HL7 Use in IHE
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
FHIR Overview 3
What does FHIR stand for? (well, that s relative) (that s what we need) (the web technology bit) 4
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
Design Philosphy of FHIR Focus on Implementers Target support for common scenarios Leverage existing technologies Make content freely available 6
Example Patient Resource References to other Resources
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
Extension with reference to its definition Human Readable Summary Standard Data Content: MRN Name Gender Date of Birth Provider 10
From model to the wire HTTP/1.1 200 OK Content-Type: application/ json;charset=utf-8 Content-Length: 627 Content-Location: /fhir/person/@1/ history/@1 Last-Modified: Tue, 29 May 2012 23:45:32 GMT ETag: "1 "Person":{"id": {"value":"1"},"identifier":[{"type": {"code":"ssn","system":"http:// hl7.org/fhir/sid 12
RESTful FHIR Examples GET http://myfhirserver.com/patient/123 Patient GET http://myfhirserver.com/encounter/904?_include=patient Patient Encounter PUT http://myfhirserver.com/encounter/904 {XML or JSON Resource expression} encounter encounter GET http://myfhirserver.com/document/800511 Bundle document patient provider medication condition condition LIST observation
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
FHIR Use in IHE 15
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
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
Interaction Diagram 18
PDQm Query Parameters 19
Profiled PDQm Response Model 20
PDQm Response Model <extension url="http://pdqm-sample:8080/iti-78/profile/pdqm#mothersmaidenname"> <valuehumanname> <family value="smith"/> <given value="mary"/> </valuehumanname> </extension>
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
DocumentReference Resource Classic XDS: ebrm based XDS DocumentEntry metadata
ImagingStudy Resource Classic XDS-I: KOS Object 24
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
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
FHIR Profiles 27
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
ExtensionDefinition Resource 29
Extend FHIR interface Read Search Update Standard FHIR REST FHIR Repository Check Drug Interaction Custom Operations Search on Maiden name Merge Patient 30
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
After Before StructureDefinition Resource 32
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
Computable Profiles FHIR Profile Structure Definition ConceptMap Extension Definition NamingSystem Conformance Operation Definition ValueSet
All-round use of Profiles Repository Guidance Find & maintain Implementation Retrieve & use Compliance 35
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
Questions? 37
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 http://fhir.furore.com/devdays Ringholm Learn * Share * Connect 38