Thoughts and comments on the HL7 FHIR standard, from a FHIR Evangelist
March 24, 2015 2 Comments
So now that we’ve established how we intend to build our model from HL7 v2 messages, let’s turn our attention to architectural issues. We’ll need to look at how FHIR thinks about managing messages – both in terms of the structure and content of a FHIR message, and also how the server should process those messages.
March 23, 2015 6 Comments
In the last post, we started to think about how we might be able to capture clinically useful information (naturally as FHIR resources) from the HL7 v2 messages that are used within many hospitals. These messages are used to move information between the various components of a hospital such as the PAS (Patient Administration System), the RIS (Radiology Information System), the LIS (Laboratory Information System) and so forth.
A common pattern is that the ‘downstream’ systems (LIS, RIS) ‘subscribe’ to these messages emitted from the PAS – generally via an Integration Engine. So all we’ll do is add ourselves to the list of interested parties, and we’ll get a copy of each message as well.
And actually, there’s no real reason why we should confine our attentions to just one hospital – if there are multiple co-operating hospitals then there’s no reason why we can’t receive messages from all of them, though we do need to be careful with identifiers (patient and visit) as these might overlap between providers.
February 10, 2015 1 Comment
Rene Spronk, talking about the importance of FHIR for Clinicians…
January 24, 2015 Leave a comment
Well, we’ve just finished the second Clinician Connectathon. I wasn’t able to attend in person, but was able to dial in from home (New Zealand) to participate and it all worked out really well.
The tooling mostly behaved itself (we had a few server issues) – which was a relief!
We’ll do a more complete review later on, but for me the take away is that these events are really worth continuing (and the others seemed to agree with this), and that the tooling needs to continue to evolve – perhaps to move away from a strictly resource focussed perspective as it is now, to a more functional one. We also need to increase the range of resources, supported properties on those resources, save more stuff to FHIR servers & improve the way we support profiling. No pressure…
We’ll continue to work on this, and we’re encouraging people to try the tooling out between events so that bugs and be squashed, enhancements can be developed, deployed & tested prior to the actual event and we can maximize the value of getting clinical folk together to talk FHIR.
If you’re interested, the tool is available here, and I do encourage you to go have a look and give us feedback (you can do that in comments to this post for the moment- we’ll figure out a better way soon). We’ll also be working on the documentation…
So, on to Paris in May! (and I’m off for a sleep…)
December 9, 2014 7 Comments
I was asked an interesting question yesterday by one of my colleagues at Orion Health – how to best represent a patients ‘Circle of Care’ (or Care Circle) in FHIR. Now, there are a number of different interpretations of what a Care Circle actually is, but in our scenario it’s all about relationships between a patient, and those who are involved in their care (which includes clinical and non-clinical alike).
November 13, 2014 3 Comments
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.
October 13, 2014 6 Comments
We’ve looked at representing a patients list of medications in a number of previous posts. This one describes using the List resource to describe the list, here we talked about updating the list using a transaction, and here were some thoughts on what a regional shared list might look like.
Just recently I’ve been involved in doing some more detailed design for this, as we’re looking at building a concrete implementation at Orion Health, so I’ve revisited how we could do it.
September 28, 2014 Leave a comment
I was going to write a post on the Clinical Connectathon that we held in Chicago at the Working Group Meeting the week before last (in fact, had just written the draft) but I see that Graham has just published a post covering the event, and a number of other FHIR related comments from the WGM, so I’ll just refer you there!
For myself, I think that the comment about the evolving FHIR community – moving from simply developing a standard to using that standard to solve ‘business’ problems is probably the most exciting for me – which is what the Clinical Connectathon was all about.
I also want to point out that there are (at least) 4 more FHIR related events in the next couple of months:
Plenty of opportunities to experience the hype for yourself!
August 8, 2014 4 Comments
One of the things that the FHIR project team is particularly keen on is having lots of examples in the spec. People (especially implementers & developers) understand examples more easily than just plain text – and an example helps illustrate what the spec is trying to say.
And the examples in the spec are guaranteed to be correct – they are automatically validated as the spec is generated.
Creating examples of FHIR resources is actually quite easy – all you need are the schema and a validating XML editor (like XML Spy or Oxygen) and you’re good to go (a validating editor will ensure that the example you create is valid according to the schema – which is 90% of the way there).
There’s a couple of ways of doing this – those who are actually building the spec can do it from their local copy of the spec and commit directly to the version control system – but this does require setting up the environment and having commit privileges into the repository, so is not suitable for everyone.
In this post, we’ll assume that we don’t have that, and will create the examples externally. It’s actually quite easy.
August 4, 2014 5 Comments
In conjunction with the Patient Care workgroup, we’re currently working on the ReferralRequest Resource. You can see a draft here, and the here is the resource request (but do be aware that it is very much a work in progress, and WILL change prior to appearing in the next DSTU).
Referrals are one of the most interesting (and contentious) aspects of the ‘art of medicine’ – particularly in this era of increasing ‘shared care’ where many providers (clinical and other) are going to be involved in a patients care.
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