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- Dumb vs. Smart Service
- Is DTS a dumb service (told what to do) or smart service (see message and know what to do) in relation to working with interoperability layer (IOL)? - Approaches to Scalability
-How to improve message throughput throughput - applications access DTS in real time or use curated copy of terminology. - Change management
-How to handle life cycle of terms. Continual periodic updates. Terms that are deprecated, superceded. - Deployment
- How terminology is disseminated throughout enterprise - via api call or sftp file transfer - SHR's persistence model
- single code or multiple codes
-only 1 cardinal code stored or 1 cardinal code and plus 1 equivalence code stored (Ministry 1 coding system, Insurance other coding system)