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Terminology Service — AI Integration

Status: populated Owner: TBD Last updated: 2026-04-18 Companion: Service Template · 03 platform-services · 02 DDD

1. AI Integration Status

Minimal — no direct AI calls.

The terminology-service has no direct integration with ai-gateway-service or any other AI/ML inference endpoint. Its query surface (code lookup, validation, expansion, drug interaction checking) is fully deterministic: it operates against a structured relational database of licensed terminology content and returns rule-based results.


2. Rationale for No AI Integration

ReasonExplanation
Determinism requiredClinical coding decisions (SNOMED CT lookup, LOINC validation, drug interaction severity) must be deterministic, auditable, and reproducible. AI-generated responses are probabilistic and cannot be used as authoritative coded-value sources.
Licensed data boundaryTerminology content (LOINC, SNOMED, RxNorm, ICD-10) is structured, licensed, and fully machine-readable. There is no natural language ambiguity to resolve.
Regulatory complianceCoded clinical values used in FHIR resources and HL7 messages must conform to published coding system standards. An AI inference layer between query and coded value would introduce non-compliant variability.
Performance profileConcept lookups have a p95 SLO of ≤ 200 ms. AI inference would add unacceptable latency.

3. Future Scope (Not Committed)

Potential future capabilityPrerequisite before enabling
Natural language → code suggestionA secondary AI-assisted search hint (not a substitute for the canonical result) could help clinicians during free-text entry. This would use ai-gateway-service as an optional suggestion layer with explicit HITL confirmation required before a code is accepted. Must not replace the authoritative $lookup or $validate-code path.
Automated concept mapping reviewAI-assisted review of concept map quality (e.g., flagging low-confidence cross-system translations) for use by terminology stewards. Result would be advisory only; no auto-update of concept maps.
Onboarding concept suggestionDuring tenant custom concept creation, an AI could suggest matching global concepts to avoid unnecessary duplication. Tenant admin must confirm before creation.

All future AI features require platform AI governance review, ai-gateway-service Tier classification, and MoPH compliance sign-off before activation.