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Vocabulary Issues. <administrative_gender_cd C="M" D="Male" S="&HL7.USA.Gender" R="3.0"/>. <administrative_gender_cd C=“10173" D="Male" S="&HL7.USA" R="3.0"/>. HL7 Concept Codes ‘Mnemonic’ vs Numeric. -. ‘Mnemonic’ Codes. NOT a mandate to use mnemonics

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Vocabulary issues

Vocabulary Issues


Hl7 concept codes mnemonic vs numeric

<administrative_gender_cd

C="M"

D="Male"

S="&HL7.USA.Gender"

R="3.0"/>

<administrative_gender_cd

C=“10173"

D="Male"

S="&HL7.USA"

R="3.0"/>

HL7 Concept Codes‘Mnemonic’ vs Numeric


Mnemonic codes

-

‘Mnemonic’ Codes

  • NOT a mandate to use mnemonics

  • With relatively small code sets (~2-50 codes), it would be permissible to use an alpha-numeric concept codes that may provide ‘hints’ about the referenced concept


Mnemonic codes continued

‘Mnemonic’ Codes(Continued)

  • Once assigned, codes could not be changed:

    CodeDesignation

    MGMedium Granularity

    IGIntermediate Granularity


Numeric codes

Numeric Codes

  • Unique, meaningless identifier assigned from HL7 V3 namespace


Mnemonic codes1

Advantages

Compatible w/ HL7 V2

More intuitive and directly human readable

If folks intend to use them anyway, we might as well deal with them for what they are

Disadvantages

Issues resulting from confusion w/ designations

English-centric

Potentially misleading if incorrectly interpreted

Smaller namespace

‘M’ vs 10173

Mnemonic Codes


Numeric codes1

Advantages

Reduces possibility of misinterpretation

Reduces (but doesn’t eliminate) language / case / character set / multi code issues

Reduces potential for confusion (‘M’ – Male, Married, …)

Disadvantages

Requires outside resources to interpret

Requires central number assignment

Not directly compatible with existing HL7 V2 codes

Numeric Codes


We could have it both ways

We could have it both ways

  • Code System 2.16.840.1.113883.5.1

    ‘M’Male

    ‘F’Female

    ‘UN’Unknown

  • Code System 2.16.840.1.113883.5

    10173Male

    10174Female

    10175Unknown

  • Map

    2.16.840.1.113883.5.1 M : 2.16.840.1.113883.5 10173

    2.16.840.1.113883.5.1 F : 2.16.840.1.113883.5 10174


Questions

Questions

  • Should we allow the assignment of alpha-numeric concept codes in the HL7 V3 Code Systems?

  • If the answer to 1 is yes, should we support both schemes with a mapping or abandon the unique (within the HL7 V3 namespace) numbers completely?


Vocabulary issues1

Vocabulary Issues

Issue 2: Multiple Codes per Concept


Multiple codes per concept

<route_cd

C=“PO”

D=“Swallow, Oral"

S="RouteOfAdministration"

R="3.0"/>

<route_cd

C=“ORAL”

D=“Swallow, Oral"

S="RouteOfAdministration"

R="3.0"/>

Multiple Codes per Concept


Multiple codes per concept1

Multiple Codes per Concept

  • Depending on earlier decision, may or may not be an issue for HL7 internal codes

  • Still have to address external code sets

  • Question: Do we need to support multiple codes per concept?


Vocabulary issues2

Vocabulary Issues

Issue 3: Case Sensitive Codes


Case sensitive codes

<unit_code

C=“m”

D=“milli"

S=“UnitsOfMeasure"

R="3.0"/>

<route_cd

C=“M”

D=“Meter"

S=“UnitsOfMeasure"

R="3.0"/>

Case Sensitive Codes


Case sensitive codes1

Case Sensitive Codes

  • Issues

    • Many SQL databases (including Access) default to case insensitive

    • Possibility for confusion

    • Cannot control external code content


Case sensitive codes2

Case Sensitive Codes

  • Proposed policy

    • No two concept codes within the same code system may have the same value if case is ignored

      uL(microLiter)UL (Underline)

    • Codes must match the case in the code system

      <units c=“UL” ….


Vocabulary issues3

Vocabulary Issues

Issue 4: Code Character Set


Code character set

Code Character Set

  • Question: Do we support concept codes drawn from non 8859-1 character sets?


Vocabulary issues4

Vocabulary Issues

Issue 5: ISO Code Sets


Iso code sets

ISO Code Sets

  • HL7 supports 3 categories of code system:

    • Internal

    • External

    • Imported

  • Question: How do we deal with language codes, country codes, etc?


Iso code sets1

ISO Code Sets

  • Policy as it stands today

    • ISO: You can publish for free but vendors must purchase a license (~$100-200 per ???)

    • ANSI: You have to pay us $1000 just to publish the codes

  • ISO codes are widely used (but not widely paid for)


Iso code sets2

ISO Code Sets

  • Do we:

    • Purchase the code sets and request that the vendors / institutions purchase licenses?

    • Try to negotiate a package deal?

    • Build our own? If so, how should translation be handled?

    • Eliminate imported category for priced systems?

    • Continue to research options? (How does W3C do it? How about IETF? UN? Post Office?...)


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