FHIR-Based Terminology Translation

The CDA module uses FHIR ConceptMap resources to support vocabulary-to-vocabulary translations, e.g. values from HL7EntityNameUse in CDA to NameUse in FHIR. Users can customize these translations by uploading their own ConceptMaps (see below), in addition to some light module configuration.

User Overrides

Terminology overrides can be added by creating FHIR ConceptMap resources containing whichever overrides are necessary. So long as each element specifies the source CodeSystem URI, and the target CodeSystem URI, the translation should be properly applied.

Example: anonymizing a name. Suppose you want to apply the FHIR NameUse of ANONYMOUS whenever a name has the CDA HL7EntityNameUse value of L. You could do this with a ConceptMap like the one below.

{
  "resourceType" : "ConceptMap",
  "url" : "<some uri you choose>",
  "status" : "active",
  "group" : [{
    "source" : "2.16.840.1.113883.5.45",
    "target" : "http://hl7.org/fhir/name-use",
    "element" : [{
      "code" : "L",
      "target" : [{
        "code" : "anonymous",
        "display" : "Anonymous",
        "equivalence" : "relatedto"
      }]
    }]
  }]
}

Note that ConceptMap.url must not share our namespace (https://smilecdr.com/fhir/ns/ConceptMap/). Additionally, this is only a bare-minimum ConceptMap. One would probably want to include more of the optional fields on the resource.

To actually apply the translation, first set up a FHIR REST endpoint in front of whichever FHIR storage module is being used to satisfy the CDA module's validation support dependency. Next, POST your ConceptMap the same way you would any other resource. The new translation will be available within a minute or so.

Default Mappings: DSTU3

The default mappings for FHIR DSTU3 are summarised in the following tables.

CDA ActStatus and FHIR CareTeamStatus

CDA ActStatus and FHIR CompositionStatus

CDA ActStatus and FHIR DeviceStatus

CDA ActStatus and FHIR DiagRepStatus

CDA ActStatus and FHIR ImmunizationStatus

CDA ActStatus and FHIR MedicationStatus

CDA ActStatus and FHIR ObservationStatus

CDA ActStatus and FHIR ProcedureStatus

CDA ActStatus and FHIR SpecificUri

CDA AddressUse and FHIR AddressType