Merge remote-tracking branch 'remotes/origin/master' into add-pid-to-created-resource

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDao.java

@@ -20,16 +20,16 @@ package ca.uhn.fhir.jpa.dao.data;
  * #L%
  */
 
-import ca.uhn.fhir.jpa.entity.TermValueSetCode;
+import ca.uhn.fhir.jpa.entity.TermValueSetConcept;
 import org.springframework.data.jpa.repository.JpaRepository;
 import org.springframework.data.jpa.repository.Modifying;
 import org.springframework.data.jpa.repository.Query;
 import org.springframework.data.repository.query.Param;
 
-public interface ITermValueSetCodeDao extends JpaRepository<TermValueSetCode, Long> {
+public interface ITermValueSetConceptDao extends JpaRepository<TermValueSetConcept, Long> {
 
-	@Query("DELETE FROM TermValueSetCode vsc WHERE vsc.myValueSet.myId = :pid")
+	@Query("DELETE FROM TermValueSetConcept vsc WHERE vsc.myValueSet.myId = :pid")
 	@Modifying
-	void deleteTermValueSetCodesByValueSetId(@Param("pid") Long theValueSetId);
+	void deleteTermValueSetConceptsByValueSetId(@Param("pid") Long theValueSetId);
 
 }

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/ITermValueSetConceptDesignationDao.java

@@ -0,0 +1,35 @@
+package ca.uhn.fhir.jpa.dao.data;
+
+/*
+ * #%L
+ * HAPI FHIR JPA Server
+ * %%
+ * Copyright (C) 2014 - 2019 University Health Network
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+
+import ca.uhn.fhir.jpa.entity.TermValueSetConceptDesignation;
+import org.springframework.data.jpa.repository.JpaRepository;
+import org.springframework.data.jpa.repository.Modifying;
+import org.springframework.data.jpa.repository.Query;
+import org.springframework.data.repository.query.Param;
+
+public interface ITermValueSetConceptDesignationDao extends JpaRepository<TermValueSetConceptDesignation, Long> {
+
+	@Query("DELETE FROM TermValueSetConceptDesignation vscd WHERE vscd.myConcept.myValueSet.myId = :pid")
+	@Modifying
+	void deleteTermValueSetConceptDesignationsByValueSetId(@Param("pid") Long theValueSetId);
+
+}

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/dstu3/FhirResourceDaoCodeSystemDstu3.java

@@ -26,6 +26,7 @@ import ca.uhn.fhir.jpa.dao.data.ITermCodeSystemVersionDao;
 import ca.uhn.fhir.jpa.entity.TermCodeSystem;
 import ca.uhn.fhir.jpa.entity.TermCodeSystemVersion;
 import ca.uhn.fhir.jpa.entity.TermConcept;
+import ca.uhn.fhir.jpa.entity.TermConceptDesignation;
 import ca.uhn.fhir.jpa.entity.TermConceptParentChildLink.RelationshipTypeEnum;
 import ca.uhn.fhir.jpa.model.entity.ResourceTable;
 import ca.uhn.fhir.jpa.searchparam.SearchParameterMap;
@@ -51,8 +52,7 @@ import java.util.Date;
 import java.util.List;
 import java.util.Set;
 
-import static org.apache.commons.lang3.StringUtils.isBlank;
+import static org.apache.commons.lang3.StringUtils.*;
-import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 public class FhirResourceDaoCodeSystemDstu3 extends FhirResourceDaoDstu3<CodeSystem> implements IFhirResourceDaoCodeSystem<CodeSystem, Coding, CodeableConcept> {
 
@@ -193,6 +193,21 @@ public class FhirResourceDaoCodeSystemDstu3 extends FhirResourceDaoDstu3<CodeSys
 				termConcept.setDisplay(next.getDisplay());
 				termConcept.addChildren(toPersistedConcepts(next.getConcept(), theCodeSystemVersion), RelationshipTypeEnum.ISA);
 				retVal.add(termConcept);
+
+				for (CodeSystem.ConceptDefinitionDesignationComponent designationComponent : next.getDesignation()) {
+					if (isNotBlank(designationComponent.getValue())) {
+						TermConceptDesignation designation = termConcept.addDesignation();
+						designation.setLanguage(designationComponent.hasLanguage() ? designationComponent.getLanguage() : null);
+						if (designationComponent.hasUse()) {
+							designation.setUseSystem(designationComponent.getUse().hasSystem() ? designationComponent.getUse().getSystem() : null);
+							designation.setUseCode(designationComponent.getUse().hasCode() ? designationComponent.getUse().getCode() : null);
+							designation.setUseDisplay(designationComponent.getUse().hasDisplay() ? designationComponent.getUse().getDisplay() : null);
+						}
+						designation.setValue(designationComponent.getValue());
+					}
+				}
+
+				// TODO: DM 2019-07-16 - We should also populate TermConceptProperty entities here.
 			}
 		}
 

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/expunge/ExpungeEverythingService.java

@@ -96,7 +96,8 @@ public class ExpungeEverythingService {
 		counter.addAndGet(expungeEverythingByType(ResourceLink.class));
 		counter.addAndGet(expungeEverythingByType(SearchResult.class));
 		counter.addAndGet(expungeEverythingByType(SearchInclude.class));
-		counter.addAndGet(expungeEverythingByType(TermValueSetCode.class));
+		counter.addAndGet(expungeEverythingByType(TermValueSetConceptDesignation.class));
+		counter.addAndGet(expungeEverythingByType(TermValueSetConcept.class));
 		counter.addAndGet(expungeEverythingByType(TermValueSet.class));
 		counter.addAndGet(expungeEverythingByType(TermConceptParentChildLink.class));
 		counter.addAndGet(expungeEverythingByType(TermConceptMapGroupElementTarget.class));

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoCodeSystemR4.java

@@ -26,8 +26,8 @@ import ca.uhn.fhir.jpa.dao.data.ITermCodeSystemVersionDao;
 import ca.uhn.fhir.jpa.entity.TermCodeSystem;
 import ca.uhn.fhir.jpa.entity.TermCodeSystemVersion;
 import ca.uhn.fhir.jpa.entity.TermConcept;
+import ca.uhn.fhir.jpa.entity.TermConceptDesignation;
 import ca.uhn.fhir.jpa.entity.TermConceptParentChildLink.RelationshipTypeEnum;
-import ca.uhn.fhir.jpa.model.entity.BaseHasResource;
 import ca.uhn.fhir.jpa.model.entity.ResourceTable;
 import ca.uhn.fhir.jpa.searchparam.SearchParameterMap;
 import ca.uhn.fhir.jpa.util.LogicUtil;
@@ -52,8 +52,7 @@ import java.util.Date;
 import java.util.List;
 import java.util.Set;
 
-import static org.apache.commons.lang3.StringUtils.isBlank;
+import static org.apache.commons.lang3.StringUtils.*;
-import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 public class FhirResourceDaoCodeSystemR4 extends FhirResourceDaoR4<CodeSystem> implements IFhirResourceDaoCodeSystem<CodeSystem, Coding, CodeableConcept> {
 
@@ -168,6 +167,21 @@ public class FhirResourceDaoCodeSystemR4 extends FhirResourceDaoR4<CodeSystem> i
 				termConcept.setDisplay(next.getDisplay());
 				termConcept.addChildren(toPersistedConcepts(next.getConcept(), theCodeSystemVersion), RelationshipTypeEnum.ISA);
 				retVal.add(termConcept);
+
+				for (CodeSystem.ConceptDefinitionDesignationComponent designationComponent : next.getDesignation()) {
+					if (isNotBlank(designationComponent.getValue())) {
+						TermConceptDesignation designation = termConcept.addDesignation();
+						designation.setLanguage(designationComponent.hasLanguage() ? designationComponent.getLanguage() : null);
+						if (designationComponent.hasUse()) {
+							designation.setUseSystem(designationComponent.getUse().hasSystem() ? designationComponent.getUse().getSystem() : null);
+							designation.setUseCode(designationComponent.getUse().hasCode() ? designationComponent.getUse().getCode() : null);
+							designation.setUseDisplay(designationComponent.getUse().hasDisplay() ? designationComponent.getUse().getDisplay() : null);
+						}
+						designation.setValue(designationComponent.getValue());
+					}
+				}
+
+				// TODO: DM 2019-07-16 - We should also populate TermConceptProperty entities here.
 			}
 		}
 

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermConceptDesignation.java

@@ -103,7 +103,6 @@ public class TermConceptDesignation implements Serializable {
 	public TermConceptDesignation setUseSystem(String theUseSystem) {
 		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theUseSystem, MAX_LENGTH,
 			"Use system exceeds maximum length (" + MAX_LENGTH + "): " + length(theUseSystem));
-
 		myUseSystem = theUseSystem;
 		return this;
 	}

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSet.java

@@ -66,7 +66,7 @@ public class TermValueSet implements Serializable {
 	private String myName;
 
 	@OneToMany(mappedBy = "myValueSet")
-	private List<TermValueSetCode> myCodes;
+	private List<TermValueSetConcept> myConcepts;
 
 	public Long getId() {
 		return myId;
@@ -102,12 +102,12 @@ public class TermValueSet implements Serializable {
 		return this;
 	}
 
-	public List<TermValueSetCode> getCodes() {
+	public List<TermValueSetConcept> getConcepts() {
-		if (myCodes == null) {
+		if (myConcepts == null) {
-			myCodes = new ArrayList<>();
+			myConcepts = new ArrayList<>();
 		}
 
-		return myCodes;
+		return myConcepts;
 	}
 
 	@Override
@@ -138,7 +138,7 @@ public class TermValueSet implements Serializable {
 			.append(myResource != null ? ("myResource=" + myResource.toString()) : ("myResource=(null)"))
 			.append("myResourcePid", myResourcePid)
 			.append("myName", myName)
-			.append(myCodes != null ? ("myCodes - size=" + myCodes.size()) : ("myCodes=(null)"))
+			.append(myConcepts != null ? ("myConcepts - size=" + myConcepts.size()) : ("myConcepts=(null)"))
 			.toString();
 	}
 }

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConcept.java

@@ -29,20 +29,22 @@ import org.apache.commons.lang3.builder.ToStringStyle;
 import javax.annotation.Nonnull;
 import javax.persistence.*;
 import java.io.Serializable;
+import java.util.ArrayList;
+import java.util.List;
 
 import static org.apache.commons.lang3.StringUtils.left;
 import static org.apache.commons.lang3.StringUtils.length;
 
-@Table(name = "TRM_VALUESET_CODE", indexes = {
+@Table(name = "TRM_VALUESET_CONCEPT", indexes = {
-	@Index(name = "IDX_VALUESET_CODE_CS_CD", columnList = "SYSTEM, CODE")
+	@Index(name = "IDX_VALUESET_CONCEPT_CS_CD", columnList = "SYSTEM, CODE")
 })
 @Entity()
-public class TermValueSetCode implements Serializable {
+public class TermValueSetConcept implements Serializable {
 	private static final long serialVersionUID = 1L;
 
