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 an independent contractor working with companies like Orion Health and Rhapsody, HL7 Fellow, Chair emeritus of HL7 New Zealand and a 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.

One Response to Clinical resources in FHIR

  1. Pingback: A Primer on Electronic Health Records (EHRs) | blog.datagene.io

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