FHIR-46365 - Remove AbsentOrUnknownSNOMEDUvIps value set and update a…

…ffected value sets and related text. Consolidate and simplify the allergy/intolerance value sets and include the SNOMED CT ECL definition in the description text (similar work still to be completed for the other profiles).
HL7 · Jul 17, 2024 · a1ad23d · a1ad23d
1 parent 6a56a5f
commit a1ad23d
Show file tree

Hide file tree

Showing 11 changed files with 25 additions and 965 deletions.
diff --git a/input/fsh/profiles/AllergyIntoleranceUvIps.fsh b/input/fsh/profiles/AllergyIntoleranceUvIps.fsh
@@ -24,13 +24,6 @@ It documents the relevant allergies or intolerances (conditions) for a patient,
 * code ^binding.extension[0].extension[0].url = "purpose"
 * code ^binding.extension[=].extension[=].valueCode = #candidate
 * code ^binding.extension[=].extension[+].url = "valueSet"
-* code ^binding.extension[=].extension[=].valueCanonical = "http://hl7.org/fhir/uv/ips/ValueSet/allergy-intolerance-snomed-ct-ips-free-set"
-* code ^binding.extension[=].extension[+].url = "documentation"
-* code ^binding.extension[=].extension[=].valueMarkdown = "Type of the substance/product, allergy or intolerance condition."
-* code ^binding.extension[=].url = "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
-* code ^binding.extension[+].extension[0].url = "purpose"
-* code ^binding.extension[=].extension[=].valueCode = #candidate
-* code ^binding.extension[=].extension[+].url = "valueSet"
 * code ^binding.extension[=].extension[=].valueCanonical = "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
 * code ^binding.extension[=].extension[+].url = "documentation"
 * code ^binding.extension[=].extension[=].valueMarkdown = "Type of the substance/product, allergy or intolerance condition."

diff --git a/input/fsh/valuesets/AbsentOrUnknownSNOMEDUvIps.fsh b/input/fsh/valuesets/AbsentOrUnknownSNOMEDUvIps.fsh
diff --git a/input/fsh/valuesets/AllergyIntoleranceSnomedCtIpsFreeSet.fsh b/input/fsh/valuesets/AllergyIntoleranceSnomedCtIpsFreeSet.fsh
diff --git a/input/fsh/valuesets/AllergyIntoleranceSubstanceConditionUvIps.fsh b/input/fsh/valuesets/AllergyIntoleranceSubstanceConditionUvIps.fsh
diff --git a/input/fsh/valuesets/AllergyIntoleranceUvIps.fsh b/input/fsh/valuesets/AllergyIntoleranceUvIps.fsh
@@ -1,17 +1,25 @@
 ValueSet: AllergyIntoleranceUvIps
 Id: allergy-intolerance-uv-ips
 Title: "Allergy Intolerance - IPS"
-Description: "IPS Allergy intolerance codes value set. This value set includes codes from SNOMED Clinical Terms®: all descendants of 373873005 \\|Pharmaceutical / biologic product (product)\\|; all descendants of 105590001 \\|Substance (substance)\\|; all descendants of 418038007 \\|Propensity to adverse reactions to substance (finding)\\| plus codes for absent and unknown allergies."
+Description: """
+IPS Allergy intolerance codes value set. This value set includes codes from SNOMED CT®: all descendants of 373873005 \|Pharmaceutical / biologic product (product)\|; all descendants of 105590001 \|Substance (substance)\|; all descendants of 420134006 \|Propensity to adverse reaction (finding)\|; all descendants of 716186003 \|No known allergy (situation)\.
+
+SNOMED CT® ECL definition: < 373873005 \|Pharmaceutical / biologic product (product)\| OR < 105590001 \|Substance (substance)\| OR < 420134006 \|Propensity to adverse reaction (finding)\| OR 716186003 \|No known allergy (situation)\|
+"""
 * ^meta.profile = "http://hl7.org/fhir/StructureDefinition/shareablevalueset"
-* ^version = "1.1.0"
 * ^status = #active
 * ^experimental = false
-* ^date = "2024-06-19T10:50:07-05:00"
 * ^publisher = "HL7 International / Patient Care"
 * ^contact.telecom.system = #url
 * ^contact.telecom.value = "http://www.hl7.org/Special/committees/patientcare"
 * ^jurisdiction = $m49.htm#001
 * ^immutable = false
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
-* include codes from valueset AllergyIntoleranceSubstanceConditionUvIps
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept descendent-of #105590001 "Substance (substance)"
+* include codes from system http://snomed.info/sct
+    where concept descendent-of #373873005 "Pharmaceutical / biologic product (product)"
+* include codes from system http://snomed.info/sct
+    where concept descendent-of #420134006 "Propensity to adverse reaction (finding)"
+* include codes from system http://snomed.info/sct
+    where concept descendent-of #716186003 "No known allergy (situation)"
diff --git a/input/fsh/valuesets/MedicalDevicesSnomedAbsentUnknownUvIps.fsh b/input/fsh/valuesets/MedicalDevicesSnomedAbsentUnknownUvIps.fsh
@@ -13,4 +13,5 @@ Description: "This value set includes codes from SNOMED Clinical Terms (SNOMED C
 * ^immutable = false
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
 * include codes from valueset MedicalDevicesSnomedCtUvIps
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept is-a #787483001 "No known device use (situation)"
diff --git a/input/fsh/valuesets/MedicationSnomedCodesAbsentUnknown.fsh b/input/fsh/valuesets/MedicationSnomedCodesAbsentUnknown.fsh
@@ -13,4 +13,5 @@ Description: "This value set includes the codes from SNOMED CT that are included
 * ^immutable = false
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
 * include codes from valueset MedicationsSnomedCtUvIps
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept is-a #787481004 "No known medications (situation)"
diff --git a/input/fsh/valuesets/ProblemsSnomedAbsentUnknownUvIps.fsh b/input/fsh/valuesets/ProblemsSnomedAbsentUnknownUvIps.fsh
@@ -14,4 +14,5 @@ Description: "This value set includes codes from SNOMED Clinical Terms®:  desce
 * ^immutable = false
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
 * include codes from valueset ProblemsSnomedCtUvIps
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept is-a #160245001 "No current problems or disability (situation)"
diff --git a/input/fsh/valuesets/ProceduresSnomedAbsentUnknownUvIps.fsh b/input/fsh/valuesets/ProceduresSnomedAbsentUnknownUvIps.fsh
@@ -13,4 +13,5 @@ Description: "This value set includes codes from SNOMED Clinical Terms®: descen
 * ^immutable = false
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
 * include codes from valueset ProceduresSnomedCtUvIps
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept is-a #787480003 "No known procedures (situation)"
diff --git a/input/fsh/valuesets/VaccinesUvIps.fsh b/input/fsh/valuesets/VaccinesUvIps.fsh
@@ -18,4 +18,5 @@ Description: "This value set provides a list of types of vaccine, plus IPS codes
 * ^copyright = "The HL7 International IPS implementation guides incorporate SNOMED CT®, used by permission of the International Health Terminology Standards Development Organisation, trading as SNOMED International. SNOMED CT was originally created by the College of American Pathologists. SNOMED CT is a registered trademark of the International Health Terminology Standards Development Organisation, all rights reserved. Implementers of SNOMED CT should review [usage terms](http://www.snomed.org/snomed-ct/get-snomed-ct) or directly contact SNOMED International: info@snomed.org"
 * include codes from system http://snomed.info/sct
     where concept descendent-of #787859002
-* include codes from valueset AbsentOrUnknownSNOMEDUvIps
+* include codes from system http://snomed.info/sct
+    where concept is-a #787482006 "No known immunizations (situation)"
diff --git a/input/pagecontent/design.md b/input/pagecontent/design.md
@@ -35,9 +35,9 @@ Implementers conforming to an IPS document in the IPS Implementation Guide:
 
