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    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ImplementationGuide hl7.fhir.uv.termchangeset</b></p><a name=\"hl7.fhir.uv.termchangeset\"> </a><a name=\"hchl7.fhir.uv.termchangeset\"> </a><a name=\"hl7.fhir.uv.termchangeset-en-US\"> </a><h2>TermChangeSet</h2><p>The official URL for this implementation guide is: </p><pre>http://hl7.org/fhir/uv/termchangeset/ImplementationGuide/hl7.fhir.uv.termchangeset</pre><div><p>This IG provides profiles and implementation guidance for exchanging terminology change sets that include full semantic detail from the source terminology utilizing the CodeSystem resource.  It also addresses exchanging terminology change sets containing provisional concepts not yet incorporated in source terminologies, such as those requiring rapid distribution during a pandemic-response context. Analysis of semantic detail to include is informed by the Tinkar Standardized Terminology Knowledgebase (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=573) Reference Model, and mappings from that architecture are included on CodeSystem profiles.  It provides background and context for the Tinkar Standardized Terminology Knowledgebase Reference Model and its native representation to enable lossless knowledge assets in various formats.  In 2021, HL7 published the HL7 Logical Model: Standardized Terminology Knowledgebase, Release 1—an informative document outlining the requirements for managing terminology across diverse healthcare organizations. This document emphasized the need for a robust terminology foundation, supporting extensions for various informatics systems. It introduced a self-describing logical model for terminology knowledge bases, specifically designed to represent standard terminology modules such as SNOMED CT Releases, value sets, coding systems, local terms, and equivalence mappings. The logical model comprehensively captured internal semantics, concept details, detailed relationships between terms, and hierarchies of standard terminology modules. The foundation for a standard-based Terminology Knowledge Architecture (Tinkar) specification was articulated to facilitate knowledge management for terminology among vendors, providers, and standards development organizations, including Health Level Seven International (HL7).</p>\n</div></div>"
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        ],
        "reference": {
          "reference": "Provenance/52b1a1d2-80ab-460b-b5fc-341edd35b032"
        },
        "name": "LOINC Change Set Provenance Example",
        "description": "An example Provenance instance referring to a Change Set derived from LOINC",
        "exampleCanonical": "http://hl7.org/fhir/uv/termchangeset/StructureDefinition/terminology-changeset-provenance-profile"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "CodeSystem"
          }
        ],
        "reference": {
          "reference": "CodeSystem/HL7VariableRoleChangeSet"
        },
        "name": "EvidenceVariableRole UTG-247 Change Set",
        "description": "Example of HL7 VariableRole code system Change Set based on UTG-427 https://jira.hl7.org/browse/UP-427",
        "exampleCanonical": "http://hl7.org/fhir/uv/termchangeset/StructureDefinition/changeset-profile"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "CodeSystem"
          }
        ],
        "reference": {
          "reference": "CodeSystem/loinc277attachmentsChangeSet"
        },
        "name": "LOINC 2.77 Attachments Change Set for targetted redistribution",
        "description": "Example of LOINC Change Set including all new Document Attachments defined in LOINC 2.77 for pre-adoption on 2.76 implementations",
        "exampleCanonical": "http://hl7.org/fhir/uv/termchangeset/StructureDefinition/loinc-changeset-profile"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "CodeSystem"
          }
        ],
        "reference": {
          "reference": "CodeSystem/snomedct413839001ChangeSet"
        },
        "name": "SNOMED CT 413839001 Chronic lung disease (Disorder) Change Set 46dc8ea230544ceba51145f774fe9fdd",
        "description": "Example of SNOMED CT Change Set including an update to the 413839001 Chronic lung disease (Disorder) concept",
        "exampleCanonical": "http://hl7.org/fhir/uv/termchangeset/StructureDefinition/snomed-changeset-profile"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:resource"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/changeset-profile"
        },
        "name": "Terminology Change Set (CodeSystem)",
        "description": "Profile of CodeSystem to enable lossless representation of a terminology change set aligned with Tinkar information model requirements"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/defining-relationship-type"
        },
        "name": "Defining Relationship Type",
        "description": "Indicator to distinguish between axioms explicitly stated vs. inferred by a reasoner or other logical processes"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/description-acceptability"
        },
        "name": "Description Acceptability",
        "description": "Boolean value to convey if a designation is case sensitive or not"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/description-case-sensitivity"
        },
        "name": "Description Case Sensitivity",
        "description": "Coded value to identify what case sensitivity is reflected in description"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/description-dialect"
        },
        "name": "Description Dialect",
        "description": "Subcategorization of language"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/el-profile-set-operator"
        },
        "name": "EL Profile Set Operator",
        "description": "EL++ profile to describe the axiom as being part of the Necessary vs. Sufficient set for defining the concept"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:resource"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/loinc-changeset-profile"
        },
        "name": "LOINC Change Set (CodeSystem)",
        "description": "Profile of CodeSystem to enable lossless representation of a LOINC change set aligned with Tinkar information model requirements. This profile is a specialization of the broader Terminology Change Set profile."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:extension"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/role-group"
        },
        "name": "SNOMED Role Group",
        "description": "Where multiple property groupings are assigned for a particular concept, this identifies the group to which this property belongs.  See also SNOMED concept 609096000 Role group (attribute)"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:resource"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/snomed-changeset-profile"
