Review the Immunization Vaccine Code Value Set and associated code system

[johnscarter]

https://build.fhir.org/ig/UP-Manila-SILab/PhilHealth-NHDR-IG-Review/branches/nhdr-branch/ValueSet-ImmunizationVaccineCodeVS.html

This value set and code system could be improved in a few ways:

-- The codes used appear to be (mostly?) FDA Registration numbers. In that case, the canonical URL of the value set should reflect FDA ownership rather than NHDR.

-- There are also some codes in the list that appear to be drug products rather than vaccines, such as DRP-4413: Hydrocortisone. Should these be there?

-- A link to FDA site should be provided, along with any other sources of the terms used in this value set (or the corresponding code system )

-- There are many codes listed with duplicate definitions, so an implementer might not know which code to report. Also, it might be necessary to create a "currently active" subset for submission purposes.

-- The International Patient Summary recommends either SNOMED or WHO ATC codes for vaccine codes. Is it possible to have any kind of mapping to either of these systems?

-- The binding to the PH_Immunization profile is "example" strength. This means that any code from any system is allowed. Is that the intent? Remember, once "bad" codes get into the database, it's really hard to get them back out.

[nhdr-gianb]

During the initial conversion of the Simplifier IG to fsh, which you know has a multitude of errors, I imported a local copy of the list from here which is what is listed in our local references. For the sake of fulfilling missing or unfinished ValueSets, I created a local CodeSystem to be expanded as a ValueSet, and used the same canonical url to be uniform across the IG.

References or linking to the actual source definitely needs to be added somehow. Whether it be in the narrative descriptions, as the canonical url, or do we add another column that points to the source? I'm just not sure yet what the end approach would be for cases such as these where the source isn't an actual terminology service that a ValueSet could expand upon.

And thank you for pointing those out John.

As for the issues about the actual coverage of the codes, I'll tag @Arlond14, as he is in charge of our list of local references, and @kinrihehe who is reviewing the ValueSets.

For a lot of the binding strengths being set to "example", those are leftovers from the conversion from Simplifier to fsh, in which we first focused on cleaning-up and minimizing errors first. I'll change them all to either "required", as I think even "extensible" is functionally the same with the "example" binding strength.

[nhdr-gianb]

I found the issue regarding the incorrect list of vaccine codes. The filter used before filtered for the entire table, meaning it also included the keyword "vaccine" in other columns such as Manufacturer.

We can resolve this by using the advanced filter to search for "vaccine" in the Pharmacologic Category column specifically, which reduced the codes from 182 to 73.

Another issue here is that there are entries under Pharmacologic Category simply marked as "-" that have also been filtered out.

We need to verify which of these are still counted as vaccines.

[NHDR-Quin]

I agree that we need to review the values of the vaccination code, as some entries do not specifically refer to vaccines and contain multiple values. I will coordinate with the FHIR mapping team, Sir @Arlond14, to ensure a thorough review. Thanks!

[nhdr-gianb]

I have updated the ValueSet by filtering for "vaccine" on the Pharmacologic Category column properly. But as I have mentioned previously, the team still needs to verify this filtered list since there are entries which have no labeled category, that may also be a vaccine, but got filtered out due to it being unlabeled.

[gpvillanuevasilab]

Update: PHIC FHIR Mapping Team is working on it - the update was already pushed in their branch (PHIC Instance).

-FDA Product
-ICD 1O
-PSGC

[upmsilab]

@NHDR-Quin - The codesystem is already linked to the FDA website. They're still working on the actual list of codes.

[upmsilab]

This ticket is done since it was already directed to the FDA Website. @johnscarter to confirm and close ticket

[upmsilab]

@nhdr-gianb - To check on what branch was the update pulled.