HL7. Use in IHE. Ringholm Learn * Share * Connect
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1 HL7 Use in IHE
2 1. Introduction to FHIR For those new to the standard Agenda 2. Use of FHIR in IHE workflow profiles MHD (XDSm), PDQm, PCD,.. 3. FHIR Resource Profiles E.g. as defined by IHE 2
3 FHIR Overview 3
4 What does FHIR stand for? (well, that s relative) (that s what we need) (the web technology bit) 4
5 Application of FHIR FHIR is suitable for application in a variety of settings: the classic in-institution exchange of data between systems in a regional setting (Regional Health Information Organizations) on a national scale, e.g. in national health hub s or EHR's in social media and mobile applications Since social media and mobile are green field for health information exchange, FHIR is expected to be used in such settings first, before penetrating in the more traditional environments. 5
6 Design Philosphy of FHIR Focus on Implementers Target support for common scenarios Leverage existing technologies Make content freely available 6
7 Example Patient Resource References to other Resources
8 Resources in FHIR Currently: about 60 Administrative Patient, Location, Encounter, Organization, Clinical Concepts AllergyIntolerance, Questionnaire, Observation Infrastructure ValueSet, Composition, Profile, Conformance Next up still about 60 to go Scheduling - Appointment, Availability, Slot Financial - Claim, Account, Coverage Consent Devices Metric, DeviceComponent Care Transfer Full support for C-CDA 9
9 Extension with reference to its definition Human Readable Summary Standard Data Content: MRN Name Gender Date of Birth Provider 10
10 From model to the wire HTTP/ OK Content-Type: application/ json;charset=utf-8 Content-Length: 627 Content-Location: Last-Modified: Tue, 29 May :45:32 GMT ETag: "1 "Person":{"id": {"value":"1"},"identifier":[{"type": {"code":"ssn","system":" hl7.org/fhir/sid 12
11 RESTful FHIR Examples GET Patient GET Patient Encounter PUT {XML or JSON Resource expression} encounter encounter GET Bundle document patient provider medication condition condition LIST observation
12 Interoperabiliteits niveaus Strategisch Tac6sch Opera6oneel Wet- en regelgeving Wetgevers en adviseurs Bestuurders Juristen Security, Privacy, Governance Beleid Zorgprocessen Informa6e Applica6es Infrastructuur Beleids- makers Business- en informa6e- architecten Systeem- architecten Zorg- Managers Informa6e- analisten, terminologen So:ware ontwikkelaars Systeem engineers Zorg- professionals Pa6ënten Systeem beheerders 14
13 FHIR Use in IHE 15
14 Use Cases for mobile profiles Mobile devices used by physicians (for example: a mobile app for electronic patient charts) Web based EHR/EMR applications A health portal securely exposing data to browser based plugins, Medical devices 16
15 PDQ Profile Patient Demographics Query Patient Demographics Supplier Patient demographics Query [ITI-21] (HL7 v2) Patient demographics Query [ITI-47] (HL7 v3) Mobile Patient Demographics Query [ITI-78] (FHIR) Patient Demographics Consumer Patient Demographics Supplier Patient demographics Query [ITI-21] (HL7 v2) Patient Demographics Consumer Patient Demographics Supplier Mobile Patient Demographics Query [ITI-78] (FHIR) Patient Demographics Consumer
16 Interaction Diagram 18
17 PDQm Query Parameters 19
18 Profiled PDQm Response Model 20
19 PDQm Response Model <extension url=" <valuehumanname> <family value="smith"/> <given value="mary"/> </valuehumanname> </extension>
20 IHE XDS/MHD Profiles Mobile access to Health Docs. Document Registry Query Documents XDS Document Consumer Document Creator Provide & Register Document Set Register Document Set Document Repository Retrieve Document Set Document Responder Document Recepient Document Source Put Document Dossier Find Document Dossier Get Document Dossier Get Document MHD Document Consumer 22
21 DocumentReference Resource Classic XDS: ebrm based XDS DocumentEntry metadata
22 ImagingStudy Resource Classic XDS-I: KOS Object 24
23 EHR FHIR+MHD+RESTful DICOM Patient condition condition encounter provider PACS/VNA ImagingStudy ImagingStudy ImagingStudy ImagingStudy Media Media XDS Registry ImagingStudy DMS/Repository document Document Reference patient provider medication Composition LIST observation
24 Interoperabiliteits niveaus Strategisch Tac6sch Opera6oneel Wet- en regelgeving Wetgevers en adviseurs Bestuurders Juristen Security, Privacy, Governance Beleid Zorgprocessen Informa6e Applica6es Infrastructuur Beleids- makers Business- en informa6e- architecten Systeem- architecten Zorg- Managers Informa6e- analisten, terminologen So:ware ontwikkelaars Systeem engineers Zorg- professionals Pa6ënten Systeem beheerders 26
25 FHIR Profiles 27
26 FHIR profiles Resources have nearly no restrictions. Parties exchanging data define the way they want to use resources Profiles define what your jurisdiction needs to communicate and store when it comes to Resources and their extensions. 28
27 ExtensionDefinition Resource 29
28 Extend FHIR interface Read Search Update Standard FHIR REST FHIR Repository Check Drug Interaction Custom Operations Search on Maiden name Merge Patient 30
29 mothersmaidenname.given mothersmaidenname.family Search Parameter 745 These parameters of type string, when supplied, specify the name of a patient s mother s maiden name. GET /Patient/search?mothersMaidenName=Kramer SearchCriteriaDefinition Resource 31
30 After Before StructureDefinition Resource 32
31 More ValueSet Resource: describes a set of codes or concepts that can be used in a context NamingSystem Resource: provides formal definitions of system namespaces for identifiers and terminologies ConceptMap Resource: maps between terminologies and/or structures
32 Computable Profiles FHIR Profile Structure Definition ConceptMap Extension Definition NamingSystem Conformance Operation Definition ValueSet
33 All-round use of Profiles Repository Guidance Find & maintain Implementation Retrieve & use Compliance 35
34 Interoperabiliteits niveaus Strategisch Tac6sch Opera6oneel Wet- en regelgeving Wetgevers en adviseurs Bestuurders Juristen Security, Privacy, Governance Beleid Zorgprocessen Informa6e Applica6es Infrastructuur Beleids- makers Business- en informa6e- architecten Systeem- architecten Zorg- Managers Informa6e- analisten, terminologen So:ware ontwikkelaars Systeem engineers Zorg- professionals Pa6ënten Systeem beheerders 36
35 Questions? 37
36 International HL7 FHIR Developer Days Education November 24-26, 2014 in Amsterdam 14 tutorials pick & choose Connectathon Meet fellow developers Put FHIR to the test Networking FHIR experts and authors on hand Ringholm Learn * Share * Connect 38
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