Nepal HMIS FHIR Implementation Guide – 🚨 DRAFT VERSION
0.0.1-ballot - ci-build

Nepal HMIS FHIR Implementation Guide – 🚨 DRAFT VERSION - Local Development build (v0.0.1-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Value Sets

For the elements whose value is from a set of (coded) options, a FHIR ValueSet should exist. SMART Guidelines can use Common ValueSets or define new ones. ValueSets are used in

- Logical Models
- Profiles

- Questionnaires

- The L3 should use same codes as defined for LM

### Inputs

- DAK
- SMART Common ValueSets
- Terminology services to lookup and validate the codes

### Outputs

- ValueSets
- Proposal for any common value sets

### Activities

This is the overview of the activities and related artifacts used:

- For each element in the DAK that has a value set - i.e. the answer depends on the options for the data element - for example sex, etc., the author shall have a value set. this can mean
- Reusing a value set
- Creating a new value set
  - only for the purpose of the current SMART Guideline
  - as a candidate for common value set
- Functionally, the valueset in the L3 level must support the L2 expressed values. However, the actual codes are typically a L3 decision, unless the L2 imposes some codes. The L2 doesn't need to impose a code system, but may do so, for example as a result of an existing SMART Guideline.

The ValueSet should include codes from one of the preferred code systems which are:

- ICD-11
- LOINC
- ICD-(others)
- Open and globally available code systems without licensing restrictions

- Jurisdictionally endorsed or required codes

- Note that FHIR has codes that may be required or extensible - in these cases the FHIR values should be preferred - however, concept maps SHALL be in place between these codes and the codes above.

- The creation of a value set may require the creation of a new code system

- The creation of a value set may, in some cases, require changes to the profiles: If a FHIR resource has a binding that is too strict and the L2 model requires a broader value set, normally a new element or extension must be created.
  - For example, adding a gender "changed" to the Administrative Gender Value Set - that is not supported and would require mapping the element and its value set to a new extension in FHIR.
  - Given the impact of this, any such deviations should be identified and discussed with the L2 author who can evaluate consistency, value, and the real need.
- ValueSet creation:
- Add "Shareable", “publishable” extensions
- ValueSet reutilization:
  - ValueSets may be reused if the application needs are consistent.
  - While reusing of ValueSets is recommended, authors should be aware that a reuse also introduces a dependency
- ValueSet validation: The ValueSet should be valid against the SMARTValueSet profile

#### CodeSystem creation

When defining a ValueSet, there may be a perceived need to create a CodeSystem:

### Review procedure

ValueSets shall be reviewed for criteria

### Output Criteria / Definition of Done

- All the elements in the L3 that have coded values shall have a corresponding valueset
- All the values in the valueset shall be valid codes:
  - Available in an available code set (for example no SNOMED unless SNOMED is supported)
  - Not deprecated

Terminology Services

- lookup
- mapping
- validate

### Terminology Value Sets

The following value sets have been defined for this Implementation Guide:

- Administrative Gender
- Age Range
- Condition/Problem/Diagnosis codes
- Condition / Diagnosis Severity
- District
- Educational Level
- Employment (रोजगारी स्थिति)
- Ethnic Code
- Free Cost
- Free Service Eligibility
- LocalBody
- Marital Status (वैवाहिक स्थिति)
- Dietary Supplements (SNOMED)
- Child Nutritional Status (SNOMED CT)
- Patient Registration Type
- Province
- Service Area Address Classification
- Service Type
- Vaccines (SNOMED CT)
- Patient Visit Ordinal
- Option Set - Yes / No / Yes-only / Don't know / Not applicable

For the complete list of terminology value sets, please refer to the Artifacts section.