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M: we map to staging table, and then to OMOP

H: why do you need a mapping table?

M: our use cases involve using FHIR as a data feed for research … data coming from different sources … CSV raw, database dump … we have a staging table that we map to, then map to OMOP … put all external data sources to staging table.

H: what's the staging table format?

M: more OMOP-friendly than FHIR-friendly … i have mapping to staging table … staging table is closer to OMOP … idea: could use FHIRbase <> (psql database) with concpets and functions for FHIR resources … i'm working with adata person; i asked if we could use FHIR-base to map it, and use ETL from there … we could ETL FHIRbase to a staging table or directly to OMOP … doesn't solve gaps, but solves some pipeline probs. … there are still some resources i can't map to OMOP

H: which resources?

M: workflow-related stuff like Care plan, Appointment … also elements in Device that we can't map into OMOP

E: OMOP defines the area that folks need for research … we don't need OMOP to be an EMR

M: not using care plan much … map as much as you can … FHIR wrapper on OMOP

E: Let' see if we're on the same page for Use Cases [reads UC, below] after doing research, we want to profit from discoveries. Evidence-based medical practices that emerge from research, be it widely-published or just clinic-wide, can leverage the same queries and heuristics to aid in enforcement of clinical practice. … does that sound like we're on the same page? [agreement] … staging table has extra workflow stuff?

M: FHIR populated by EHR, with arbitrary coding system … we use the stating table to standardize codes, e.g. NDC … staging table useful for review.

E: could others implement the mapping without your staging table?

M: we map *Georgia Tech* FHIR to OMOP. … when i search in the concept table, and i can't find the right entry, what do i do? … i have to have a concept ID. … i use the source column to preserve the FHIR data

E: so it's good to have something in the role of staging table

M: the staging table is customizable. … if there is data we need to preserve but we can't map it, we can create a table.

E: but we don't need data we can't map

M: but we may have a VA-specific coding

E: there are: … 1 (information model) FHIR resources that don't have an analog in OMOP. … 2 (terminology model) resources that map but don't use required terminologies. … are you buying commodity terminology mappings?

M: at Georgia Tech, we force folks to use the OMOP codings

E: are OMOP terminology requirements almost universally tighter than in FHIR?

M: LOINC, SNOMED, CPT, ICD … i don't know how many folks will follow that.

E: for a high bar, we could say “though shalt use this terminology for X” … for a low bar, we could say “both FHIR and OMOP accept these terminologies”

H: OMOP and FHIR allow you to define code sets equivalence. … could be useful but tricky … they line up mostly … there's a vocabulary table in OMOP. … likewise in FHIR, but in coding objects … we could say that there's a coding X FHIR and import that into OMOP … the UC is: many FHIR resources have a wide variety of code sets

E: i guess the proposal is to exchange FHIR and OMOP terminology definition structures. … let's do the easy stuff first [structural transformation]. … enable terminological transformation if use cases warrant. … depends on level of non-coordination we want to enable.

H: I can speak with Daniella about that.

– -ericP

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