The Canadian Clinical Drug Data Set April 2025 release is now available for access and implementation on the Terminology Server and Terminology Gateway.
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Important Update: We are pleased to announce significant enhancements to our FHIR Terminology Server, offering more seamless and standards-based access to terminology content for healthcare data exchange. Discover the new features and upcoming changes to our Terminology Gateway.
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This next generation Terminology Server (TS) hosts a variety of standards including SNOMED CT, LOINC, pCLOCD, CCDD, and PrescribeIT. This server will eventually replace the Terminology Gateway and if you already have access to the gateway, then you should be able to access the server without any further action.
Useful Links
Tool
Description
URL
Ontocommand
OntoCommand is an administration user interface that comes with Ontoserver.
You will be redirected to the OpenAM single sign-on (SSO) page. This is the same InfoCentral account you created earlier or already had previously.
Once login is successful, you will be taken to the main page of the Terminology Server.
If your access is working as expected, you should be able to click on the "Resources" menu on the navigation bar on the left and see the various terminologies available.
If you’re having trouble logging in, try refreshing the page, clearing your browser cookies, and/or using a different browser. If the issue persists, please This email address is being protected from spambots. You need JavaScript enabled to view it. for further assistance.
Shrimp
Shrimp is the tool used to browse the Code Systems and Value Sets. Shrimp can be accessed in two ways. You can go to Shrimp directly or through the main OntoCommand URL mentioned below. You may be asked to login to Shrimp which uses the same OpenAM credentials as the Terminology Server.
Click on Shrimp in the navigation bar on the left.
Snapper
Snapper is an authoring tool which allow users to add or update Code Systems and/or Value Sets. It can be accessed via the direct link or from the main OntoCommand URL. The first time you visit the site, you will be required to agree to a license agreement for Snapper.
Canada Health Infoway is excited to introduce our innovative Terminology Server, a managed service solution that serves as a helpful resource for standards subject matter experts, developers, healthcare organizations, vendors, healthcare data providers, and consumers nationwide.
Our Terminology Server is powered by Ontoserver from CSIRO. The Ontoserver product is a world-leading clinical terminology solution implementing FHIR terminology services and supporting syndication–based content. This advanced technology ensures that our Terminology Server is equipped to meet the highest levels of healthcare interoperability and improved healthcare delivery across Canada.
What is a Terminology Server?
Infoway’s Terminology Server is a fully HL7 FHIR-compliant, cloud-based solution that stores, maintains, and distributes international and nationally approved terminologies. It offers scalability, security, reliability, and flexibility for secure access. The server hosts high-quality international and pan-Canadian terminologies, as well as ValueSets, making these resources accessible and shareable across digital health solutions, systems, and healthcare data providers to facilitate standardization of health data. This fosters interoperability and semantic consistency.
What are the Terminology Server Benefits?
Centralizes Access to Standardized Health Terminologies. Serves as a central repository for those maintaining standardized healthcare terminologies and those using the content, ensuring uniformity in data collection and data exchange.
Enables Interoperability. Facilitates more frequent updates of standard clinical terminologies across diverse pan-Canadian digital solutions and systems. This enables health care staff to access more reliable, standardized information, leading to more informed treatment decisions and improved patient care.
Supports Improved Collaboration. Tools to enable content creation and content use, offering the ability to participate as part of the healthcare ecosystem and work collaboratively.
Provides Pathways for Advanced Use of Terminologies. Realizes the benefits of adopting terminologies for enhanced reporting, analytics, and research purposes through the availability of comparable information.
Fully Enabled FHIR Terminology Capabilities. Includes broad support for the standard FHIR terminology resources and operations. These capabilities include Search, Create, Read, Update, and Delete operations on ValueSet, ConceptMap, CodeSystem, NamingSystem, and StructureDefinition; as well as other terminology-specific operations such as $expand, $validate-code, $lookup, $subsumes, $find-matches, $closure, $translate, and $validate.
Information Modeling and Specification Development. Support Concept Maps, binds terminology and ValueSets to data models and specifications, validates terminology content against specifications, and ensures FHIR resource compliance.
Terminology Server Content
The Terminology Server provides access to CodeSystems, ValueSets, and other Terminology artifacts for International and Canadian Terminologies, and Classifications, such as:
SNOMED CT CA
LOINC
pCLOCD
UCUM
Pan-Canadian ValueSets
Canadian Clinical Drug Data Set (CCDD)
Who Can Use the Terminology Server?
