Thoughts and comments on the HL7 FHIR standard, from a FHIR Evangelist
March 26, 2021 8 Comments
In New Zealand (and other places as well I expect) we’ve had a national registry for immunizations for a number of years – the National Immunization Register or NIR
It’s currently fed by HL7 version 2 messages and there’s a User Interface for authorized users, but there was always a plan to introduce a FHIR interface to some point – something that has been accelerated by the current COVID pandemic of course.
Read more of this postMarch 2, 2021 4 Comments
So we’ve got an interesting issue in New Zealand (from a FHIR perspective of course). We’re in the process of creating extensions to be used nationally, and one of the requirements we have is to be able to store the HealthLink EDI number – an ‘address’ used to send information electronically between healthcare providers.
Some background: in New Zealand we have a messaging service that is operated by a private company (HealthLink) which has national coverage that connects Primary care with Hospitals, Laboratories and other services such as eReferrals. It’s actually been running for a number of decades and has certainly helped with electronic sharing of information. The company provides vendors with client-side applications they they use to interact with the service.
Users of the service are assigned a unique code (the EDI number) that acts as a delivery address for the user (which can be an individual or an organization). For example, when a hospital wishes to send a Discharge Summary to the patient’s General Practitioner (their Primary / Ambulatory care provider) then they will send the summary to the service, asking for it to be delivered to that EDI account.
As we move into FHIR, the question is how do we represent that number? For the purposes of this discussion, we’ll assume that we wish to attach it to a Practitioner resource, though it will also need to be applied to others such as Organization or PractitionerRole.
August 18, 2020 1 Comment
I’ve always been fond of creating functional prototypes when designing apps. There are a number of advantages over simply documenting what the app should do:
May 1, 2020 11 Comments
As readers will know, I’m a big fan of FHIR Shorthand as a way of making it much easier to create Implementation Guides and examples in conjunction with the IG publisher. In fact, I’m coming to the conclusion that all systems that expose FHIR API’s should have an IG that describes it (along with the CapabilityStatement resource of course) – and unless you have experience with creating StructureDefinitions directly, then FSH – and SUSHI – is the way to go.
Of course, creating IG’s is still not easy (it’s just easier) so I thought it would be a good idea to write about common patterns that you might want to express – and serve as a reminder for me when I forget! Read more of this post
March 12, 2020 5 Comments
As you’ll likely be aware, FHIR uses Implementation Guides (IG) to describe how to use FHIR for specific scenarios or use cases. In the past it has been technically challenging to create these guides, but this is changing – in large part due to new tooling/approaches like shorthand and sushi, but also because the FHIR community (and especially Lloyd) have been working on a template based publisher.
The idea behind the template based publisher is that there are a number of standard templates for specific purposes such as an ‘official’ HL7 FHIR IG or a plain template, and these can then be adapted for specific purposes – such as a National IG or a vendor specific one describing a FHIR based implementation. The project is still relatively new, but becoming stable enough that people are able to use it. However, the newness means that the documentation is still catching up, so when my colleague Jose Costa Teixeira offered to write a ‘beginners guide to creating your very own template’ I said great!
He’s published it on his blog, but kindly allowed me to reproduce it here.
Without further ado, take it away Jose… Read more of this post
February 10, 2020 6 Comments
I was trying to remember how to represent family relationships in FHIR – to record that one person is related to another, maybe a mother / daughter relationship, assuming that each person is already represented by a Patient resource. I asked my good friend Brian Postlethwaite who kindly didn’t say “I’ve told you this before”, but rather pointed me at the RelatedPerson resource and the example in the spec.
For example, to create a link from mother to child, what you do is to create the 2 Patient resources that represent the mother and the child, then create a RelatedPerson resource that directly references the child (the ‘to’ of the relationship) through the RelatedPerson.patient element, and then use the mothers Patient.link to refer to that RelatedPerson (the ‘from’). In effect both the mothers Patient and the RelatedPerson resources both have information about the mother (hopefully not contradictory) and it’s the RelatedPerson.patient & RelatedPerson.relationship that provides the relationship to the child. The Patient.link then has a type of ‘seealso’ to the Related person.
January 31, 2020 3 Comments
Examples are probably one of the more useful things to an implementer – yet likely the least exciting part of building an Implementation Guide (IG) to the designer. And not only are they useful to the implementer, they are a good way to double check the actual IG – it’s surprising how often having to create an example finds issues with the artifacts within an IG.
But the tooling to create examples is not that great. Generally you’re using a generic JSON or XML tool which offers no editing support to ensure that the example is valid (you can use the $validate operation that I’ve discussed before, but the workflow is tedious). I’ve tried to use clinFHIR for that – and it does work, though chokes some of the more complex profiles, and is still quite slow to create the resource instance.
There is an alternative that I’m currently using that seems to resolve these issues – the shorthand spec (with associated sushi reference implementation) that I blogged about last week. As well as producing profiles, it can also create resource instances using the same syntax as for profiles, and even better – when you run sushi to generate the resources, it will pick up the more egregious errors.
January 24, 2020 3 Comments
The 23rd FHIR connectathon in Sydney is almost upon us, and despite the trials and tribulations that the weather has thrown at us, it’s going to be a great event with over 150 people currently scheduled to attend. There are 15 tracks, a number of which are for local initiatives (like the Primary Care track or ePrescribing track) as well as the more general ones, so there’s plenty of choice for attendees. We do recommend that you choose one track as your primary track – perhaps observing others of particular interest – as that seems to bring the best benefit to attendees and the spec.
For myself, I’m going to participate in the FHIR shorthand track. This is an initiative being driven by the Mitre Corporation in the US, which is a not-for-profit organization heavily involved in the FHIR community to create a simpler way to produce FHIR profiles.
January 13, 2020 Leave a comment
For those interested in Subscriptions – here’s a blog post from Gino Canessa of Microsoft who is deeply involved in the R5 redesign of this, particularly the Subscription resource.
December 20, 2019 1 Comment
In the previous post we created a bundle of Patient resources for sending to a FHIR server. However, if you take a look at the Bundle generated by executing the transform, you’ll see that it has a type of ‘transaction’ but the entry elements only contain a ‘resource’ element (that contains the actual resource) – it’s missing the ‘request’ element that tells the server what to do with that resource, and so is not a valid transaction.
Let’s fix that.
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