Creating Clinical and Analysis models

As you may know, one of the things that excites me about FHIR is the potential that it has to involve the clinician in the design of health IT systems (and I’m using ‘clinician’ in the widest sense – doctor, nurse allied health etc – anyone who delivers care to a patient).

So far a lot of my thoughts have been theory rather than practice, so it is great to try these ideas out on a real project – the reporting of Adverse Drug Reactions (ADR) by a clinician to a central service – such as a National EHR!

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Scenario 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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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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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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clinFHIR Profiling Walk Through

So I’m in the middle of getting ready for the Furore  devdays event – part of the preparation being a writing series of posts on the various stages we’ll be exploring as part of that event.

Quite co-incidentally, Mark Braunstein from Georgia Tech asked me to do a presentation for their FHIR class which is happening in a couple of days, so I thought it a good idea to write this walk through of the complete process from end to end – from a requirement to a profiled resource instance.

We’ll return to the more detailed consideration of the steps after this.

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More on FHIR Logical Models

So a couple of weeks ago I posted on a new component that has been added to clinFHIR – a tool that will generate Logical Models – models of something that uses the FHIR infrastructure but doesn’t generate ‘real’ resources. The idea is that it is used as a requirements gathering tool when when interacting with clinicians to describe what information and processes are needed to meet some interoperability related need.

Since then, we’ve added a few new capabilities to the tool, and also further refined how it can work with the other clinFHIR components to provide an ‘end to end’ solution that starts with an idea, and ends with the various FHIR resources (profiles, valueSets, extension definitions etc) that will be needed. This post starts a ‘mini series’ that describes how this could work (and do note that this is just my idea – there are lots of other ways that this could be done).

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