The Terminology Server is designed for:
Jurisdictions
Developers
Vendors
Healthcare Organizations & Healthcare Data Providers
Health Terminology Standards Specialists
Health Researchers
Accessing the Terminology Server
Our service is designed to cater to users of all expertise levels, offering multiple access options for convenience and efficiency. Beginners can rely on the intuitive User Interfaces (UI) to seamlessly access terminology data, download files, and perform information searches. These interfaces are user-friendly, making it easy for newcomers to get started without any technical barriers. For advanced users, including developers and power users, the Terminology Server provides robust APIs and additional services to interact with the data programmatically. These options allow for deeper integration and automation, enabling advanced workflows and customized solutions to meet specific needs. This flexibility ensures that both novice and experienced users can effectively utilize the Terminology Server to its fullest potential.
Beginners
Individual users can access the Terminology Server with a registered InfoCentral account. To assist with this, a comprehensive User Access Guide is available, providing detailed instructions on accessing and utilizing the Terminology Server.
The Terminology Server implements robust security measures, including role-based access control, encryption, and audit logging, to ensure that sensitive terminology data is protected and accessed only by authorized users. Infoway remains committed to prioritizing security and privacy in all its endeavors, including in our partnerships and when deploying new tools and solutions.
The Terminology Server also offers RESTful HTTP APIs, supporting both JSON and XML formats. This allows any platform, application, or integration engine capable of making RESTful HTTP calls and processing JSON or XML to interact with the Terminology Server. The FHIR APIs enable rich integration with the Terminology Server, facilitating both the subscription to and download of the latest content, as well as enabling runtime use of the terminology. This unlocks the full potential of the terminology, driving improvements in consistent data representation and the ability to collect standardized data.
The Terminology Server supports various integration approaches, allowing systems to incorporate the latest terminology content and create internal system representations. It also facilitates vendor-specific functions to find system-specific representations of the terminology if needed. By externalizing terminology through APIs, the Terminology Server ensures consistency in how terminology is accessed across different systems and vendors. This approach benefits both large systems and smaller vendors, promoting standardized data usage and interoperability.
Developers and system administrators have the flexibility to connect with the new Terminology Server using automated scripts or software applications. To make API calls to Infoway’s Terminology Server, a system account is required. This involvessubmitting a request form to obtain system credentials tailored to your specific project or organization. Once issued, these credentials can be exchanged for an authorization token, enabling your system to securely communicate with the Terminology Server without relying on personal usernames or passwords. It is essential to treat these credentials with the same level of care and confidentiality as you would a username and password, ensuring they remain protected and private.
Some examples of where these system API calls would be required are:
Querying the Terminology Server FHIR API to access CodeSystems, ValueSets and more
Downloading files from the Terminology Server Syndication server
Terminology Server Platform
The Terminology Server offers several applications to consume and understand the FHIR Resources available via Infoway’s Terminology Server.
OntoCommand
Understand what FHIR resources are available on the server
View resource metadata
Perform comparisons of FHIR resources
*NEW Download CodeSystems in various formats (e.g., SNOMED CT® RF2, pCLOCD and CCDD in Excel, HL7)
Advanced users encompass roles such as developers, power users, Terminology Server administrators, and users utilizing HL7 International tools, among others. These individuals possess a deeper technical understanding and are well-equipped to leverage sophisticated tools and workflows. A primary use case for advanced users is the utilization of the FHIR (Fast Healthcare Interoperability Resources) API, which allows seamless integration and access to healthcare data, fostering innovative solutions in health IT. In this section, you can also explore how advanced users can gain access to essential resources and programmatically download files using the syndication feed. For additional information and detailed guidance, visit the Advanced Users page.
Training Resources
We recognize that users have varying levels of knowledge and understanding about our Terminology Server (Ontoserver). These online training resources are designed to aid in understanding and leveraging the full capabilities of the solution.
Yes, our Ontoserver allows you to seamlessly browse, search, and download terminology content in multiple formats to fit your needs. Through FHIR APIs, you can integrate terminology content programmatically and access files in FHIR-compliant XML and JSON formats, as well as simplified CSV representations for operations like ValueSet $expand. You can automate the downloads for terminology resources using the Syndication API feed, which provides detailed listings for each CodeSystem. Additionally, the Shrimp Browser provides an intuitive way to search and explore terminology content, while our enhanced OntoCommand interface enables direct downloads of CodeSystems and ValueSet artifacts in your preferred formats.
As part of the transition to a FHIR-based Terminology Server, there will be no changes to how ValueSets are accessed for review purposes. The Canonical Value Set FHIR URIs in IGs should already be using the ValueSet FHIR URI and these will be mapped to the new FHIR-based Terminology Server.