 	@Id()
-	@SequenceGenerator(name = "SEQ_VALUESET_CODE_PID", sequenceName = "SEQ_VALUESET_CODE_PID")
+	@SequenceGenerator(name = "SEQ_VALUESET_CONCEPT_PID", sequenceName = "SEQ_VALUESET_CONCEPT_PID")
-	@GeneratedValue(strategy = GenerationType.AUTO, generator = "SEQ_VALUESET_CODE_PID")
+	@GeneratedValue(strategy = GenerationType.AUTO, generator = "SEQ_VALUESET_CONCEPT_PID")
 	@Column(name = "PID")
 	private Long myId;
 
@@ -65,6 +67,9 @@ public class TermValueSetCode implements Serializable {
 	@Column(name = "DISPLAY", nullable = true, length = TermConcept.MAX_DESC_LENGTH)
 	private String myDisplay;
 
+	@OneToMany(mappedBy = "myConcept")
+	private List<TermValueSetConceptDesignation> myDesignations;
+
 	public Long getId() {
 		return myId;
 	}
@@ -73,7 +78,7 @@ public class TermValueSetCode implements Serializable {
 		return myValueSet;
 	}
 
-	public TermValueSetCode setValueSet(TermValueSet theValueSet) {
+	public TermValueSetConcept setValueSet(TermValueSet theValueSet) {
 		myValueSet = theValueSet;
 		return this;
 	}
@@ -98,7 +103,7 @@ public class TermValueSetCode implements Serializable {
 		return mySystem;
 	}
 
-	public TermValueSetCode setSystem(@Nonnull String theSystem) {
+	public TermValueSetConcept setSystem(@Nonnull String theSystem) {
 		ValidateUtil.isNotBlankOrThrowIllegalArgument(theSystem, "theSystem must not be null or empty");
 		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theSystem, TermCodeSystem.MAX_URL_LENGTH,
 			"System exceeds maximum length (" + TermCodeSystem.MAX_URL_LENGTH + "): " + length(theSystem));
@@ -110,7 +115,7 @@ public class TermValueSetCode implements Serializable {
 		return myCode;
 	}
 
-	public TermValueSetCode setCode(@Nonnull String theCode) {
+	public TermValueSetConcept setCode(@Nonnull String theCode) {
 		ValidateUtil.isNotBlankOrThrowIllegalArgument(theCode, "theCode must not be null or empty");
 		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theCode, TermConcept.MAX_CODE_LENGTH,
 			"Code exceeds maximum length (" + TermConcept.MAX_CODE_LENGTH + "): " + length(theCode));
@@ -122,18 +127,26 @@ public class TermValueSetCode implements Serializable {
 		return myDisplay;
 	}
 
-	public TermValueSetCode setDisplay(String theDisplay) {
+	public TermValueSetConcept setDisplay(String theDisplay) {
 		myDisplay = left(theDisplay, TermConcept.MAX_DESC_LENGTH);
 		return this;
 	}
 
+	public List<TermValueSetConceptDesignation> getDesignations() {
+		if (myDesignations == null) {
+			myDesignations = new ArrayList<>();
+		}
+
+		return myDesignations;
+	}
+
 	@Override
 	public boolean equals(Object theO) {
 		if (this == theO) return true;
 
-		if (!(theO instanceof TermValueSetCode)) return false;
+		if (!(theO instanceof TermValueSetConcept)) return false;
 
-		TermValueSetCode that = (TermValueSetCode) theO;
+		TermValueSetConcept that = (TermValueSetConcept) theO;
 
 		return new EqualsBuilder()
 			.append(getValueSetUrl(), that.getValueSetUrl())
@@ -161,6 +174,7 @@ public class TermValueSetCode implements Serializable {
 			.append("mySystem", mySystem)
 			.append("myCode", myCode)
 			.append("myDisplay", myDisplay)
+			.append(myDesignations != null ? ("myDesignations - size=" + myDesignations.size()) : ("myDesignations=(null)"))
 			.toString();
 	}
 }

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/entity/TermValueSetConceptDesignation.java

@@ -0,0 +1,177 @@
+package ca.uhn.fhir.jpa.entity;
+
+/*
+ * #%L
+ * HAPI FHIR JPA Server
+ * %%
+ * Copyright (C) 2014 - 2019 University Health Network
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+
+import ca.uhn.fhir.util.ValidateUtil;
+import org.apache.commons.lang3.builder.EqualsBuilder;
+import org.apache.commons.lang3.builder.HashCodeBuilder;
+import org.apache.commons.lang3.builder.ToStringBuilder;
+import org.apache.commons.lang3.builder.ToStringStyle;
+
+import javax.annotation.Nonnull;
+import javax.persistence.*;
+import java.io.Serializable;
+
+import static org.apache.commons.lang3.StringUtils.left;
+import static org.apache.commons.lang3.StringUtils.length;
+
+@Table(name = "TRM_VALUESET_C_DESIGNATION", indexes = {
+	@Index(name = "IDX_VALUESET_C_DSGNTN_VAL", columnList = "VAL")
+})
+@Entity()
+public class TermValueSetConceptDesignation implements Serializable {
+	private static final long serialVersionUID = 1L;
+
+	public static final int MAX_LENGTH = 500;
+
+	@Id()
+	@SequenceGenerator(name = "SEQ_VALUESET_C_DSGNTN_PID", sequenceName = "SEQ_VALUESET_C_DSGNTN_PID")
+	@GeneratedValue(strategy = GenerationType.AUTO, generator = "SEQ_VALUESET_C_DSGNTN_PID")
+	@Column(name = "PID")
+	private Long myId;
+
+	@ManyToOne()
+	@JoinColumn(name = "VALUESET_CONCEPT_PID", referencedColumnName = "PID", nullable = false, foreignKey = @ForeignKey(name = "FK_TRM_VALUESET_CONCEPT_PID"))
+	private TermValueSetConcept myConcept;
+
+	@Column(name = "LANG", nullable = true, length = MAX_LENGTH)
+	private String myLanguage;
+
+	@Column(name = "USE_SYSTEM", nullable = true, length = MAX_LENGTH)
+	private String myUseSystem;
+
+	@Column(name = "USE_CODE", nullable = true, length = MAX_LENGTH)
+	private String myUseCode;
+
+	@Column(name = "USE_DISPLAY", nullable = true, length = MAX_LENGTH)
+	private String myUseDisplay;
+
+	@Column(name = "VAL", nullable = false, length = MAX_LENGTH)
+	private String myValue;
+
+	public Long getId() {
+		return myId;
+	}
+
+	public TermValueSetConcept getConcept() {
+		return myConcept;
+	}
+
+	public TermValueSetConceptDesignation setConcept(TermValueSetConcept theConcept) {
+		myConcept = theConcept;
+		return this;
+	}
+
+	public String getLanguage() {
+		return myLanguage;
+	}
+
+	public TermValueSetConceptDesignation setLanguage(String theLanguage) {
+		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theLanguage, MAX_LENGTH,
+			"Language exceeds maximum length (" + MAX_LENGTH + "): " + length(theLanguage));
+		myLanguage = theLanguage;
+		return this;
+	}
+
+	public String getUseSystem() {
+		return myUseSystem;
+	}
+
+	public TermValueSetConceptDesignation setUseSystem(String theUseSystem) {
+		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theUseSystem, MAX_LENGTH,
+			"Use system exceeds maximum length (" + MAX_LENGTH + "): " + length(theUseSystem));
+		myUseSystem = theUseSystem;
+		return this;
+	}
+
+	public String getUseCode() {
+		return myUseCode;
+	}
+
+	public TermValueSetConceptDesignation setUseCode(String theUseCode) {
+		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theUseCode, MAX_LENGTH,
+			"Use code exceeds maximum length (" + MAX_LENGTH + "): " + length(theUseCode));
+		myUseCode = theUseCode;
+		return this;
+	}
+
+	public String getUseDisplay() {
+		return myUseDisplay;
+	}
+
+	public TermValueSetConceptDesignation setUseDisplay(String theUseDisplay) {
+		myUseDisplay = left(theUseDisplay, MAX_LENGTH);
+		return this;
+	}
+
+	public String getValue() {
+		return myValue;
+	}
+
+	public TermValueSetConceptDesignation setValue(@Nonnull String theValue) {
+		ValidateUtil.isNotBlankOrThrowIllegalArgument(theValue, "theValue must not be null or empty");
+		ValidateUtil.isNotTooLongOrThrowIllegalArgument(theValue, MAX_LENGTH,
+			"Value exceeds maximum length (" + MAX_LENGTH + "): " + length(theValue));
+		myValue = theValue;
+		return this;
+	}
+
+	@Override
+	public boolean equals(Object theO) {
+		if (this == theO) return true;
+
+		if (!(theO instanceof TermValueSetConceptDesignation)) return false;
+
+		TermValueSetConceptDesignation that = (TermValueSetConceptDesignation) theO;
+
+		return new EqualsBuilder()
+			.append(getLanguage(), that.getLanguage())
+			.append(getUseSystem(), that.getUseSystem())
+			.append(getUseCode(), that.getUseCode())
+			.append(getUseDisplay(), that.getUseDisplay())
+			.append(getValue(), that.getValue())
+			.isEquals();
+	}
+
+	@Override
+	public int hashCode() {
+		return new HashCodeBuilder(17, 37)
+			.append(getLanguage())
+			.append(getUseSystem())
+			.append(getUseCode())
+			.append(getUseDisplay())
+			.append(getValue())
+			.toHashCode();
+	}
+
+	@Override
+	public String toString() {
+		return new ToStringBuilder(this, ToStringStyle.SHORT_PREFIX_STYLE)
+			.append("myId", myId)
+			.append(myConcept != null ? ("myConcept - id=" + myConcept.getId()) : ("myConcept=(null)"))
+			.append("myLanguage", myLanguage)
+			.append("myUseSystem", myUseSystem)
+			.append("myUseCode", myUseCode)
+			.append("myUseDisplay", myUseDisplay)
+			.append("myValue", myValue)
+			.toString();
+	}
+}

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/BaseHapiTerminologySvcImpl.java

@@ -91,8 +91,7 @@ import java.util.concurrent.atomic.AtomicInteger;
 import java.util.function.Supplier;
 import java.util.stream.Collectors;
 
-import static org.apache.commons.lang3.StringUtils.isBlank;
+import static org.apache.commons.lang3.StringUtils.*;
-import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc, ApplicationContextAware {
 	public static final int DEFAULT_FETCH_SIZE = 250;
@@ -121,7 +120,9 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 	@Autowired
 	protected ITermValueSetDao myValueSetDao;
 	@Autowired
-	protected ITermValueSetCodeDao myValueSetCodeDao;
+	protected ITermValueSetConceptDao myValueSetConceptDao;
+	@Autowired
+	protected ITermValueSetConceptDesignationDao myValueSetConceptDesignationDao;
 	@Autowired
 	protected FhirContext myContext;
 	@PersistenceContext(type = PersistenceContextType.TRANSACTION)
@@ -152,54 +153,39 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 	@Autowired(required = false)
 	private IFulltextSearchSvc myFulltextSearchSvc;
 
