Extending a required ValueSet Binding

One of the issues we come across quite a lot at Orion Health is where we are creating a read FHIR interface to an existing data service with elements in the FHIR resource that are coded and have a ‘required’ binding to a ValueSet (which means that you must only use one of the values in the ValueSet) – and the data we are mapping from has a different value. AllergyIntolerance is a particular culprit in this regard as it has a number of required bindings, but it has come up most recently in MedicationStatement.status where we have values that are different to the ones in STU2 – the FHIR version we are using.

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Simple Builder: Library and Documents

In the last post we talked about the new builder component that was developed to help people (especially clinicians) develop sets of resources to represent clinical scenarios. There are a couple of features we didn’t have time to discuss then – the Library and Documents – so let’s talk about them now.

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Building a set of resources in FHIR

One of the primary goals for clinFHIR is to help people who are new to the standard understand how it works – and increasingly these are clinicians whose interest is less in the technology and more about how FHIR can be used to represent the clinical information they wish to exchange.

While the current app does allow this, it has been aimed more at the people actually developing the resources than the casual user, and so can be time consuming to develop sets of resource instances that represent real world scenarios.

The component described by this post (called a simple builder – though a better name is needed!) is intended to allow someone completely new to FHIR to build sets of resources that represent clinical scenarios, to help them understand how the resources can be linked together – rather like Lego is used to build a complete model.

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Presentations from Amsterdam devdays

https://vimeopro.com/user12740828/hl7-fhir-developer-days-2016-amsterdam

enjoy!

 

Challenges with Lists

So one of the challenges we’re facing at work at the moment is Lists – more specifically ‘current’ lists – eg the medications a patient is taking right now, their problem list and set of allergies.

A bit of background.

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Using workflow to track comments

So there’s a requirement that’s come out of the UK profiling work (among others) to be able to gather comments about logical models as part of getting feedback – particularly from Clinicians.

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Basic Pregnancy Logical Model

So there was an interesting conversation in the FHIR chat just recently about representing maternity information in FHIR. It was pointed out by Lloyd that some elements that seem simple – like the LMP (Last Menstrual Period date) – are actually more complex than that, they are more properly Observations made by someone, at some date, with a degree of certainty etc.

So what this means is that a single logical model – like a summary of pregnancy – is going to wind up being represented in FHIR by a number of different resources, presumably ‘bound together’ in some way (eg  a bundle of some sort Document/Message – or just a Composition with appropriate references) and described by an Implementation Guide.

Given that I’m working on a logical modeler in clinFHIR, this seemed like something to address. Here’s where I’ve got to so far.

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