Using Scenario Builder for developing Resources

I had an email this morning from the organizers of the ‘Clinicians On FHIR’ event at the upcoming Working Group Meeting asking if it was possible to use the Scenario Builder to examine a resource type that had been altered after publication (i.e. one that was being worked on for the next release of FHIR – R4). As it turns out, this is quite straightforward to do – albeit with some limitations.

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A sense of history with clinFHIR

I’m definitely going to finish off the series on building extensions (we have to cover coded extensions) but I must admit I’ve been a bit sidetracked in the last couple of days. You see we had a call with the ‘Clinicians on FHIR’ team talking about plans for the upcoming event at the WGM in Spain, and during the course of the discussion, Emma asked if clinFHIR could show versions of resources as she wanted to describe medication reconciliation.

At the time I said we could certainly do something like that (though I’ve not yet got that working in the Scenario Builder) but after the call I was thinking about it, and it occurred to me that what we really need is to be able to version scenarios – so we can show how they are built up, and potentially to model a workflow like fulfillment of an order or reconciliation.

So, may I present…

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Adding extensions to a resource

So a colleague of mine asked me this morning if the clinFHIR scenario builder supported modifier extensions.

If you’re not familiar with these, they are extensions that actually change the meaning of the resource to which they are attached. For example, if you wanted to indicate that a patient did not have a particular condition, then you could attach a ‘negation’ extension to the Condition to indicate that you looked for – but did not find – that particular condition. Or, a statement that indicates that a patient is not taking a particular medication.

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A complex scenario…

Bob Milius has kindly allowed me to share an example of a more complex genetics based scenario that he has built (by hand!) – you can download it from here.

To load it into clinFHIR, follow the steps I described in this post and you can then view it as a graph. Here’s an image:

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Import resources into clinFHIR Scenario Builder

Just a short note to let you know that I’ve added the ability to import resources directly into the clinFHIR Scenario Builder (people have asked about this for a while). There are 3 formats currently supported:

  • A single Json resource
  • A Json bundle
  • An XML bundle

(Note that a single XML resource is not yet supported – just place it in a bundle if this is a problem right now)

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The FHIR EndPoint resource

In the previous post, we talked about how FHIR could support a provider registry – the resources that would be involved and the types of query that you could use to access data within the registry. I was talking with Brian Postlethwaite (who is one of the authors of these resources, being a co-chair of the Patient Administration committee within HL7) and he pointed out that I didn’t mention the Endpoint resource.

Let’s rectify that.

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Provider registries in FHIR

So we’ve had some interest in New Zealand concerning Provider registries – locations where the details of providers and the services they provide can be maintained and discovered. There are a lot of potential uses for such a registry, but the two that we’ve been discussing are locating targets for referrals, and locating providers by specialty as part of Care Pathways.

Typical query use cases could include:

  • Find a Provider by name (or other personal detail)
  • Find a Provider by specialty – eg a physiotherapist
  • Locate a Service provided by a facility like a hospital

There are lots more of course, but these will get us started.

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