-
+	private void addCodeIfNotAlreadyAdded(IValueSetCodeAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, TermConcept theConcept, boolean theAdd, AtomicInteger theCodeCounter) {
-	private void addCodeIfNotAlreadyAdded(ValueSet.ValueSetExpansionComponent theExpansionComponent, Set<String> theAddedCodes, TermConcept theConcept, boolean theAdd, AtomicInteger theCodeCounter) {
 		String codeSystem = theConcept.getCodeSystemVersion().getCodeSystem().getCodeSystemUri();
 		String code = theConcept.getCode();
 		String display = theConcept.getDisplay();
 		Collection<TermConceptDesignation> designations = theConcept.getDesignations();
-		addCodeIfNotAlreadyAdded(theExpansionComponent, theAddedCodes, designations, theAdd, theCodeCounter, codeSystem, code, display);
+		addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, designations, theAdd, theCodeCounter, codeSystem, code, display);
 	}
 
-	private void addCodeIfNotAlreadyAdded(ValueSet.ValueSetExpansionComponent theExpansionComponent, Set<String> theAddedCodes, Collection<TermConceptDesignation> theDesignations, boolean theAdd, AtomicInteger theCodeCounter, String theCodeSystem, String theCode, String theDisplay) {
+	private void addCodeIfNotAlreadyAdded(IValueSetCodeAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, Collection<TermConceptDesignation> theDesignations, boolean theAdd, AtomicInteger theCodeCounter, String theCodeSystem, String theCode, String theDisplay) {
-		if (isNotBlank(theCode) && theAdd && theAddedCodes.add(theCode)) {
+		if (isNoneBlank(theCodeSystem, theCode)) {
-			ValueSet.ValueSetExpansionContainsComponent contains = theExpansionComponent.addContains();
+			if (theAdd && theAddedCodes.add(theCodeSystem + "|" + theCode)) {
-			contains.setCode(theCode);
+				theValueSetCodeAccumulator.includeCodeWithDesignations(theCodeSystem, theCode, theDisplay, theDesignations);
-			contains.setSystem(theCodeSystem);
+				theCodeCounter.incrementAndGet();
-			contains.setDisplay(theDisplay);
+			}
-			if (theDesignations != null) {
+
-				for (TermConceptDesignation nextDesignation : theDesignations) {
+			if (!theAdd && theAddedCodes.remove(theCodeSystem + "|" + theCode)) {
-					contains
+				theValueSetCodeAccumulator.excludeCode(theCodeSystem, theCode);
-						.addDesignation()
+				theCodeCounter.decrementAndGet();
-						.setValue(nextDesignation.getValue())
+			}
-						.getUse()
+		}
-						.setSystem(nextDesignation.getUseSystem())
+	}
-						.setCode(nextDesignation.getUseCode())
+
-						.setDisplay(nextDesignation.getUseDisplay());
+	private void addConceptsToList(IValueSetCodeAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, String theSystem, List<CodeSystem.ConceptDefinitionComponent> theConcept, boolean theAdd) {
+		for (CodeSystem.ConceptDefinitionComponent next : theConcept) {
+			if (isNoneBlank(theSystem, next.getCode())) {
+				if (theAdd && theAddedCodes.add(theSystem + "|" + next.getCode())) {
+					theValueSetCodeAccumulator.includeCode(theSystem, next.getCode(), next.getDisplay());
+				}
+				if (!theAdd && theAddedCodes.remove(theSystem + "|" + next.getCode())) {
+					theValueSetCodeAccumulator.excludeCode(theSystem, next.getCode());
 				}
 			}
-
+			addConceptsToList(theValueSetCodeAccumulator, theAddedCodes, theSystem, next.getConcept(), theAdd);
-			theCodeCounter.incrementAndGet();
-		}
-
-		if (!theAdd && theAddedCodes.remove(theCode)) {
-			removeCodeFromExpansion(theCodeSystem, theCode, theExpansionComponent);
-			theCodeCounter.decrementAndGet();
-		}
-	}
-
-	private void addConceptsToList(ValueSet.ValueSetExpansionComponent theExpansionComponent, Set<String> theAddedCodes, String theSystem, List<CodeSystem.ConceptDefinitionComponent> theConcept, boolean theAdd) {
-		for (CodeSystem.ConceptDefinitionComponent next : theConcept) {
-			if (theAdd && theAddedCodes.add(next.getCode())) {
-				ValueSet.ValueSetExpansionContainsComponent contains = theExpansionComponent.addContains();
-				contains.setCode(next.getCode());
-				contains.setSystem(theSystem);
-				contains.setDisplay(next.getDisplay());
-			}
-			if (!theAdd && theAddedCodes.remove(next.getCode())) {
-				removeCodeFromExpansion(theSystem, next.getCode(), theExpansionComponent);
-			}
-			addConceptsToList(theExpansionComponent, theAddedCodes, theSystem, next.getConcept(), theAdd);
 		}
 	}
 
@@ -400,12 +386,14 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 			TermValueSet existingTermValueSet = optionalExistingTermValueSetById.get();
 
 			ourLog.info("Deleting existing TermValueSet {} and its children...", existingTermValueSet.getId());
-			myValueSetCodeDao.deleteTermValueSetCodesByValueSetId(existingTermValueSet.getId());
+			myValueSetConceptDesignationDao.deleteTermValueSetConceptDesignationsByValueSetId(existingTermValueSet.getId());
+			myValueSetConceptDao.deleteTermValueSetConceptsByValueSetId(existingTermValueSet.getId());
 			myValueSetDao.deleteTermValueSetById(existingTermValueSet.getId());
 			ourLog.info("Done deleting existing TermValueSet {} and its children.", existingTermValueSet.getId());
 
 			ourLog.info("Flushing...");
-			myValueSetCodeDao.flush();
+			myValueSetConceptDesignationDao.flush();
+			myValueSetConceptDao.flush();
 			myValueSetDao.flush();
 			ourLog.info("Done flushing.");
 		}
@@ -466,26 +454,13 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 	@Transactional(propagation = Propagation.REQUIRED)
 	public ValueSet expandValueSet(ValueSet theValueSetToExpand) {
 
-		ValueSet.ValueSetExpansionComponent expansionComponent = new ValueSet.ValueSetExpansionComponent();
+		ValueSetExpansionComponentWithCodeAccumulator expansionComponent = new ValueSetExpansionComponentWithCodeAccumulator();
 		expansionComponent.setIdentifier(UUID.randomUUID().toString());
 		expansionComponent.setTimestamp(new Date());
 
-		Set<String> addedCodes = new HashSet<>();
 		AtomicInteger codeCounter = new AtomicInteger(0);
 
-		// Handle includes
+		expandValueSet(theValueSetToExpand, expansionComponent, codeCounter);
-		ourLog.debug("Handling includes");
-		for (ValueSet.ConceptSetComponent include : theValueSetToExpand.getCompose().getInclude()) {
-			boolean add = true;
-			expandValueSetHandleIncludeOrExclude(expansionComponent, addedCodes, include, add, codeCounter);
-		}
-
-		// Handle excludes
-		ourLog.debug("Handling excludes");
-		for (ValueSet.ConceptSetComponent include : theValueSetToExpand.getCompose().getExclude()) {
-			boolean add = false;
-			expandValueSetHandleIncludeOrExclude(expansionComponent, addedCodes, include, add, codeCounter);
-		}
 
 		expansionComponent.setTotal(codeCounter.get());
 
@@ -496,6 +471,30 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 		return valueSet;
 	}
 
+	@Override
+	@Transactional(propagation = Propagation.REQUIRED)
+	public void expandValueSet(ValueSet theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator) {
+		expandValueSet(theValueSetToExpand, theValueSetCodeAccumulator, new AtomicInteger(0));
+	}
+
+	private void expandValueSet(ValueSet theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator, AtomicInteger theCodeCounter) {
+		Set<String> addedCodes = new HashSet<>();
+
+		// Handle includes
+		ourLog.debug("Handling includes");
+		for (ValueSet.ConceptSetComponent include : theValueSetToExpand.getCompose().getInclude()) {
+			boolean add = true;
+			expandValueSetHandleIncludeOrExclude(theValueSetCodeAccumulator, addedCodes, include, add, theCodeCounter);
+		}
+
+		// Handle excludes
+		ourLog.debug("Handling excludes");
+		for (ValueSet.ConceptSetComponent include : theValueSetToExpand.getCompose().getExclude()) {
+			boolean add = false;
+			expandValueSetHandleIncludeOrExclude(theValueSetCodeAccumulator, addedCodes, include, add, theCodeCounter);
+		}
+	}
+
 	protected List<VersionIndependentConcept> expandValueSetAndReturnVersionIndependentConcepts(org.hl7.fhir.r4.model.ValueSet theValueSetToExpandR4) {
 		org.hl7.fhir.r4.model.ValueSet.ValueSetExpansionComponent expandedR4 = expandValueSet(theValueSetToExpandR4).getExpansion();
 
@@ -507,7 +506,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 		return retVal;
 	}
 
-	public void expandValueSetHandleIncludeOrExclude(ValueSet.ValueSetExpansionComponent theExpansionComponent, Set<String> theAddedCodes, ValueSet.ConceptSetComponent theInclude, boolean theAdd, AtomicInteger theCodeCounter) {
+	private void expandValueSetHandleIncludeOrExclude(IValueSetCodeAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, ValueSet.ConceptSetComponent theInclude, boolean theAdd, AtomicInteger theCodeCounter) {
 		String system = theInclude.getSystem();
 		boolean hasSystem = isNotBlank(system);
 		boolean hasValueSet = theInclude.getValueSet().size() > 0;
@@ -525,7 +524,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 				 * since we're going to do it without the database.
 				 */
 				if (myFulltextSearchSvc == null) {
-					expandWithoutHibernateSearch(theExpansionComponent, theAddedCodes, theInclude, system, theAdd, theCodeCounter);
+					expandWithoutHibernateSearch(theValueSetCodeAccumulator, theAddedCodes, theInclude, system, theAdd, theCodeCounter);
 					return;
 				}
 
@@ -649,7 +648,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 				for (Object next : jpaQuery.getResultList()) {
 					count.incrementAndGet();
 					TermConcept concept = (TermConcept) next;
-					addCodeIfNotAlreadyAdded(theExpansionComponent, theAddedCodes, concept, theAdd, theCodeCounter);
+					addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, concept, theAdd, theCodeCounter);
 				}
 