        },
        "name": "SNOMED Change Set (CodeSystem)",
        "description": "Profile of CodeSystem to enable lossless representation of a SNOMED change set aligned with Tinkar information model requirements. This profile is a specialization of the broader Terminology Change Set profile."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "StructureDefinition:resource"
          }
        ],
        "reference": {
          "reference": "StructureDefinition/terminology-changeset-provenance-profile"
        },
        "name": "Terminology Change Set Provenance (Provenance)",
        "description": "Profile of Provenance to use in concert with terminology change sets compliant with Tinkar information model requirements"
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/case-significance-vs"
        },
        "name": "Case Significance Value Set",
        "description": "Codes describing case significance for a terminology concept. The value set includes all codes from the SNOMED CT descending from 900000000000447004 Case significance."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/defining-relationship-type-vs"
        },
        "name": "Defining Relationship Type Value Set",
        "description": "Codes describing the nature of a relationship used to define a terminology concept. The value set includes all codes from the SNOMED CT descending from 900000000000006009 Defining relationship."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/description-acceptability-vs"
        },
        "name": "Description Acceptability Value Set",
        "description": "Codes describing acceptability of a given description for a terminology concept. The value set includes all codes from the SNOMED CT descending from 900000000000511003 Acceptability."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/dialect-vs"
        },
        "name": "Dialect Value Set",
        "description": "Codes representing the specific dialect used in a description for a concept. The value set includes all codes from the SNOMED CT descending from 900000000000506000 Language type reference set."
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
            "valueString": "ValueSet"
          }
        ],
        "reference": {
          "reference": "ValueSet/el-profile-set-operator-vs"
        },
        "name": "EL Profile Set Operator Value Set",
        "description": "Codes describing the nature of an axiom in relationship to a concept, in terms of if it is part of the Necessary vs. Sufficient set for defining the concept. The value set includes all codes from the SNOMED CT descending from 900000000000444006 Definition status."
      }
    ],
    "page": {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode": "informative"
        },
        {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl": "toc.html"
        }
      ],
      "nameUrl": "toc.html",
      "title": "Table of Contents",
      "generation": "html",
      "page": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "index.html"
            }
          ],
          "nameUrl": "index.html",
          "title": "Home",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "guidance.html"
            }
          ],
          "nameUrl": "guidance.html",
          "title": "Guidance",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "TerminologyDistribution.html"
            }
          ],
          "nameUrl": "TerminologyDistribution.html",
          "title": "Terminology Distribution",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "FhirLimitations.html"
            }
          ],
          "nameUrl": "FhirLimitations.html",
          "title": "FHIR Limitiations",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "ChangeSetUseCase.html"
            }
          ],
          "nameUrl": "ChangeSetUseCase.html",
          "title": "Change Set Exchange",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "TinkarBackground.html"
            }
          ],
          "nameUrl": "TinkarBackground.html",
          "title": "Tinkar Background",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "TinkarOverview.html"
            }
          ],
          "nameUrl": "TinkarOverview.html",
          "title": "Tinkar Overview",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "TinkarModelConcepts.html"
            }
          ],
          "nameUrl": "TinkarModelConcepts.html",
          "title": "Tinkar Model Concepts",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "TinkarBusinessRequirements.html"
            }
          ],
          "nameUrl": "TinkarBusinessRequirements.html",
          "title": "Tinkar Business Requirements",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "protobufbackground.html"
            }
          ],
          "nameUrl": "protobufbackground.html",
          "title": "Protobuf Native Representation",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "downloads.html"
            }
          ],
          "nameUrl": "downloads.html",
          "title": "Useful Downloads",
          "generation": "html"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
              "valueCode": "informative"
            },
            {
              "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
              "valueUrl": "changes.html"
            }
          ],
          "nameUrl": "changes.html",
          "title": "IG Change History",
          "generation": "html"
        }
      ]
    },
    "parameter": [
      {
        "code": "path-resource",
        "value": "input\\history"
      },
      {
        "code": "path-resource",
        "value": "input/capabilities"
      },
      {
        "code": "path-resource",
        "value": "input/examples"
      },
      {
        "code": "path-resource",
        "value": "input/extensions"
      },
      {
        "code": "path-resource",
        "value": "input/models"
      },
      {
        "code": "path-resource",
        "value": "input/operations"
      },
      {
        "code": "path-resource",
        "value": "input/profiles"
      },
      {
        "code": "path-resource",
        "value": "input/resources"
      },
      {
        "code": "path-resource",
        "value": "input/vocabulary"
      },
      {
        "code": "path-resource",
        "value": "input/testing"
      },
      {
        "code": "path-resource",
        "value": "input/history"
      },
      {
        "code": "path-resource",
        "value": "fsh-generated/resources"
      },
      {
        "code": "path-pages",
        "value": "template/config"
      },
      {
        "code": "path-pages",
        "value": "input/images"
      },
      {
        "code": "path-tx-cache",
        "value": "input-cache/txcache"
      }
    ]
  }
}

name : TermChangeSet

{

}