Yes, the Terminology Server is designed to support all FHIR terminology operations including the ValueSets compose element (both intensional and extensional) to perform the $validate-code operation. ValueSetsare loaded as composed on the Terminology Server.This enables enhanced functionality, including $validate-code, and allows for $expand operations. The $expand operation supports full expansion requests and a wide variety of parameterized and focused expansions. For more information, please refer to the HL7 FHIR documentation.
ValueSets will automatically be updated in the Terminology Server via releases from HL7 Terminology (THO). Updates and changes will exclusively occur within the Terminology Server. To assist you in navigating the Terminology Server and effectively accessing ValueSets, comprehensive training materials and resources are available in the training materials section. Request for additions or changesto the ValueSets will need a Request for Change (RFC).
AValueSet in healthcare informatics, particularly in standards like FHIR (Fast Healthcare Interoperability Resources), refers to a uniquely identifiable set of valid concept representations. This means it is a collection of codes or terms from one or more code systems, which can be used to specify the allowable values for an element in a healthcare resource. Each concept in the ValueSet can be tested to confirm whether it is included in the set or not.In Terminology Gateway, the term “Subset” is used to identify a set where all elements are also contained in another set. In other words, if you have a set A, a subset of A (denoted B) includes only elements that are also in A. These subsets include constrained lists of allowable values or terminology from the source code systems (i.e. SNOMED CT Canadian Edition, pCLOCD, UCUM, SCP or HL7). Therefore, the terms “ValueSet” and “Subset” are used interchangeably. Subsets previously hosted on the Terminology Gateway are the same as ValueSets now hosted on the FHIR Terminology Server.
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While Ontoserver has the capability for runtime use and access by end systems, Infoway’s Terminology Server currently does not cover runtime use by end systems within its Service Level Agreement (SLA). Alternatively, the content available in the Terminology Server can be syndicated for runtime use, allowing consumer systems to have autonomous control over the terminology data.
Ontoserver is designed to be flexible and can function both as an integrated component and as a standalone solution. With the FHIR APIs, Ontoserver can support vendor-specific functions, allowing systems to find specific representations of terminology as needed.
The Terminology Gateway will be partially decommissioned as of April 30, 2025, as part of our service enhancement initiative. Since that date, the Terminology Gateway will no longer publish ongoing standard releases—with the exception ofPrescribeIT® content, which will remain supported on the legacy system. This means that all future standard releases will be available exclusively through our enhanced FHIR Terminology Server. For downloading resources, please note that the final official release for SNOMED CT CA, pCLOCD, CCDD, and ValueSets on the Terminology Gateway is the March 2025 release. After this release, the Terminology Server will be the sole source for updates and downloads. We kindly encourage you to transition to the FHIR Terminology Server at your earliest convenience to take advantage of its up-to-date content and robust features. Comprehensive training resources are available to help you navigate the enhanced server and fully realize its benefits.We appreciate your understanding and cooperation during this transition and are here to support you every step of the way.
Shrimp has been enhanced with a language toggle in the top right-hand corner, which applies to both the terminology content and the application interface, including menus and links. To browse in your preferred language, you can use the language toggle to select “en” or “fr”. Please note that as the Shrimp browser is available globally, there may be additional languages added in the menu options. For example, “id” which represents the Indonesian language. This would not apply to Canadian terminology content which is available only in EN and FR. Please see our Shrimp User Guide for more details regarding this new feature. We appreciate your continued patience as we work to further improve this functionality.
Yes, you can use the following API calls to determine the latest version for code systems, such as SNOMED CT and pCLOCD within the Postman Collection. For detailed instructions on how to access the Postman Collection, please refer to the following link: System Account Requisition Process:
For SNOMED CT, please use the following:
HTTP GET https://terminologystandardsservice.ca/fhir/CodeSystem?url=http://snomed.info/sct&_elements=version&_sort=-version&_count=1
For pCLOCD, please use the following:
HTTP GET https://terminologystandardsservice.ca/fhir/ValueSet/$expand?url=https://fhir.infoway-inforoute.ca/CodeSystem/pCLOCD?fhir_vs&count=0
Please note that you will need to authenticate before making these requests.
Example CURL Command is provided below:
Yes, “latest” refers to the most recent version of the Code System available in the current versioning stream. We aim to ensure that the most up-to-date content is accessible in the Terminology Server. For guidance on browsing Code Systems in Shrimp, the Shrimp User Guide and Shrimp training video are available in the training resources section for your reference.
Yes, there are two ways to access this content. One method involves using an API, such as Postman, which can handle larger datasets without the limitations that may be encountered with other tools. A demonstration of this process is available in our training video, "Terminology Server Drop-in Session FHIR API" (timestamp 35:20). If you need access to the entire content, the Syndication server allows you to retrieve the full artifact.
