Concept Dictionary

The Concept Dictionary is a place in the system where Code Systems, Concepts, and Concept Sets are defined and managed

When thinking of a Concept Dictionary, visualize a mapping of terms that the system will carry forth.

Example

A good example to think about is Administrative Gender for a Patient (i.e. AdministrativeGender).

Administrative Gender is the concept of gender as recorded in a patient's demographic or administrative record — not necessarily their clinical sex or gender identity

This field can be used for administrative purposes such as billing, registration, and insurance.

Considering the Use Case

Given this field can have many possible uses amongst systems in different configurations — one way to manage this is through the Concept Dictionary.

Since there are many external systems to communicate with, we need to break core concepts down into Code Systems, Concepts, and Concept Sets

Code Systems, Concepts, and Concept Sets

Code Systems, Concepts, and Concept Sets are terms which can be defined below

Code System

A Code System is a collection of reference terms defined by a standards body and is typically used on the SanteDB FHIR, HL7v2, or GS1 interfaces

The Code System is similar to a dictionary of terms for a particular stands body. Consider a Code System like a mapping of abbreviated terms that external systems understand.

This mapping allows data to be translated between what the User will see and the Data that the external system will use.

Great Use Case

When updating a code system, Organizations such as the WHO might ask for a list of the available codes being used.

When prompted, the codes from each Code System can easily be exported, and updated by or communicated to the Organization when needed.

Using the Example

Using Administrative Gender, we can define the different code systems for each system used

Different Mappings Between 2 Systems

For Administrative Gender, we will compare two different systems regarding AdministrativeGender — HL7v2 and FHIR

Therefore, a Code System would be defined — one for HL7v2 and one for FHIR

HL7v2 Mapping

FHIR Mapping

Some common uses of this field is:

  • M — Male

  • F — Female

  • O — Other

  • U — Unknown

  • A — Ambiguous

  • N — Not applicable (e.g. non-human, organization)

Some common uses of this field is:

  • male — Male

  • female — Female

  • other — Other

  • unknown — Unknown or Ambiguous

  • other — Unknown or Ambiguous

Concepts

Concepts are core concepts which are registered in the system. Concepts are used as a canonical form of structured terminology internally within SanteDB's CDR.

A Concept is similar to the actual mapping between something displayed within the system, and something mapped to a Code System.

Using the Example

When registering a patient and setting the gender to Male:

  • the database record carries the canonical concept of Male — to uuid: f4e3a6bb-612e-46b2-9f77-ff844d971198.

    • This UUID is consistent for all males between all installations of this system — permitting data portability.

This concept (e.g. the use of Male) would then be mapped to a wire-level reference term:

  • M if the patient is being expressed in HL7v2

  • male if the patient is being expressed via FHIR

This architecture isolates the CDR from changes in wire-formats.

Using the knowledge of the 2 systems (i.e. HL7v2 and Fhir), a mapping can be done similar to below

Name
HL7 Mnemonic
FHIR Mnemonic
Concept Mappings

Male

M

male

Male

Female

F

female

Female

Other

O

other

Gender-Other

Unknown

U

unknown

Gender-Unknown

So any time the system will see M or male:

  • the system can always map those values to be displayed as Male — and thus to any of the other Administrative Genders in the table.

Below is the example Male, Female, Other, and Unknown in the application as a Concept

AdministrativeGender — Male

Concept Sets

A Concept Set is a collection of concepts which are used for a particular purpose.

Purpose and Use Cases

Purpose and Best Practices

Concept Sets are meant to be used in the following situations:

  • 🗒️ As an explicit list of concepts which are members of the set

  • ✅ As a composition of other concepts sets via "include" or "exclude"

  • 📌 As a mix of direct inclusions and compositions

Use Cases

Concept sets are used for:

  • 🔍Data Validation — Whether a particular value belongs on a particular data field or relationship

  • 🔽Drop Downs — In the user interface to drive selections of concepts

  • 🏷️Grouping — grouping of related concepts for export/import

The example below shows the Concept Set for Administrative Genders

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