 There are currently 14 sections defined in the IPS. All sections have 0..* references in the [IPS Composition.section.entry](./StructureDefinition-Composition-uv-ips.html) element of the IPS, meaning that a section may be included without a reference to a structured resource. For required sections (allergies, problems and medications), Composition.section.emptyReason must be included in this circumstance. For non-required sections, document creators may alternatively choose to omit sections when no data is available. For all sections populated of an IPS document, Composition.section.text must still be populated to provide a human readable presentation of the information in the section. See [Narrative and Language Translation](#narrative-and-language-translation) for more on this design decision.
 
-Resources may also be used to assert the known absence of data rather than using the [IPS Composition.section.emptyReason](./StructureDefinition-Composition-uv-ips.html). To do so, it is recommended to use patterns established within FHIR generally to assert known absence. For example with an AllergyIntolerance, a [SNOMED code may be used to represent no known allergy](https://hl7.org/fhir/R4/allergyintolerance-nka.json.html). Prior versions of the IPS implementation guide had included a code system for no known data circumstances, although this terminology has been removed from the guide and is no longer recommended for use. A recommended value set for [absent or unknown concepts using SNOMED](./ValueSet-absent-or-unknown-snomed-uv-ips.html) is now included in the guide.
+Resources may also be used to assert the known absence of data rather than using the [IPS Composition.section.emptyReason](./StructureDefinition-Composition-uv-ips.html). To do so, it is recommended to use patterns established within FHIR generally to assert known absence. For example with an AllergyIntolerance, a [SNOMED CT code may be used to represent no known allergy](https://hl7.org/fhir/R4/allergyintolerance-nka.json.html). Prior versions of the IPS implementation guide had included a code system for no known data circumstances, although this terminology has been removed from the guide and is no longer recommended for use. The recommended SNOMED CT concepts for representing known absent data for specific profiles are included in the value sets that are bound for the "primary" element in the resource (typically the 'code' element).
 
-It is recommended that when a source system has no information about a particular IPS section, that the emptyReason element for that section be populated with the [code "unavailable"](https://hl7.org/fhir/R4/valueset-list-empty-reason.html). When a clinical statement is asserting the absence of information, however, it is recommended that a resource be included in the relevant section using a code from the [SNOMED absent or unknown value set](./ValueSet-absent-or-unknown-snomed-uv-ips.html) to represent the explicit context.
+It is recommended that when a source system has no information about a particular IPS section, that the emptyReason element for that section be populated with the code ['unavailable'](https://hl7.org/fhir/R4/valueset-list-empty-reason.html). However, if it is desired to use an explicit clinical statement to assert the absence of information, it is recommended that a resource be included in the relevant section using the SNOMED CT code ['1287211007'](https://browser.ihtsdotools.org/?perspective=full&conceptId1=1287211007) for "No information available".
 
 #### Optional MustSupport Data Elements (cardinality of 0..1 or 0..*)