 
@@ -670,24 +669,21 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 				if (theInclude.getConcept().isEmpty() == false) {
 					for (ValueSet.ConceptReferenceComponent next : theInclude.getConcept()) {
 						String nextCode = next.getCode();
-						if (isNotBlank(nextCode) && !theAddedCodes.contains(nextCode)) {
+						if (isNoneBlank(system, nextCode) && !theAddedCodes.contains(system + "|" + nextCode)) {
 							CodeSystem.ConceptDefinitionComponent code = findCode(codeSystemFromContext.getConcept(), nextCode);
 							if (code != null) {
-								if (theAdd && theAddedCodes.add(nextCode)) {
+								if (theAdd && theAddedCodes.add(system + "|" + nextCode)) {
-									ValueSet.ValueSetExpansionContainsComponent contains = theExpansionComponent.addContains();
+									theValueSetCodeAccumulator.includeCode(system, nextCode, code.getDisplay());
-									contains.setCode(nextCode);
-									contains.setSystem(system);
-									contains.setDisplay(code.getDisplay());
 								}
-								if (!theAdd && theAddedCodes.remove(nextCode)) {
+								if (!theAdd && theAddedCodes.remove(system + "|" + nextCode)) {
-									removeCodeFromExpansion(system, nextCode, theExpansionComponent);
+									theValueSetCodeAccumulator.excludeCode(system, nextCode);
 								}
 							}
 						}
 					}
 				} else {
 					List<CodeSystem.ConceptDefinitionComponent> concept = codeSystemFromContext.getConcept();
-					addConceptsToList(theExpansionComponent, theAddedCodes, system, concept, theAdd);
+					addConceptsToList(theValueSetCodeAccumulator, theAddedCodes, system, concept, theAdd);
 				}
 
 			}
@@ -702,12 +698,12 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 						myConceptDao
 							.findByCodeSystemAndCode(codeSystem.getCurrentVersion(), nextConcept.getCode())
 							.ifPresent(concept ->
-								addCodeIfNotAlreadyAdded(theExpansionComponent, theAddedCodes, concept, theAdd, theCodeCounter)
+								addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, concept, theAdd, theCodeCounter)
 							);
 
 					}
-					if (!theAdd && theAddedCodes.remove(nextConcept.getCode())) {
+					if (isNoneBlank(nextConcept.getSystem(), nextConcept.getCode()) && !theAdd && theAddedCodes.remove(nextConcept.getSystem() + "|" + nextConcept.getCode())) {
-						removeCodeFromExpansion(nextConcept.getSystem(), nextConcept.getCode(), theExpansionComponent);
+						theValueSetCodeAccumulator.excludeCode(nextConcept.getSystem(), nextConcept.getCode());
 					}
 				}
 
@@ -717,9 +713,11 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 		}
 	}
 
-	private void expandWithoutHibernateSearch(ValueSet.ValueSetExpansionComponent theExpansionComponent, Set<String> theAddedCodes, ValueSet.ConceptSetComponent theInclude, String theSystem, boolean theAdd, AtomicInteger theCodeCounter) {
+	private void expandWithoutHibernateSearch(IValueSetCodeAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, ValueSet.ConceptSetComponent theInclude, String theSystem, boolean theAdd, AtomicInteger theCodeCounter) {
 		ourLog.trace("Hibernate search is not enabled");
-		Validate.isTrue(theExpansionComponent.getParameter().isEmpty(), "Can not expand ValueSet with parameters - Hibernate Search is not enabled on this server.");
+		if (theValueSetCodeAccumulator instanceof ValueSetExpansionComponentWithCodeAccumulator) {
+			Validate.isTrue(((ValueSetExpansionComponentWithCodeAccumulator) theValueSetCodeAccumulator).getParameter().isEmpty(), "Can not expand ValueSet with parameters - Hibernate Search is not enabled on this server.");
+		}
 		Validate.isTrue(theInclude.getFilter().isEmpty(), "Can not expand ValueSet with filters - Hibernate Search is not enabled on this server.");
 		Validate.isTrue(isNotBlank(theSystem), "Can not expand ValueSet without explicit system - Hibernate Search is not enabled on this server.");
 
@@ -727,7 +725,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 			if (!theSystem.equals(theInclude.getSystem())) {
 				continue;
 			}
-			addCodeIfNotAlreadyAdded(theExpansionComponent, theAddedCodes, null, theAdd, theCodeCounter, theSystem, next.getCode(), next.getDisplay());
+			addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, null, theAdd, theCodeCounter, theSystem, next.getCode(), next.getDisplay());
 		}
 	}
 
@@ -1038,14 +1036,6 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 
 	}
 
-	private void removeCodeFromExpansion(String theCodeSystem, String theCode, ValueSet.ValueSetExpansionComponent theExpansionComponent) {
-		theExpansionComponent
-			.getContains()
-			.removeIf(t ->
-				theCodeSystem.equals(t.getSystem()) &&
-					theCode.equals(t.getCode()));
-	}
-
 	private int saveConcept(TermConcept theConcept) {
 		int retVal = 0;
 
@@ -1144,7 +1134,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 		List<TermCodeSystemVersion> existing = myCodeSystemVersionDao.findByCodeSystemResource(theCodeSystemResourcePid);
 
 		/*
-		 * For now we always delete old versions.. At some point it would be nice to allow configuration to keep old versions
+		 * For now we always delete old versions. At some point it would be nice to allow configuration to keep old versions.
 		 */
 
 		ourLog.info("Deleting old code system versions");
@@ -1318,8 +1308,7 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 						TermConceptMapGroupElement termConceptMapGroupElement;
 						for (ConceptMap.SourceElementComponent element : group.getElement()) {
 							if (isBlank(element.getCode())) {
-								// FIXME: JA - send this to an interceptor message so it can be
+								// FIXME: JA - send this to an interceptor message so it can be output
-								// output
 								continue;
 							}
 							termConceptMapGroupElement = new TermConceptMapGroupElement();
@@ -1386,26 +1375,53 @@ public abstract class BaseHapiTerminologySvcImpl implements IHapiTerminologySvc,
 		Optional<TermValueSet> optionalExistingTermValueSetByUrl = myValueSetDao.findByUrl(url);
 		if (!optionalExistingTermValueSetByUrl.isPresent()) {
 			myValueSetDao.save(termValueSet);
-			int codesSaved = 0;
+			int conceptsSaved = 0;
+			int designationsSaved = 0;
 
+			// FIXME: DM 2019-07-15 - Here we should call expandValueSet(ValueSet theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator).
+			// FIXME: DM 2019-07-15 - We need an implementation IValueSetCodeAccumulator that saves ValueSetConcept records and their children.
 			ValueSet expandedValueSet = expandValueSet(theValueSet);
 			if (expandedValueSet.hasExpansion()) {
 				if (expandedValueSet.getExpansion().hasTotal() && expandedValueSet.getExpansion().getTotal() > 0) {
-					TermValueSetCode code;
+					TermValueSetConcept concept;
 					for (ValueSet.ValueSetExpansionContainsComponent contains : expandedValueSet.getExpansion().getContains()) {
-						ValidateUtil.isNotBlankOrThrowInvalidRequest(contains.getSystem(), "ValueSet contains a code with no system value");
+						ValidateUtil.isNotBlankOrThrowInvalidRequest(contains.getSystem(), "ValueSet contains a concept with no system value");
-						ValidateUtil.isNotBlankOrThrowInvalidRequest(contains.getCode(), "ValueSet contains a code with no code value");
+						ValidateUtil.isNotBlankOrThrowInvalidRequest(contains.getCode(), "ValueSet contains a concept with no code value");
 
-						code = new TermValueSetCode();
+						concept = new TermValueSetConcept();
-						code.setValueSet(termValueSet);
+						concept.setValueSet(termValueSet);
-						code.setSystem(contains.getSystem());
+						concept.setSystem(contains.getSystem());
-						code.setCode(contains.getCode());
+						concept.setCode(contains.getCode());
-						code.setDisplay(contains.hasDisplay() ? contains.getDisplay() : null);
+						concept.setDisplay(contains.hasDisplay() ? contains.getDisplay() : null);
-						myValueSetCodeDao.save(code);
+						myValueSetConceptDao.save(concept);
 
-						if (codesSaved++ % 250 == 0) {
+						TermValueSetConceptDesignation designation;
-							ourLog.info("Have pre-expanded {} codes in ValueSet", codesSaved);
+						for (ValueSet.ConceptReferenceDesignationComponent containedDesignation : contains.getDesignation()) {
-							myValueSetCodeDao.flush();
+							ValidateUtil.isNotBlankOrThrowInvalidRequest(containedDesignation.getValue(), "ValueSet contains a concept designation with no value");
+
+							designation = new TermValueSetConceptDesignation();
+							designation.setConcept(concept);
+							designation.setLanguage(containedDesignation.hasLanguage() ? containedDesignation.getLanguage() : null);
+							if (containedDesignation.hasUse()) {
+								designation.setUseSystem(containedDesignation.getUse().hasSystem() ? containedDesignation.getUse().getSystem() : null);
+								designation.setUseCode(containedDesignation.getUse().hasCode() ? containedDesignation.getUse().getCode() : null);
+								designation.setUseDisplay(containedDesignation.getUse().hasDisplay() ? containedDesignation.getUse().getDisplay() : null);
+							}
+							designation.setValue(containedDesignation.getValue());
+							myValueSetConceptDesignationDao.save(designation);
+
+							if (designationsSaved++ % 250 == 0) {
+								ourLog.info("Have pre-expanded {} designations in ValueSet", designationsSaved);
+								myValueSetConceptDesignationDao.flush();
+							}
+						}
+
+						// TODO: DM 2019-07-16 - We need TermValueSetConceptProperty, similar to TermConceptProperty.
+						// TODO: DM 2019-07-16 - We should also populate TermValueSetConceptProperty entities here.
+
+						if (conceptsSaved++ % 250 == 0) {
+							ourLog.info("Have pre-expanded {} concepts in ValueSet", conceptsSaved);
+							myValueSetConceptDao.flush();
 						}
 					}
 				}

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/HapiTerminologySvcDstu2.java

@@ -86,6 +86,11 @@ public class HapiTerminologySvcDstu2 extends BaseHapiTerminologySvcImpl {
 		throw new UnsupportedOperationException();
 	}
 
+	@Override
+	public void expandValueSet(IBaseResource theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator) {
+		throw new UnsupportedOperationException();
+	}
+
 	@Override
 	public List<VersionIndependentConcept> expandValueSet(String theValueSet) {
 		throw new UnsupportedOperationException();

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/HapiTerminologySvcDstu3.java

@@ -25,8 +25,7 @@ import java.util.Collections;
 import java.util.List;
 import java.util.Optional;
 
-import static org.apache.commons.lang3.StringUtils.isBlank;
+import static org.apache.commons.lang3.StringUtils.*;
-import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 /*
  * #%L
@@ -171,6 +170,19 @@ public class HapiTerminologySvcDstu3 extends BaseHapiTerminologySvcImpl implemen
 		}
 	}
 
+	@Override
+	public void expandValueSet(IBaseResource theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator) {
+		ValueSet valueSetToExpand = (ValueSet) theValueSetToExpand;
+
+		try {
+			org.hl7.fhir.r4.model.ValueSet valueSetToExpandR4;
+			valueSetToExpandR4 = VersionConvertor_30_40.convertValueSet(valueSetToExpand);
+			super.expandValueSet(valueSetToExpandR4, theValueSetCodeAccumulator);
+		} catch (FHIRException e) {
+			throw new InternalErrorException(e);
+		}
+	}
+
 	@Override
 	public List<VersionIndependentConcept> expandValueSet(String theValueSet) {
 		ValueSet vs = myValidationSupport.fetchResource(myContext, ValueSet.class, theValueSet);

