CH Core (R4)
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This page is part of the CH Core (R4) (v5.0.0-ballot: STU 5 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Guidance

SNOMED CT Swiss Extension

Within the EPR, SNOMED CT is used for the metadata and in the exchange formats, see here.
SNOMED CT is designed so that the International Edition can be complemented by creating extensions to meet national or local requirements. Since December 2021, the Swiss Extension is available and includes translations in German, French and Italian.

The guidance for Switzerland is that the version element should only be added when using codes from the Swiss extension.
In the following sections, the usage in instances and value sets is illustrated exemplarily.

Usage in Instances

To illustrate how the SNOMED CT codes (international vs. Swiss extension) are used in instances, examples of the CH EMED exchange format are shown below.

SNOMED CT international: 721912009 “Medication summary document (record artifact)”

Composition.type of a Medication Prescription document (see full example):

"type" : {
  "coding" : [
    {
      "system" : "http://snomed.info/sct",
      "code" : "761938008",
      "display" : "Medicinal prescription record (record artifact)"
    }
  ]
}

SNOMED CT Swiss extension: 82291000195104 “Medication dispense document (record artifact)”

Composition.type of a Medication Dispense document (see full example):

"type" : {
  "coding" : [
    {
      "system" : "http://snomed.info/sct",
      "version" : "http://snomed.info/sct/2011000195101",
      "code" : "82291000195104",
      "display" : "Medication dispense document (record artifact)"
    }
  ]
}

Usage in Value Sets

To illustrate how the SNOMED CT codes (international vs. Swiss extension) are used in value sets, examples of the CH Term are shown below.

SNOMED CT international: 17621005 “Normal (qualifier value)”

ValueSet.compose.include of the DocumentEntry.confidentialityCode ValueSet (see full ValueSet):

"compose" : {
  "include" : [
    {
      "system" : "http://snomed.info/sct",
      "concept" : [
        {
          "code" : "17621005",
          "display" : "Normal (qualifier value)"
        }
      ]
    }
  ]
}

SNOMED CT Swiss extension: 1141000195107 “Secret (qualifier value)”

ValueSet.compose.include of the DocumentEntry.confidentialityCode ValueSet (see full ValueSet):

"compose" : {
  "include" : [
    {
      "system" : "http://snomed.info/sct",
      "version" : "http://snomed.info/sct/2011000195101",
      "concept" : [
        {
          "code" : "1141000195107",
          "display" : "Secret (qualifier value)",
        }
      ]
    }
  ]
}