Depending on your needs, it’s important to choose the correct format for downloading the content. We always make the FHIR representation available, with the exception of SNOMED CT CA and LOINC. For these two Code Systems, there are binary and native versions, as they cannot be represented in a flat Code System. For simpler, standard artifacts, the Syndication system provides all the necessary data.
All pan-Canadian ValueSets defined by Infoway will transition to semantic versioning as part of the migration to the new Terminology Server.
Semantic versioning is considered a best practice, especially as we move to a fully FHIR-enabled Terminology Server. It reduces conflicts and maintenance efforts for FHIR Implementation Guide (IG) developers and implementers by providing a more consistent versioning structure. The shift addresses known limitations of dynamic versioning in the Terminology Gateway, a concern discussed and supported by the expert community. More information on these discussions can be found here: FHIR Chat Discussion on Versioning.
Changes for Implementers:
Baseline Versioning:All ValueSets on the new Terminology Server will begin with a baseline version of 1.0.0, following semantic versioning principles for improved stability and predictability in updates.
FHIR Implementation Guides with “Stub” ValueSets: FHIR implementation guides that employ “stub” ValueSetsusing date-based versioning will encounter collisions when using FHIR tooling. FHIR tooling will try to compare the date-versionedstub ValueSet against TS’ssemantically-versionedValueSet, and will fail todetermine which ValueSet takes priority. FHIR guides using stub ValueSets should be republished using semantic versioning, and a reasonable backdate (e.g. 1900-01-01).
Continuity with Terminology Gateway: The current Terminology Gateway (TG) will be partially decommissioned and will only host PrescribeIT content as of April 30th, 2025. Versioning on the TG will remain unchanged for the foreseeable future, ensuring continuity for users who still rely on it during the transition.
Consistency and Clarity: Semantic versioning clearly communicates the significance of changes. Major updates (e.g., 2.0.0) indicate breaking changes, while minor or patch updates (e.g., 1.1.0 or 1.0.1) signify additions or fixes without disruption, aiding implementers in assessing impacts.
Simplified Upgrades and Compatibility: Implementers gain better visibility into backward-compatible changes, streamlining the update process by clarifying when major upgrades are necessary versus when minor updates can be safely applied.
Improved Governance and Change Management: The new versioning scheme allows implementers to align their processes for managing updates, establishing protocols to adopt changes while minimizing disruption risks.
Impact on Implementation Timelines: Unlike date-based versioning, updates under semantic versioning will depend on the nature of changes rather than a fixed schedule, potentially altering when updates need to be applied by implementers.
This transition aims to streamline the management of ValueSets, enhance stability, and simplify the implementation process for developers and users alike.
From the FHIR perspective, the national SNOMED CT CA Edition code.system is the default global code system "http://snomed.info/sct". Use of “version’ would be included to denote that a code is from the Canadian Edition. This version is based on the most dependent module (French module): http://snomed.info/sct/20611000087101.
If an implementation is not leveraging a Canadian terminology service such as Infoway’s Terminology Server that defaults to the Canadian Edition, solutions would need to include the SNOMED CT CA Edition (in the coding.version)
Examples by Use Case
Example of recommended format without reference to version for use in Canada in ecosystems where tooling and vendor software implicitly use the SNOMED CT CA edition in their valuesets, terminology services (e.g. National Vaccine Catalogue):
Example of recommended format including version for use in ecosystems where data exchange may occur with tooling and vendor software that operate in US or other jurisdictions where SNOMED CT CA edition isn’t the default. This might apply to vendors that use SNOMED International or SNOMED CT US Edition by default, for example, such as a US based vendor operating in Canada (e.g. for smartphone apps).
Guidance on the application of code system versioning
For implementers, look to the respective FHIR Implementation Guide for guidance on whether to include the code system version.
For FHIR implementation guide authors, use the guidance above based on the expected data exchange ecosystem.
Your feedback is invaluable in helping us refine and improve our Terminology Server and we look forward to your continued support and collaboration to ensure that together we are driving health care interoperability forward in Canada. Please use the above contact us method to submit your feedback.
Disclaimer: Infoway’s Terminology Server shares Provider Content and User Content to support healthcare terminology data usage. While we strive to ensure the quality, accuracy, and completeness of the content provided, it is ultimately the User’s responsible to ensure that the content is adequate for the intended use. Infoway disclaims any liability for errors and/or omissions in said content, which is provided “as is” in accordance with our Terms of Use. Terminology licensing information
Improving the quality of patient care through the effective sharing of clinical information among health care organizations, clinicians and their patients.
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