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/HapiTerminologySvcR4.java

@@ -131,6 +131,11 @@ public class HapiTerminologySvcR4 extends BaseHapiTerminologySvcImpl implements
 		return super.expandValueSet(valueSetToExpand);
 	}
 
+	@Override
+	public void expandValueSet(IBaseResource theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator) {
+		ValueSet valueSetToExpand = (ValueSet) theValueSetToExpand;
+		super.expandValueSet(valueSetToExpand, theValueSetCodeAccumulator);
+	}
 
 	@Override
 	public ValueSetExpander.ValueSetExpansionOutcome expandValueSet(FhirContext theContext, ConceptSetComponent theInclude) {

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/IHapiTerminologySvc.java

@@ -41,11 +41,15 @@ public interface IHapiTerminologySvc {
 
 	ValueSet expandValueSet(ValueSet theValueSetToExpand);
 
+	void expandValueSet(ValueSet theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator);
+
 	/**
 	 * Version independent
 	 */
 	IBaseResource expandValueSet(IBaseResource theValueSetToExpand);
 
+	void expandValueSet(IBaseResource theValueSetToExpand, IValueSetCodeAccumulator theValueSetCodeAccumulator);
+
 	List<VersionIndependentConcept> expandValueSet(String theValueSet);
 
 	Optional<TermConcept> findCode(String theCodeSystem, String theCode);

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/IValueSetCodeAccumulator.java

@@ -0,0 +1,35 @@
+package ca.uhn.fhir.jpa.term;
+
+/*
+ * #%L
+ * HAPI FHIR JPA Server
+ * %%
+ * Copyright (C) 2014 - 2019 University Health Network
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+
+import ca.uhn.fhir.jpa.entity.TermConceptDesignation;
+
+import java.util.Collection;
+
+public interface IValueSetCodeAccumulator {
+
+	void includeCode(String theSystem, String theCode, String theDisplay);
+
+	void includeCodeWithDesignations(String theSystem, String theCode, String theDisplay, Collection<TermConceptDesignation> theDesignations);
+
+	void excludeCode(String theSystem, String theCode);
+
+}

hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/ValueSetExpansionComponentWithCodeAccumulator.java

@@ -0,0 +1,65 @@
+package ca.uhn.fhir.jpa.term;
+
+/*
+ * #%L
+ * HAPI FHIR JPA Server
+ * %%
+ * Copyright (C) 2014 - 2019 University Health Network
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+
+import ca.uhn.fhir.jpa.entity.TermConceptDesignation;
+import org.hl7.fhir.r4.model.ValueSet;
+
+import java.util.Collection;
+
+public class ValueSetExpansionComponentWithCodeAccumulator extends ValueSet.ValueSetExpansionComponent implements IValueSetCodeAccumulator {
+	@Override
+	public void includeCode(String theSystem, String theCode, String theDisplay) {
+		ValueSet.ValueSetExpansionContainsComponent contains = this.addContains();
+		contains.setSystem(theSystem);
+		contains.setCode(theCode);
+		contains.setDisplay(theDisplay);
+	}
+
+	@Override
+	public void includeCodeWithDesignations(String theSystem, String theCode, String theDisplay, Collection<TermConceptDesignation> theDesignations) {
+		ValueSet.ValueSetExpansionContainsComponent contains = this.addContains();
+		contains.setSystem(theSystem);
+		contains.setCode(theCode);
+		contains.setDisplay(theDisplay);
+		if (theDesignations != null) {
+			for (TermConceptDesignation termConceptDesignation : theDesignations) {
+				contains
+					.addDesignation()
+					.setValue(termConceptDesignation.getValue())
+					.setLanguage(termConceptDesignation.getLanguage())
+					.getUse()
+					.setSystem(termConceptDesignation.getUseSystem())
+					.setCode(termConceptDesignation.getUseCode())
+					.setDisplay(termConceptDesignation.getUseDisplay());
+			}
+		}
+	}
+
+	@Override
+	public void excludeCode(String theSystem, String theCode) {
+		this
+			.getContains()
+			.removeIf(t ->
+				theSystem.equals(t.getSystem()) &&
+					theCode.equals(t.getCode()));
+	}
+}

hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/dstu3/BaseJpaDstu3Test.java

@@ -16,7 +16,6 @@ import ca.uhn.fhir.jpa.search.IStaleSearchDeletingSvc;
 import ca.uhn.fhir.jpa.search.reindex.IResourceReindexingSvc;
 import ca.uhn.fhir.jpa.searchparam.registry.ISearchParamRegistry;
 import ca.uhn.fhir.jpa.sp.ISearchParamPresenceSvc;
-import ca.uhn.fhir.jpa.subscription.SubscriptionInterceptorLoader;
 import ca.uhn.fhir.jpa.term.BaseHapiTerminologySvcImpl;
 import ca.uhn.fhir.jpa.term.IHapiTerminologySvc;
 import ca.uhn.fhir.jpa.util.ResourceCountCache;
@@ -27,7 +26,6 @@ import ca.uhn.fhir.parser.StrictErrorHandler;
 import ca.uhn.fhir.rest.api.Constants;
 import ca.uhn.fhir.rest.api.EncodingEnum;
 import ca.uhn.fhir.rest.server.exceptions.InternalErrorException;
-import ca.uhn.fhir.rest.server.interceptor.IServerInterceptor;
 import ca.uhn.fhir.util.TestUtil;
 import ca.uhn.fhir.util.UrlUtil;
 import org.apache.commons.io.IOUtils;
@@ -59,7 +57,6 @@ import java.io.InputStream;
 import java.util.Map;
 
 import static org.junit.Assert.fail;
-import static org.mockito.Mockito.mock;
 
 @RunWith(SpringJUnit4ClassRunner.class)
 @ContextConfiguration(classes = {TestDstu3Config.class})
@@ -240,6 +237,10 @@ public abstract class BaseJpaDstu3Test extends BaseJpaTest {
 	@Qualifier("myTaskDaoDstu3")
 	protected IFhirResourceDao<Task> myTaskDao;
 	@Autowired
+	protected ITermConceptDao myTermConceptDao;
+	@Autowired
+	protected ITermCodeSystemDao myTermCodeSystemDao;
+	@Autowired
 	protected IHapiTerminologySvc myTermSvc;
 	@Autowired
 	protected PlatformTransactionManager myTransactionMgr;

hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/r4/BaseJpaR4Test.java

@@ -130,6 +130,8 @@ public abstract class BaseJpaR4Test extends BaseJpaTest {
 	@Autowired
 	protected ITermConceptDao myTermConceptDao;
 	@Autowired
+	protected ITermConceptDesignationDao myTermConceptDesignationDao;
+	@Autowired
 	@Qualifier("myConditionDaoR4")
 	protected IFhirResourceDao<Condition> myConditionDao;
 	@Autowired
@@ -293,7 +295,9 @@ public abstract class BaseJpaR4Test extends BaseJpaTest {
 	@Autowired
 	protected ITermValueSetDao myTermValueSetDao;
 	@Autowired
-	protected ITermValueSetCodeDao myTermValueSetCodeDao;
+	protected ITermValueSetConceptDao myTermValueSetConceptDao;
+	@Autowired
+	protected ITermValueSetConceptDesignationDao myTermValueSetConceptDesignationDao;
 	@Autowired
 	protected ITermConceptMapDao myTermConceptMapDao;
 	@Autowired

hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplDstu3Test.java

@@ -1,12 +1,12 @@
 package ca.uhn.fhir.jpa.term;
 
 import ca.uhn.fhir.jpa.dao.DaoConfig;
-import ca.uhn.fhir.jpa.dao.data.ITermCodeSystemDao;
 import ca.uhn.fhir.jpa.dao.dstu3.BaseJpaDstu3Test;
-import ca.uhn.fhir.jpa.model.entity.ResourceTable;
+import ca.uhn.fhir.jpa.entity.TermCodeSystem;
 import ca.uhn.fhir.jpa.entity.TermCodeSystemVersion;
 import ca.uhn.fhir.jpa.entity.TermConcept;
 import ca.uhn.fhir.jpa.entity.TermConceptParentChildLink.RelationshipTypeEnum;
+import ca.uhn.fhir.jpa.model.entity.ResourceTable;
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.rest.server.exceptions.UnprocessableEntityException;
 import ca.uhn.fhir.util.TestUtil;
@@ -19,7 +19,11 @@ import org.hl7.fhir.r4.model.ValueSet;
 import org.junit.After;
 import org.junit.AfterClass;
 import org.junit.Test;
-import org.springframework.beans.factory.annotation.Autowired;
+import org.slf4j.Logger;
+import org.slf4j.LoggerFactory;
+import org.springframework.transaction.TransactionStatus;
+import org.springframework.transaction.support.TransactionCallbackWithoutResult;
+import org.springframework.transaction.support.TransactionTemplate;
 
 import java.util.ArrayList;
 import java.util.List;
@@ -30,11 +34,13 @@ import static org.hamcrest.Matchers.*;
 import static org.junit.Assert.*;
 
 public class TerminologySvcImplDstu3Test extends BaseJpaDstu3Test {
+	private static final Logger ourLog = LoggerFactory.getLogger(TerminologySvcImplDstu3Test.class);
 
 	private static final String CS_URL = "http://example.com/my_code_system";
 	private static final String CS_URL_2 = "http://example.com/my_code_system2";
-	@Autowired
+
-	private ITermCodeSystemDao myTermCodeSystemDao;
+	private IIdType myExtensionalCsId;
+	private IIdType myExtensionalVsId;
 
 	@After
 	public void after() {
@@ -76,6 +82,7 @@ public class TerminologySvcImplDstu3Test extends BaseJpaDstu3Test {
 		childAAB.addPropertyString("propA", "valueAAB");
 		childAAB.addPropertyString("propB", "foo");
 		childAAB.addDesignation()
+			.setLanguage("D1L")
 			.setUseSystem("D1S")
 			.setUseCode("D1C")
 			.setUseDisplay("D1D")
@@ -546,13 +553,13 @@ public class TerminologySvcImplDstu3Test extends BaseJpaDstu3Test {
 		assertEquals("childAAB", concept.getCode());
 		assertEquals("http://example.com/my_code_system", concept.getSystem());
 		assertEquals(null, concept.getDisplay());
+		assertEquals("D1L", concept.getDesignation().get(0).getLanguage());
 		assertEquals("D1S", concept.getDesignation().get(0).getUse().getSystem());
 		assertEquals("D1C", concept.getDesignation().get(0).getUse().getCode());
 		assertEquals("D1D", concept.getDesignation().get(0).getUse().getDisplay());
 		assertEquals("D1V", concept.getDesignation().get(0).getValue());
 	}
 
