How to upload USCDI Valuesets, Profiles, Etc on Se...
# supportd
Doug DeBold
07/14/2025, 8:20 PMSorry if this is a basic question, but I've been able to figure out how to import the USCDI data into our self-hosted system. I have run the rebuild structure definitions and value sets from the super admin UI but that just rebuilds them and doesn't fix the issue. Did I miss something in the docs somewhere?
m
Maddy
07/15/2025, 5:58 PMHi Doug! Would you mind sharing how you imported the data? We would generally recommend running the import using your CLI, since the file is quite large
Maddy
07/15/2025, 6:55 PMHere are some docs on code system importing: https://www.medplum.com/docs/api/fhir/operations/codesystem-import
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rahul1
07/15/2025, 7:20 PMAs part of our enterprise offering, we will upload our parsed version of the USCDI into your self-hosted instance
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Doug DeBold
07/15/2025, 9:37 PMAhh ok, so it's not part of the initial bootstrap and we have to upload ourselves. Is that correct?
Doug DeBold
07/15/2025, 9:38 PMI was just experimenting with some of the exmples like the charting demo and kept hitting errors b/c all of the USCDI data was missing and so I assumed that it was automatically imported
c
Charles Li
07/16/2025, 4:04 PMi think i just asked this same question
Charles Li
07/16/2025, 4:04 PMHow do we do this as self hosted forked?
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Maddy
07/16/2025, 4:52 PMHi @Charles Li , you should be able to import any code system with the import operation: https://www.medplum.com/docs/api/fhir/operations/codesystem-import
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rahul1
07/16/2025, 4:53 PMTo expand - you can upload the
StructureDefinitionsValueSetrahul1
07/16/2025, 4:53 PMThe fundamental blocker will be importing the underlying code sytems
rahul1
07/16/2025, 4:55 PMThose can be downloaded from https://www.nlm.nih.gov/research/umls/index.html . But they will need to be parsed into a format to be imported using
CodeSystem/$importd
Doug DeBold
07/16/2025, 9:22 PMGot it. Thank you for the clarification!
Doug DeBold
07/22/2025, 8:02 PMFollowing up on this. I see this discussion: https://github.com/medplum/medplum/discussions/1411
It gave 3 high-level options and it looks like option 1 with a public terminology setup was prefered but I don't think I saw any final decision in there or the other linked docs. What was decided and implemented?
I'm most of the way through uploading the valuesets and code systems but this question came up since we have a multi-tenant system and recreating the terminologies across each project would explode our database size as mentioned in option 3
Doug DeBold
07/22/2025, 9:14 PMTo add even more color, we want to be able to share the base terminologies across project (tenants) but then also have tenants be able to configure their own valuesets and code systems for their specific use cases
Doug DeBold
07/22/2025, 9:16 PMAnd just like that I think I answered my own question https://www.medplum.com/docs/access/projects#common-use-cases
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rahul1
07/23/2025, 5:04 PM@Doug DeBold glad you were able to get it working
rahul1
07/23/2025, 5:05 PMProject linking is how we solve this in our hosted solution
rahul1
07/23/2025, 5:05 PMOut of curiousity, would you mind sharing your multi-tenancy use case? Would love to learn more about how you're using the platform
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Doug DeBold
07/23/2025, 8:57 PMYeah! It's a bit of a long and convoluted road but we are a digital health tech consultancy and over the years have built out a suite of products/features to help our clients. We primary work with startups and found that many typical Saas products that normal tech startups take for granted are wayyyyy too expensive to get a BAA, so we have built out a suite of products to help fill that gap for our clients. Admin tooling, analytics, marketing automation provider portal etc. Most of our clients have either kept using their EHR or been cash pay or healthcare adjacent so a proper EHR has never been needed.
We now have had a bunch of similar clients in the cash-pay space where they need a very light EHR so we're integrating medplum into our multi-tenant platform as the clinical data repository. Because each tenant is quite different it doesn't quite fit the MSO model as each tenant has their own workflow, patients, providers, value sets and all the configurations.
We're definitely in still in the learning curve with medplum, but building out a basic provider portal/EHR alongside a multi-tenant React Native app for our clients.
Doug DeBold
07/23/2025, 8:58 PMWe had a chat with Reshma a few months ago but decided to stay on the open-source self-hosted version as adding another service to our current infra was quick and easy
Doug DeBold
07/23/2025, 9:00 PMSome quick feedback on the docs is that the purpose of the FHIR R4 project when you self-host is really unclear. I finally found it's hos you share terminology across all projects but I think that some mention of this in the self-hosting docs would make it much more clear that this is really a system administered project that shouldn't be messed with
Doug DeBold
07/23/2025, 9:56 PMHopefully my final question. Do you recommend encoding the parent-child associations in snomed, icd10 and loinc or just flattening the codes and using only non-heirarchical
i
Ian Plunkett
07/23/2025, 10:04 PM@Doug DeBold can you be a little more specific here? Do you have an example?
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Doug DeBold
07/24/2025, 3:24 AMWith ICD10, Loinc, Snomed etc you could have all of the codes flattened and have not relationship between them OR you could do like the below example where Chest Pain is a grand-child of "Clinical Finding". With medplum, what is the recommended approach?
```
{
"resourceType": "CodeSystem",
"id": "snomed-subset",
"url": "http://snomed.info/sct",
"version": "20230301",
"name": "SNOMEDSubset",
"title": "SNOMED CT Subset",
"status": "active",
"experimental": false,
"date": "2025-07-21",
"publisher": "Your Organization",
"content": "complete",
"hierarchyMeaning": "is-a",
"concept": [
{
"code": "404684003",
"display": "Clinical finding",
"concept": [
{
"code": "409586006",
"display": "Complaint",
"concept": [
{
"code": "162467007",
"display": "Chest pain"
},
{
"code": "24700007",
"display": "Headache"
}
]
}
]
}
]
}
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