Clinical resources in FHIR

I gave a talk on Clinical resources in FHIR at the recent seminar in Melbourne, which was actually a bit more work to prepare than I had anticipated. I’ve given a few FHIR talks, but generally they were about the fundamentals of FHIR or more technical training, and this was intended to be aimed more at a clinical audience.

The actual presentation is here if you want to see the whole thing, but as I was trying to figure out what to say, I realised that the main point I wanted to get across was the idea of FHIR resources as an interconnected ‘web’ of basic building blocks assembled in a way that tells the clinical story. We’ve looked at a few of these in this blog – here’s a simple one that we looked at in Melbourne.

procedure

It shows the main characteristics of a resource:

  • The links (or references) to other resources (each of which is a named property on the resource)
  • The coded properties – that link to terminologies of varying sizes and types
  • The other properties that are straightforward datatypes
  • and extensions.

Of course, looking at a single resource and its relations isn’t all that interesting – it gets better in the context of a clinical scenario. We considered a fairly simple scenario that’s not uncommon in Primary Care:

 

Screen Shot 2014-11-13 at 7.07.11 pm

and then overlaid resources on top of it like so:

Screen Shot 2014-11-13 at 5.49.10 pm

Of course there is plenty of room for debate about whether these are the correct resources to represent the components within the scenario – that’s actually a focus of the Patient Care workgroup at the moment (and, of course, and interested clinicians).

What’s even neater is looking at this using the ‘graph format’:

 

graph1

(It’s not exactly the same as the scenario, but you get the idea).

What’s even neater is that if you need to generate a summary of the encounter (like a Progress Note document), then you simply need to start at the encounter resource (upper right, with the arrow) and follow the references to the ones you need! You’d probably add a few resources to tidy things up (like the odd List resource and maybe a Composition), but by and large, all the information you need has already been collected as part of recording the encounter.

And collecting information for documents and other summaries as a ‘by product’ of the clinical process is the most efficient way to do it. I believe that John Halamka would say “that’s cool!”

About David Hay
I'm a Product Strategist at Orion Health, Chair emeritus of HL7 New Zealand and co-Chair of the FHIR Management Group. I have a keen interest in health IT, especially health interoperability with HL7 and the new FHIR standard.

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