-
 	@Test
 	public void testStoreCodeSystemInvalidCyclicLoop() {
 		CodeSystem codeSystem = new CodeSystem();
@@ -585,6 +592,103 @@ public class TerminologySvcImplDstu3Test extends BaseJpaDstu3Test {
 		}
 	}
 
+	@Test
+	public void testStoreTermCodeSystemAndNestedChildren() {
+		IIdType codeSystemId = createCodeSystem();
+		CodeSystem codeSystemResource = myCodeSystemDao.read(codeSystemId);
+		ourLog.info("CodeSystem:\n" + myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(codeSystemResource));
+
+		new TransactionTemplate(myTxManager).execute(new TransactionCallbackWithoutResult() {
+			@Override
+			protected void doInTransactionWithoutResult(TransactionStatus theStatus) {
+				TermCodeSystem codeSystem = myTermCodeSystemDao.findByResourcePid(codeSystemId.getIdPartAsLong());
+				assertEquals(CS_URL, codeSystem.getCodeSystemUri());
+				assertEquals("SYSTEM NAME", codeSystem.getName());
+
+				TermCodeSystemVersion codeSystemVersion = codeSystem.getCurrentVersion();
+				assertEquals(9, codeSystemVersion.getConcepts().size());
+
+				List<TermConcept> concepts = myTermConceptDao.findByCodeSystemVersion(codeSystemVersion);
+
+				TermConcept parentWithNoChildrenA = concepts.get(0);
+				assertEquals("ParentWithNoChildrenA", parentWithNoChildrenA.getCode());
+				assertNull(parentWithNoChildrenA.getDisplay());
+				assertEquals(0, parentWithNoChildrenA.getChildren().size());
+				assertEquals(0, parentWithNoChildrenA.getParents().size());
+				assertEquals(0, parentWithNoChildrenA.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenA.getProperties().size());
+
+				TermConcept parentWithNoChildrenB = concepts.get(1);
+				assertEquals("ParentWithNoChildrenB", parentWithNoChildrenB.getCode());
+				assertNull(parentWithNoChildrenB.getDisplay());
+				assertEquals(0, parentWithNoChildrenB.getChildren().size());
+				assertEquals(0, parentWithNoChildrenB.getParents().size());
+				assertEquals(0, parentWithNoChildrenB.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenB.getProperties().size());
+
+				TermConcept parentWithNoChildrenC = concepts.get(2);
+				assertEquals("ParentWithNoChildrenC", parentWithNoChildrenC.getCode());
+				assertNull(parentWithNoChildrenC.getDisplay());
+				assertEquals(0, parentWithNoChildrenC.getChildren().size());
+				assertEquals(0, parentWithNoChildrenC.getParents().size());
+				assertEquals(0, parentWithNoChildrenC.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenC.getProperties().size());
+
+				TermConcept parentA = concepts.get(3);
+				assertEquals("ParentA", parentA.getCode());
+				assertNull(parentA.getDisplay());
+				assertEquals(2, parentA.getChildren().size());
+				assertEquals(0, parentA.getParents().size());
+				assertEquals(0, parentA.getDesignations().size());
+				assertEquals(0, parentA.getProperties().size());
+
+				TermConcept childAA = concepts.get(4);
+				assertEquals("childAA", childAA.getCode());
+				assertNull(childAA.getDisplay());
+				assertEquals(2, childAA.getChildren().size());
+				assertEquals(1, childAA.getParents().size());
+				assertSame(parentA, childAA.getParents().iterator().next().getParent());
+				assertEquals(0, childAA.getDesignations().size());
+				assertEquals(0, childAA.getProperties().size());
+
+				TermConcept childAAA = concepts.get(5);
+				assertEquals("childAAA", childAAA.getCode());
+				assertNull(childAAA.getDisplay());
+				assertEquals(0, childAAA.getChildren().size());
+				assertEquals(1, childAAA.getParents().size());
+				assertSame(childAA, childAAA.getParents().iterator().next().getParent());
+				assertEquals(0, childAAA.getDesignations().size());
+				assertEquals(2, childAAA.getProperties().size());
+
+				TermConcept childAAB = concepts.get(6);
+				assertEquals("childAAB", childAAB.getCode());
+				assertNull(childAAB.getDisplay());
+				assertEquals(0, childAAB.getChildren().size());
+				assertEquals(1, childAAB.getParents().size());
+				assertSame(childAA, childAAB.getParents().iterator().next().getParent());
+				assertEquals(1, childAAB.getDesignations().size());
+				assertEquals(2, childAAB.getProperties().size());
+
+				TermConcept childAB = concepts.get(7);
+				assertEquals("childAB", childAB.getCode());
+				assertNull(childAB.getDisplay());
+				assertEquals(0, childAB.getChildren().size());
+				assertEquals(1, childAB.getParents().size());
+				assertSame(parentA, childAB.getParents().iterator().next().getParent());
+				assertEquals(0, childAB.getDesignations().size());
+				assertEquals(0, childAB.getProperties().size());
+
+				TermConcept parentB = concepts.get(8);
+				assertEquals("ParentB", parentB.getCode());
+				assertNull(parentB.getDisplay());
+				assertEquals(0, parentB.getChildren().size());
+				assertEquals(0, parentB.getParents().size());
+				assertEquals(0, parentB.getDesignations().size());
+				assertEquals(0, parentB.getProperties().size());
+			}
+		});
+	}
+
 	/**
 	 * Check that a custom ValueSet against a custom CodeSystem expands correctly
 	 */

hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/term/TerminologySvcImplR4Test.java

@@ -3,6 +3,7 @@ package ca.uhn.fhir.jpa.term;
 import ca.uhn.fhir.jpa.dao.DaoConfig;
 import ca.uhn.fhir.jpa.dao.r4.BaseJpaR4Test;
 import ca.uhn.fhir.jpa.entity.*;
+import ca.uhn.fhir.jpa.model.entity.ResourceTable;
 import ca.uhn.fhir.rest.server.exceptions.UnprocessableEntityException;
 import ca.uhn.fhir.util.TestUtil;
 import org.hl7.fhir.instance.model.api.IIdType;
@@ -10,6 +11,7 @@ import org.hl7.fhir.r4.model.*;
 import org.hl7.fhir.r4.model.Enumerations.ConceptMapEquivalence;
 import org.junit.*;
 import org.junit.rules.ExpectedException;
+import org.mockito.Mock;
 import org.slf4j.Logger;
 import org.slf4j.LoggerFactory;
 import org.springframework.transaction.TransactionStatus;
@@ -21,6 +23,9 @@ import java.util.List;
 import java.util.Optional;
 
 import static org.junit.Assert.*;
+import static org.mockito.ArgumentMatchers.*;
+import static org.mockito.Mockito.times;
+import static org.mockito.Mockito.verify;
 
 public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 	private static final Logger ourLog = LoggerFactory.getLogger(TerminologySvcImplR4Test.class);
@@ -30,6 +35,9 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 	private IIdType myExtensionalCsId;
 	private IIdType myExtensionalVsId;
 
+	@Mock
+	IValueSetCodeAccumulator myValueSetCodeAccumulator;
+
 	@Before
 	public void before() {
 		myDaoConfig.setAllowExternalReferences(true);
@@ -40,6 +48,57 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 		myDaoConfig.setAllowExternalReferences(new DaoConfig().isAllowExternalReferences());
 		myDaoConfig.setPreExpandValueSetsExperimental(new DaoConfig().isPreExpandValueSetsExperimental());
 	}
+
+	private IIdType createCodeSystem() {
+		CodeSystem codeSystem = new CodeSystem();
+		codeSystem.setUrl(CS_URL);
+		codeSystem.setContent(CodeSystem.CodeSystemContentMode.NOTPRESENT);
+		IIdType id = myCodeSystemDao.create(codeSystem, mySrd).getId().toUnqualified();
+
+		ResourceTable table = myResourceTableDao.findById(id.getIdPartAsLong()).orElseThrow(IllegalArgumentException::new);
+
+		TermCodeSystemVersion cs = new TermCodeSystemVersion();
+		cs.setResource(table);
+
+		TermConcept parent;
+		parent = new TermConcept(cs, "ParentWithNoChildrenA");
+		cs.getConcepts().add(parent);
+		parent = new TermConcept(cs, "ParentWithNoChildrenB");
+		cs.getConcepts().add(parent);
+		parent = new TermConcept(cs, "ParentWithNoChildrenC");
+		cs.getConcepts().add(parent);
+
+		TermConcept parentA = new TermConcept(cs, "ParentA");
+		cs.getConcepts().add(parentA);
+
+		TermConcept childAA = new TermConcept(cs, "childAA");
+		parentA.addChild(childAA, TermConceptParentChildLink.RelationshipTypeEnum.ISA);
+
+		TermConcept childAAA = new TermConcept(cs, "childAAA");
+		childAAA.addPropertyString("propA", "valueAAA");
+		childAAA.addPropertyString("propB", "foo");
+		childAA.addChild(childAAA, TermConceptParentChildLink.RelationshipTypeEnum.ISA);
+
+		TermConcept childAAB = new TermConcept(cs, "childAAB");
+		childAAB.addPropertyString("propA", "valueAAB");
+		childAAB.addPropertyString("propB", "foo");
+		childAAB.addDesignation()
+			.setUseSystem("D1S")
+			.setUseCode("D1C")
+			.setUseDisplay("D1D")
+			.setValue("D1V");
+		childAA.addChild(childAAB, TermConceptParentChildLink.RelationshipTypeEnum.ISA);
+
+		TermConcept childAB = new TermConcept(cs, "childAB");
+		parentA.addChild(childAB, TermConceptParentChildLink.RelationshipTypeEnum.ISA);
+
+		TermConcept parentB = new TermConcept(cs, "ParentB");
+		cs.getConcepts().add(parentB);
+
+		myTermSvc.storeNewCodeSystemVersion(table.getId(), CS_URL, "SYSTEM NAME", cs);
+
+		return id;
+	}
 	
 	private void createAndPersistConceptMap() {
 		ConceptMap conceptMap = createConceptMap();
@@ -60,11 +119,21 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 		loadAndPersistValueSet();
 	}
 
+	private void loadAndPersistCodeSystemAndValueSetWithDesignations() throws IOException {
+		loadAndPersistCodeSystemWithDesignations();
+		loadAndPersistValueSet();
+	}
+
 	private void loadAndPersistCodeSystem() throws IOException {
 		CodeSystem codeSystem = loadResourceFromClasspath(CodeSystem.class, "/extensional-case-3-cs.xml");
 		persistCodeSystem(codeSystem);
 	}
 
+	private void loadAndPersistCodeSystemWithDesignations() throws IOException {
+		CodeSystem codeSystem = loadResourceFromClasspath(CodeSystem.class, "/extensional-case-3-cs-with-designations.xml");
+		persistCodeSystem(codeSystem);
+	}
+
 	private void persistCodeSystem(CodeSystem theCodeSystem) {
 		new TransactionTemplate(myTxManager).execute(new TransactionCallbackWithoutResult() {
 			@Override
@@ -202,6 +271,173 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 		loadAndPersistValueSet();
 	}
 
