In the context of this SNOMED implementation guide, we have chosen to use the FHIR context model as an example of an information model for several reasons. FHIR is a widely adopted standard in the healthcare industry for exchanging electronic health records and related data. Its modular and extensible design makes it an ideal candidate to demonstrate how context information can be represented outside terminologies like SNOMED CT.
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The following table maps SNOMED CT “Situations with Explicit Context” subhierarchies to relevant FHIR resources, showing how clinical context is represented across terminology and information models.
Where FHIR Resource is listed as N/A, there may be no direct mapping in the base FHIR specification.
Context properties such as subject and temporal frame help clarify how the SNOMED concept aligns with FHIR resource attributes like subject, status, or effective[x].
The table below maps specific types of Situations with Explicit contexts to specific FHIR resources and states the associated context properties
As seen in the previous table, depending on the type of context represented in the SWEC concept, it can be transformed into a Condition or Observation resource. Here, we provide some examples of values for different key elements.
417662000 |History of clinical finding in subject (situation)|
Condition
Clinical finding
Known present
Subject of record
In the past
416471007 |Family history of clinical finding (situation)|
FamilyMemberHistory
Clinical finding
Known present
Condition.clinicalStatus
inactive
Temporal context
In the past
Condition.clinicalStatus
active
Temporal context
Current
Observation.code
Clinical finding
Associated finding
<< Clinical finding
Procedure.code
Procedure
Associated procedure
<< Procedure
Person in the family
Current or past
160266009 |No family history of clinical finding (situation)|
(None / N/A)
Clinical finding
Known absent
Person in the family
All times of past
1260502004 |History of event in life of subject (situation)|
Condition
Event
Known present
Subject of record
In the past
373572006 |Clinical finding absent (situation)|
Observation
Clinical finding
Known absent
Subject of record
Current or specified time
History Events with finding context
Observation
Event
Known absent
Subject of record
Current or specified time
373573001 |Clinical finding present (situation)|
Condition
Clinical finding
Known present
Subject of record
Current
443859009 |Possible clinical finding (situation)|
Condition
Clinical finding
Known possible
Subject of record
Current or specified time
443938003 |Procedure carried out on subject (situation)|
Procedure
Procedure
Done
Subject of record
Current or specified time
416237000 |Procedure not done (situation)|
Procedure
Procedure
Not done
Subject of record
Current or specified time
439763000 |Procedure on family member (situation)|
Procedure
Procedure
—
Person in the family
Current or specified time
Condition.code
Clinical finding
Associated finding
<< Clinical finding
Condition.code
Clinical finding
Associated finding
<< Clinical finding
Observation.value
Known absent
Finding context
Known absent
Procedure.status
Completed
Procedure context
Done
Procedure.category
Surgical
(Ancestor)
Surgical procedure
Procedure.reasonCode
Disease
Has focus
<< Clinical finding
Procedure.bodySite
Body site
Procedure site - direct
<< Anatomical structure