification documents covers Reference Set formats and is available in part 2 of RF2 at: http://www.ihtsdo.org/publications/draft-for-review-and-trial-use/ \. This draft specification includes support for "language refsets", which may be of particular interest to you\. Access to the collaborative space where these documents are made available is described at: http://www.ihtsdo.org/about-ihtsdo/collaborative-space/ \. 3\. To my knowledge there is no formal IHTSDO proposal for a query language to express Refset membership specifications\. However, the IHTSDO Terminology Workbench does incorporate quite a sophisticated mechanism for building refsets using an underlying \( and evolving\) query\-based expression language\. Note: these refsets do not necessarily need to be specific to SNOMED\. The refset specifications, however, are currently designed to construct static files for distribution alongside the SNOMED core and national extension files, rather than for producing dynamically evaluated termsets for local needs, as might be supported for openEHR templates, say\. eric --- ## Post #6 by @michael.lawley I would add to Eric's point 3 that \(based on the content of an IHTSDO webinar\) the workflow/process implemented in the IHTSDO workbench involves an explicit manual approval step for every item in the generated "static" refset\. I don't know how/if there is any special support for dealing with re\-generating the refset based on a new SNOMED release or a modified set of specification queries\. m --- ## Post #7 by @ian.mcnicoll Thanks Michael, Can I ask if the workflow/process elements of the Workbench are regarded as separate from the Refset 2 specifications, or within other offical IHTSDO specs? Or is this just intended as a local feature of the workbench? Although the Refset2 sepcifications define a greate deal of 'metadata', as far as I can tell , other than Refset name, this is almost wholly technical in nature and clinical metadata elements e.g use, misuse, purpose, authoring details are not defined - is this correct? Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll [ian.mcnicoll@oceaninformatics.com](mailto:ian.mcnicoll@oceaninformatics.com) [ian@mcmi.co.uk](mailto:ian@mcmi.co.uk) Clinical Analyst Ocean Informatics openEHR Archetype Editorial Group Member BCS Primary Health Care SG Group [www.phcsg.org](http://www.phcsg.org) / BCS Health Scotland --- ## Post #8 by @mikael Hi Thomas, As another member of IHTSDO Technical Committee I would like to ask from where you have got your impression that RefSets should mainly be maintained by the national release centers, because that is not at all my impression. Some of the national release centers, like NHS in UK, maintain Subsets/RefSets, but I have never heard anything about that only the national release centers should create and maintain RefSets. My impression is that whoever that find it useful to create and maintain an own RefSet should be able to do it. The only requirement to create a RefSet is the technical requirement to have an own namespace to create the RefSet into. However, all organizations and persons with a valid SNOMED CT license can get an own namespace. (I have my own namespace, so if I would I could immediately produce and release as many RefSets that I want.) Greetings, Mikael --- ## Post #9 by @SEABURY_Tom_NHS_DIGI Hi Mikael, Thomas There are certainly instances of sets being generated by authorities other than national release centres, ones that conform to the SNOMED CT guidance, which requires their identifiers include a recognised namespace. Two aspects of this topic are 1) that you need access to tools which allocate unique identifiers, in accord with the standard and 2) that the allocation of namespace identifiers cannot be assumed to be a free-for-all although at last count there were in the region of 110, some of which were allocated to individuals. To use a Namespace you are obliged to conform to the SNOMED CT licence conditions and similar good behaviour. Those with an interest in this topic may wish to join, for example, the SNOMED CT Implementation Special Interest Group via this link:- http://www.ihtsdo.org/join-us/help-improve-snomed-ct/ To join an established Special Interest Group mail to: info(at)ihtsdo.org stating which group you wish to join, ‘Special Interest Groups (SIGs) are open and ongoing bodies that examine issues related to specified topics that are relevant to the IHTSDO and its members.’ Tom Seabury IHTSDO --- ## Post #10 by @system Thanks all, This is really helpful. I followed Eric's link to set up an account to get access to the Specs draft and got an account within hours with access to the Specs draft. I hope the query language will be standardised and published as well at some stage - would be very useful to have a formal expression of what the intention is of an RefSet. Ian, I just went through the document quickly, so far I couldn't see any use, misuse, etc. metadata. Sebastian Ian McNicoll wrote: [details="(attachments)"] ![oceanlogo.png|84x82](upload://2EtFgZ1bS4JNl1d51FusTB7hg8M.png) [/details] --- ## Post #11 by @thomas.beale I have to say that it is my impression nearly all activity IHTSDO talks about seems to be centred on either the international release aka 'the core' or the national release centres. I have not heard a single presentation or discussion talking about any details of lower-than-national level extensions, although there are examples in the meta-data map (from Nehta). But I was not trying to imply that this was policy in any way, only that I suspect that the thinking has not yet engaged with local and other kinds of extensions. I am certainly very happy if I am wrong, and everyone (but me) already knows how this should work... - thomas --- ## Post #12 by @michael.lawley Yes, the workflow stuff is just a tool feature\. The RF2 spec is merely a file format and the spec has nothing to say about how such files may/should be generated\. Regarding the clinical metadata elements you mention, these are not defined as part of RF2, but it should be possible to represent them using RF2 as it was designed to be an extensible format\. michael --- ## Post #13 by @thomas.beale I have updated the visualisations of the RF2 ref set and other rmeta-data at [http://www.openehr.org/wiki/display/term/SNOMED+CT+RF2](http://www.openehr.org/wiki/display/term/SNOMED+CT+RF2) which may help people get their heads around it. --- ## Post #14 by @mikael Hi, I can add that the workflows are possible to customize, so it is up to each user \(or the organization the user works for\) to create and/or select the workflows to use\.   Greetings,   Mikael --- ## Post #15 by @mikael Hi Tom, I agree that I need a tool to create RefSets, but it is still simple tools that are needed. I also agree that the namespaces are not for everyone, but the Namespace Allocation Policy document is very liberal about who that should be able to acquire a namespace. I therefore don’t think that lack of a namespace is a practical problem for RefSet creation. Greetings, Mikael --- ## Post #16 by @mikael Hi All, As written below most of IHTSDO:s activities are currently performed inside IHTSDO:s "Collaborative space" \(also known as "Basecamp"\)\. This Collaborative space is a legacy system from before IHTSDO acquired SNOMED CT and probably not the best system due to the current needs, but the system is still there because of lack of time to change system\. However, there are now ongoing discussions and there seems to be a new project initiated to supplement or replace the current Collaborative space to make it easier for people outside IHTSDO:s groups to get information and share resources\. More information about how to get access to the Collaborative space is, as written below, available at http://www.ihtsdo.org/about-ihtsdo/collaborative-space/. The currently existing Special Interest Groups at the Collaborative space are: Anesthesia Special Interest Group Concept Model Special Interest Group Education Special Interest Group Implementation SIG International Pathology & Laboratory Medicine SIG Machine & Human Readable Concept Model Project Mapping SNOMED CT to ICD\-10 Project Nursing Special Interest Group Pharmacy Special Interest Group Primary Care Special Interest Group Translation Special Interest Group And the currently existing project groups are: Anatomy Model Project Collaborative Editing Project Group Enhanced Release Format, Interchange Format & RefSet PG Event, Condition and Episode Model Project Workbench RefSet Module Project Observable and Investigation Model Project Organism & Infectious Disease Model Project Pre\-coordination Roadmap Project Request Submission Project Substance Hierarchy Redesign Project Translation Standard Processes Project There are also a affiliate forum\.   Greetings,   Mikael --- ## Post #17 by @mikael Hi Thomas, I agree that that the main talks on the IHTSDO meetings are centered on the international release and the releases from the national release centers. However, I am quite sure that the reason is that there are still mainly representatives from IHTSDO and the national release centers on the IHTSDO meetings. It sadly still seems to be difficult to get vendors and other interested people from outside UK and US to the IHTSDO meetings. Greetings, Mikael --- **Canonical:** https://discourse.openehr.org/t/ihtsdo-meeting-term-binding-presentation-available/14985 **Original content:** https://discourse.openehr.org/t/ihtsdo-meeting-term-binding-presentation-available/14985