In accordance with § 355 Paragraph 12 and 13 of the German Social Code Book V, the gematik GmbH and the Federal Institute for Drugs and Medical Devices  hold the task of operating a platform for the provision, maintenance and updating of medical classifications, terminologies, nomenclatures and other semantic standards on a terminology server and of coordinating these activities within the framework of the national competence centre for medical terminologies referred to in Paragraph 7 with the users of the terminology server and the Coordination Office for Interoperability in Health Care in accordance with § 3 Paragraph 1 of the IOP Governance Regulation.

A central terminology service is an integral component of interoperability in the German health care system. The provision and use of structured data is the basis for a cross-sectoral exchange of data, for the linking of different data sources and for an effective and high-quality data evaluation.

The objectives of a central terminology server are

• central provision of code systems, value sets and concept maps for different applications in the healthcare sector
• a reliable source of reference for use across applications and sectors (single point of truth)
• Long-term availability and traceability of different versions
• technical provision and retrieval in machine-readable and automatable formats (FHIR-REST-API)

The working group "Analysis of the requirements for national terminology services" of the Interop Council identified as requirements that "terminologies should be distributed in a standardised process via a terminology package server” via "terminology FHIR packages".

Development stage 0 - Provision of coding systems and value lists as FHIR packages (commenting phase)

In a first step, the BfArM's coding systems and value lists have been converted to a FHIR format and are made available in FHIR packages for commenting.

The following FHIR-packages can be downloaded and commented:

• ICD-10-GM version 2024, 2023, 2022, incl. Transitions old - new / new - old
• OPS version 2024, 2023, 2022, incl. Transitions old - new / new - old
• ICF Version 2005
• ICD-O-3 Second Revision 2019
• Orphanet Nomenclature Version 2023
• LOINC Linguistic Variant deDE Version 2.77
• UCUM Common Codes deDE Version 28/07/2023

The commenting period is from May 22 to July 03 2024.

The provided coding systems, value lists and mappings are adapted to the use in the electronic patient record. The packages contain all values to be used for structured data collection and data transfer in health care settings. The purpose of using the formats is to validate semantic content.

The provision is an additional offer to the known formats, which will continue to be made available via the website of the Coding Systems Division and via the BfArM download centre.

Next steps

The next step is to replace this application for commenting by the first development stage (stage 1) of the central terminology server under the same link https://terminologieserver.bfarm.de.