+	@Test
+	public void testExpandValueSetWithValueSetCodeAccumulator() {
+		createCodeSystem();
+
+		ValueSet vs = new ValueSet();
+		ValueSet.ConceptSetComponent include = vs.getCompose().addInclude();
+		include.setSystem(CS_URL);
+
+		myTermSvc.expandValueSet(vs, myValueSetCodeAccumulator);
+		verify(myValueSetCodeAccumulator, times(9)).includeCodeWithDesignations(anyString(), anyString(), nullable(String.class), anyCollection());
+	}
+
+	@Test
+	public void testStoreTermCodeSystemAndChildren() throws Exception {
+		loadAndPersistCodeSystemWithDesignations();
+
+		CodeSystem codeSystem = myCodeSystemDao.read(myExtensionalCsId);
+		ourLog.info("CodeSystem:\n" + myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(codeSystem));
+
+		new TransactionTemplate(myTxManager).execute(new TransactionCallbackWithoutResult() {
+			@Override
+			protected void doInTransactionWithoutResult(TransactionStatus theStatus) {
+				TermCodeSystem codeSystem = myTermCodeSystemDao.findByResourcePid(myExtensionalCsId.getIdPartAsLong());
+				assertEquals("http://acme.org", codeSystem.getCodeSystemUri());
+				assertNull(codeSystem.getName());
+
+				TermCodeSystemVersion codeSystemVersion = codeSystem.getCurrentVersion();
+				assertEquals(24, codeSystemVersion.getConcepts().size());
+
+				List<TermConcept> concepts = myTermConceptDao.findByCodeSystemVersion(codeSystemVersion);
+
+				TermConcept concept = concepts.get(0);
+				assertEquals("8450-9", concept.getCode());
+				assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
+				assertEquals(1, concept.getDesignations().size());
+
+				TermConceptDesignation designation = concept.getDesignations().iterator().next();
+				assertEquals("nl", designation.getLanguage());
+				assertEquals("http://snomed.info/sct", designation.getUseSystem());
+				assertEquals("900000000000013009", designation.getUseCode());
+				assertEquals("Synonym", designation.getUseDisplay());
+				assertEquals("Systolische bloeddruk - expiratie", designation.getValue());
+
+				concept = concepts.get(1);
+				assertEquals("11378-7", concept.getCode());
+				assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
+				assertEquals(0, concept.getDesignations().size());
+
+				// ...
+
+				concept = concepts.get(22);
+				assertEquals("8491-3", concept.getCode());
+				assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
+				assertEquals(1, concept.getDesignations().size());
+
+				designation = concept.getDesignations().iterator().next();
+				assertEquals("nl", designation.getLanguage());
+				assertEquals("http://snomed.info/sct", designation.getUseSystem());
+				assertEquals("900000000000013009", designation.getUseCode());
+				assertEquals("Synonym", designation.getUseDisplay());
+				assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
+
+				concept = concepts.get(23);
+				assertEquals("8492-1", concept.getCode());
+				assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
+				assertEquals(0, concept.getDesignations().size());
+			}
+		});
+	}
+
+	@Test
+	public void testStoreTermCodeSystemAndNestedChildren() {
+		IIdType codeSystemId = createCodeSystem();
+		CodeSystem codeSystemResource = myCodeSystemDao.read(codeSystemId);
+		ourLog.info("CodeSystem:\n" + myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(codeSystemResource));
+
+		new TransactionTemplate(myTxManager).execute(new TransactionCallbackWithoutResult() {
+			@Override
+			protected void doInTransactionWithoutResult(TransactionStatus theStatus) {
+				TermCodeSystem codeSystem = myTermCodeSystemDao.findByResourcePid(codeSystemId.getIdPartAsLong());
+				assertEquals(CS_URL, codeSystem.getCodeSystemUri());
+				assertEquals("SYSTEM NAME", codeSystem.getName());
+
+				TermCodeSystemVersion codeSystemVersion = codeSystem.getCurrentVersion();
+				assertEquals(9, codeSystemVersion.getConcepts().size());
+
+				List<TermConcept> concepts = myTermConceptDao.findByCodeSystemVersion(codeSystemVersion);
+
+				TermConcept parentWithNoChildrenA = concepts.get(0);
+				assertEquals("ParentWithNoChildrenA", parentWithNoChildrenA.getCode());
+				assertNull(parentWithNoChildrenA.getDisplay());
+				assertEquals(0, parentWithNoChildrenA.getChildren().size());
+				assertEquals(0, parentWithNoChildrenA.getParents().size());
+				assertEquals(0, parentWithNoChildrenA.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenA.getProperties().size());
+
+				TermConcept parentWithNoChildrenB = concepts.get(1);
+				assertEquals("ParentWithNoChildrenB", parentWithNoChildrenB.getCode());
+				assertNull(parentWithNoChildrenB.getDisplay());
+				assertEquals(0, parentWithNoChildrenB.getChildren().size());
+				assertEquals(0, parentWithNoChildrenB.getParents().size());
+				assertEquals(0, parentWithNoChildrenB.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenB.getProperties().size());
+
+				TermConcept parentWithNoChildrenC = concepts.get(2);
+				assertEquals("ParentWithNoChildrenC", parentWithNoChildrenC.getCode());
+				assertNull(parentWithNoChildrenC.getDisplay());
+				assertEquals(0, parentWithNoChildrenC.getChildren().size());
+				assertEquals(0, parentWithNoChildrenC.getParents().size());
+				assertEquals(0, parentWithNoChildrenC.getDesignations().size());
+				assertEquals(0, parentWithNoChildrenC.getProperties().size());
+
+				TermConcept parentA = concepts.get(3);
+				assertEquals("ParentA", parentA.getCode());
+				assertNull(parentA.getDisplay());
+				assertEquals(2, parentA.getChildren().size());
+				assertEquals(0, parentA.getParents().size());
+				assertEquals(0, parentA.getDesignations().size());
+				assertEquals(0, parentA.getProperties().size());
+
+				TermConcept childAA = concepts.get(4);
+				assertEquals("childAA", childAA.getCode());
+				assertNull(childAA.getDisplay());
+				assertEquals(2, childAA.getChildren().size());
+				assertEquals(1, childAA.getParents().size());
+				assertSame(parentA, childAA.getParents().iterator().next().getParent());
+				assertEquals(0, childAA.getDesignations().size());
+				assertEquals(0, childAA.getProperties().size());
+
+				TermConcept childAAA = concepts.get(5);
+				assertEquals("childAAA", childAAA.getCode());
+				assertNull(childAAA.getDisplay());
+				assertEquals(0, childAAA.getChildren().size());
+				assertEquals(1, childAAA.getParents().size());
+				assertSame(childAA, childAAA.getParents().iterator().next().getParent());
+				assertEquals(0, childAAA.getDesignations().size());
+				assertEquals(2, childAAA.getProperties().size());
+
+				TermConcept childAAB = concepts.get(6);
+				assertEquals("childAAB", childAAB.getCode());
+				assertNull(childAAB.getDisplay());
+				assertEquals(0, childAAB.getChildren().size());
+				assertEquals(1, childAAB.getParents().size());
+				assertSame(childAA, childAAB.getParents().iterator().next().getParent());
+				assertEquals(1, childAAB.getDesignations().size());
+				assertEquals(2, childAAB.getProperties().size());
+
+				TermConcept childAB = concepts.get(7);
+				assertEquals("childAB", childAB.getCode());
+				assertNull(childAB.getDisplay());
+				assertEquals(0, childAB.getChildren().size());
+				assertEquals(1, childAB.getParents().size());
+				assertSame(parentA, childAB.getParents().iterator().next().getParent());
+				assertEquals(0, childAB.getDesignations().size());
+				assertEquals(0, childAB.getProperties().size());
+
+				TermConcept parentB = concepts.get(8);
+				assertEquals("ParentB", parentB.getCode());
+				assertNull(parentB.getDisplay());
+				assertEquals(0, parentB.getChildren().size());
+				assertEquals(0, parentB.getParents().size());
+				assertEquals(0, parentB.getDesignations().size());
+				assertEquals(0, parentB.getProperties().size());
+			}
+		});
+	}
+
 	@Test
 	public void testStoreTermConceptMapAndChildren() {
 		createAndPersistConceptMap();
@@ -384,7 +620,7 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 	public void testStoreTermValueSetAndChildren() throws Exception {
 		myDaoConfig.setPreExpandValueSetsExperimental(true);
 
-		loadAndPersistCodeSystemAndValueSet();
+		loadAndPersistCodeSystemAndValueSetWithDesignations();
 
 		CodeSystem codeSystem = myCodeSystemDao.read(myExtensionalCsId);
 		ourLog.info("CodeSystem:\n" + myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(codeSystem));
@@ -406,33 +642,51 @@ public class TerminologySvcImplR4Test extends BaseJpaR4Test {
 				ourLog.info("ValueSet:\n" + valueSet.toString());
 				assertEquals("http://www.healthintersections.com.au/fhir/ValueSet/extensional-case-2", valueSet.getUrl());
 				assertEquals("Terminology Services Connectation #1 Extensional case #2", valueSet.getName());
-				assertEquals(codeSystem.getConcept().size(), valueSet.getCodes().size());
+				assertEquals(codeSystem.getConcept().size(), valueSet.getConcepts().size());
 
-				TermValueSetCode code = valueSet.getCodes().get(0);
+				TermValueSetConcept concept = valueSet.getConcepts().get(0);
-				ourLog.info("Code:\n" + code.toString());
+				ourLog.info("Code:\n" + concept.toString());
-				assertEquals("http://acme.org", code.getSystem());
+				assertEquals("http://acme.org", concept.getSystem());
-				assertEquals("8450-9", code.getCode());
+				assertEquals("8450-9", concept.getCode());
-				assertEquals("Systolic blood pressure--expiration", code.getDisplay());
+				assertEquals("Systolic blood pressure--expiration", concept.getDisplay());
+				assertEquals(1, concept.getDesignations().size());
 
-				code = valueSet.getCodes().get(1);
+				TermValueSetConceptDesignation designation = concept.getDesignations().get(0);
-				ourLog.info("Code:\n" + code.toString());
+				assertEquals("nl", designation.getLanguage());
-				assertEquals("http://acme.org", code.getSystem());
+				assertEquals("http://snomed.info/sct", designation.getUseSystem());
-				assertEquals("11378-7", code.getCode());
+				assertEquals("900000000000013009", designation.getUseCode());
-				assertEquals("Systolic blood pressure at First encounter", code.getDisplay());
+				assertEquals("Synonym", designation.getUseDisplay());
+				assertEquals("Systolische bloeddruk - expiratie", designation.getValue());
+
+				concept = valueSet.getConcepts().get(1);
+				ourLog.info("Code:\n" + concept.toString());
+				assertEquals("http://acme.org", concept.getSystem());
+				assertEquals("11378-7", concept.getCode());
+				assertEquals("Systolic blood pressure at First encounter", concept.getDisplay());
+				assertEquals(0, concept.getDesignations().size());
 
 				// ...
 
