The FHIR specification provides a mechanism to access clinical terminologies using a standard API, and many existing terminologies, such as SNOMED CT, are well supported. However, in areas such as genomics, terminologies from other domains are starting to be used in clinical settings. Many of these are authored or distributed in Web Ontology Language (OWL) format. In this paper we describe a transformation between OWL ontologies and FHIR terminology resources. The results show that there are several challenges in implementing the transformation, with the major one being the lack of a modularisation mechanism in the FHIR code system resource that resembles the import mecha nism available in OWL. A workaround with minimal drawbacks was successfully implemented in this solution. The availability of this transformation is significant because it enables a broad range of terminologies that are currently available in OWL to be available using the FHIR API.
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