-				code = valueSet.getCodes().get(22);
+				concept = valueSet.getConcepts().get(22);
-				ourLog.info("Code:\n" + code.toString());
+				ourLog.info("Code:\n" + concept.toString());
-				assertEquals("http://acme.org", code.getSystem());
+				assertEquals("http://acme.org", concept.getSystem());
-				assertEquals("8491-3", code.getCode());
+				assertEquals("8491-3", concept.getCode());
-				assertEquals("Systolic blood pressure 1 hour minimum", code.getDisplay());
+				assertEquals("Systolic blood pressure 1 hour minimum", concept.getDisplay());
+				assertEquals(1, concept.getDesignations().size());
 
-				code = valueSet.getCodes().get(23);
+				designation = concept.getDesignations().get(0);
-				ourLog.info("Code:\n" + code.toString());
+				assertEquals("nl", designation.getLanguage());
-				assertEquals("http://acme.org", code.getSystem());
+				assertEquals("http://snomed.info/sct", designation.getUseSystem());
-				assertEquals("8492-1", code.getCode());
+				assertEquals("900000000000013009", designation.getUseCode());
-				assertEquals("Systolic blood pressure 8 hour minimum", code.getDisplay());
+				assertEquals("Synonym", designation.getUseDisplay());
+				assertEquals("Systolische bloeddruk minimaal 1 uur", designation.getValue());
+
+				concept = valueSet.getConcepts().get(23);
+				ourLog.info("Code:\n" + concept.toString());
+				assertEquals("http://acme.org", concept.getSystem());
+				assertEquals("8492-1", concept.getCode());
+				assertEquals("Systolic blood pressure 8 hour minimum", concept.getDisplay());
+				assertEquals(0, concept.getDesignations().size());
 			}
 		});
 	}

hapi-fhir-jpaserver-base/src/test/resources/extensional-case-3-cs-with-designations.xml

@@ -0,0 +1,117 @@
+<CodeSystem xmlns="http://hl7.org/fhir">
+	<url value="http://acme.org" />
+	<concept>
+		<code value="8450-9" />
+		<display value="Systolic blood pressure--expiration" />
+		<designation>
+			<language value="nl"/>
+			<use>
+				<system value="http://snomed.info/sct"/>
+				<code value="900000000000013009"/>
+				<display value="Synonym"/>
+			</use>
+			<value value="Systolische bloeddruk - expiratie"/>
+		</designation>
+	</concept>
+	<concept>
+		<code value="11378-7" />
+		<display value="Systolic blood pressure at First encounter" />
+	</concept>
+	<concept>
+		<code value="8493-9" />
+		<display value="Systolic blood pressure 10 hour minimum" />
+	</concept>
+	<concept>
+		<code value="8494-7" />
+		<display value="Systolic blood pressure 12 hour minimum" />
+	</concept>
+	<concept>
+		<code value="8495-4" />
+		<display value="Systolic blood pressure 24 hour minimum" />
+	</concept>
+	<concept>
+		<code value="8451-7" />
+		<display value="Systolic blood pressure--inspiration" />
+	</concept>
+	<concept>
+		<code value="8452-5" />
+		<display value="Systolic blood pressure.inspiration - expiration" />
+	</concept>
+	<concept>
+		<code value="8459-0" />
+		<display value="Systolic blood pressure--sitting" />
+	</concept>
+	<concept>
+		<code value="8460-8" />
+		<display value="Systolic blood pressure--standing" />
+	</concept>
+	<concept>
+		<code value="8461-6" />
+		<display value="Systolic blood pressure--supine" />
+	</concept>
+	<concept>
+		<code value="8479-8" />
+		<display value="Systolic blood pressure by palpation" />
+	</concept>
+	<concept>
+		<code value="8480-6" />
+		<display value="Systolic blood pressure" />
+	</concept>
+	<concept>
+		<code value="8481-4" />
+		<display value="Systolic blood pressure 1 hour maximum" />
+	</concept>
+	<concept>
+		<code value="8482-2" />
+		<display value="Systolic blood pressure 8 hour maximum" />
+	</concept>
+	<concept>
+		<code value="8483-0" />
+		<display value="Systolic blood pressure 10 hour maximum" />
+	</concept>
+	<concept>
+		<code value="8484-8" />
+		<display value="Systolic blood pressure 12 hour maximum" />
+	</concept>
+	<concept>
+		<code value="8485-5" />
+		<display value="Systolic blood pressure 24 hour maximum" />
+	</concept>
+	<concept>
+		<code value="8486-3" />
+		<display value="Systolic blood pressure 1 hour mean" />
+	</concept>
+	<concept>
+		<code value="8487-1" />
+		<display value="Systolic blood pressure 8 hour mean" />
+	</concept>
+	<concept>
+		<code value="8488-9" />
+		<display value="Systolic blood pressure 10 hour mean" />
+	</concept>
+	<concept>
+		<code value="8489-7" />
+		<display value="Systolic blood pressure 12 hour mean" />
+	</concept>
+	<concept>
+		<code value="8490-5" />
+		<display value="Systolic blood pressure 24 hour mean" />
+	</concept>
+	<concept>
+		<code value="8491-3" />
+		<display value="Systolic blood pressure 1 hour minimum" />
+		<designation>
+			<language value="nl"/>
+			<use>
+				<system value="http://snomed.info/sct"/>
+				<code value="900000000000013009"/>
+				<display value="Synonym"/>
+			</use>
+			<value value="Systolische bloeddruk minimaal 1 uur"/>
+		</designation>
+	</concept>
+	<concept>
+		<code value="8492-1" />
+		<display value="Systolic blood pressure 8 hour minimum" />
+	</concept>
+</CodeSystem>

hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java

@@ -23,6 +23,7 @@ package ca.uhn.fhir.jpa.migrate.tasks;
 import ca.uhn.fhir.jpa.entity.TermCodeSystem;
 import ca.uhn.fhir.jpa.entity.TermConcept;
 import ca.uhn.fhir.jpa.entity.TermValueSet;
+import ca.uhn.fhir.jpa.entity.TermValueSetConceptDesignation;
 import ca.uhn.fhir.jpa.migrate.DriverTypeEnum;
 import ca.uhn.fhir.jpa.migrate.taskdef.AddColumnTask;
 import ca.uhn.fhir.jpa.migrate.taskdef.ArbitrarySqlTask;
@@ -96,23 +97,43 @@ public class HapiFhirJpaMigrationTasks extends BaseMigrationTasks<VersionEnum> {
 			.references("HFJ_RESOURCE", "RES_ID");
 		termValueSetTable.addColumn("NAME").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSet.MAX_NAME_LENGTH);
 
-		// TermValueSetCode
+		// TermValueSetConcept
-		version.startSectionWithMessage("Processing table: TRM_VALUESET_CODE");
+		version.startSectionWithMessage("Processing table: TRM_VALUESET_CONCEPT");
-		version.addIdGenerator("SEQ_VALUESET_CODE_PID");
+		version.addIdGenerator("SEQ_VALUESET_CONCEPT_PID");
-		Builder.BuilderAddTableByColumns termValueSetCodeTable = version.addTableByColumns("TRM_VALUESET_CODE", "PID");
+		Builder.BuilderAddTableByColumns termValueSetConceptTable = version.addTableByColumns("TRM_VALUESET_CONCEPT", "PID");
-		termValueSetCodeTable.addColumn("PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
+		termValueSetConceptTable.addColumn("PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
-		termValueSetCodeTable.addColumn("VALUESET_PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
+		termValueSetConceptTable.addColumn("VALUESET_PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
-		termValueSetCodeTable
+		termValueSetConceptTable
 			.addForeignKey("FK_TRM_VALUESET_PID")
 			.toColumn("VALUESET_PID")
 			.references("TRM_VALUESET", "PID");
-		termValueSetCodeTable.addColumn("SYSTEM").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermCodeSystem.MAX_URL_LENGTH);
+		termValueSetConceptTable.addColumn("SYSTEM").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermCodeSystem.MAX_URL_LENGTH);
-		termValueSetCodeTable.addColumn("CODE").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermConcept.MAX_CODE_LENGTH);
+		termValueSetConceptTable.addColumn("CODE").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermConcept.MAX_CODE_LENGTH);
-		termValueSetCodeTable
+		termValueSetConceptTable
-			.addIndex("IDX_VALUESET_CODE_CS_CD")
+			.addIndex("IDX_VALUESET_CONCEPT_CS_CD")
 			.unique(false)
 			.withColumns("SYSTEM", "CODE");
-		termValueSetCodeTable.addColumn("DISPLAY").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermConcept.MAX_DESC_LENGTH);
+		termValueSetConceptTable.addColumn("DISPLAY").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermConcept.MAX_DESC_LENGTH);
+
+		// TermValueSetConceptDesignation
+		version.startSectionWithMessage("Processing table: TRM_VALUESET_C_DESIGNATION");
+		version.addIdGenerator("SEQ_VALUESET_C_DSGNTN_PID");
+		Builder.BuilderAddTableByColumns termValueSetConceptDesignationTable = version.addTableByColumns("TRM_VALUESET_C_DESIGNATION", "PID");
+		termValueSetConceptDesignationTable.addColumn("PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
+		termValueSetConceptDesignationTable.addColumn("VALUESET_CONCEPT_PID").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.LONG);
+		termValueSetConceptDesignationTable
+			.addForeignKey("FK_TRM_VALUESET_CONCEPT_PID")
+			.toColumn("VALUESET_CONCEPT_PID")
+			.references("TRM_VALUESET_CONCEPT", "PID");
+		termValueSetConceptDesignationTable.addColumn("LANG").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSetConceptDesignation.MAX_LENGTH);
+		termValueSetConceptDesignationTable.addColumn("USE_SYSTEM").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSetConceptDesignation.MAX_LENGTH);
+		termValueSetConceptDesignationTable.addColumn("USE_CODE").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSetConceptDesignation.MAX_LENGTH);
+		termValueSetConceptDesignationTable.addColumn("USE_DISPLAY").nullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSetConceptDesignation.MAX_LENGTH);
+		termValueSetConceptDesignationTable.addColumn("VAL").nonNullable().type(BaseTableColumnTypeTask.ColumnTypeEnum.STRING, TermValueSetConceptDesignation.MAX_LENGTH);
+		termValueSetConceptDesignationTable
+			.addIndex("IDX_VALUESET_C_DSGNTN_VAL")
+			.unique(false)
+			.withColumns("VAL");
 	}
 
 

src/changes/changes.xml

@@ -284,6 +284,13 @@
 				profiles via the $snapshot operation, and will automatically generate a snapshot when
 				needed for validation.
 			</action>
+			<action type="add">
+				Creating/updating CodeSystems now persist <![CDATA[<code>CodeSystem.concept.designation</code>]]> to
+				the terminology tables.
+			</action>
+			<action type="add">
+				Expanded ValueSets now populate <![CDATA[<code>ValueSet.expansion.contains.designation.language</code>]]>.
+			</action>
 		</release>
 		<release version="3.8.0" date="2019-05-30" description="Hippo">
 			<action type="fix">