Our speaker, Joshua Mandel, will provide a lightning tour of Fast Healthcare Interoperability Resources (FHIR), an emerging clinical data standard, with a focus on its resource-oriented approach, and a discussion of how FHIR intersects with the Semantic Web. We'll look at how FHIR represents links between entities; how FHIR represents concepts from standards-based vocabularies; and how a set of FHIR instance data can be represented in RDF.

1. Clinical data in FHIR
Intro & RDF representation
Josh Mandel, MD
SemanticWeb.com
December 12, 2014

2. What's the problem?
Healthcare workflows:
referrals and transitions of care
patient communications
quality improvement
clinical trial eligibility
→ need accessible data to flow

3. What is FHIR?
Draft standard within HL7
Open standard (→ CC0)
Resources, Datatypes, Value Sets ("80/20")
REST API
High conceptual alignment with sem web...
But vis-à-vis RDF, FHIR "reinvents" quite a bit.

4. What is FHIR? Resources
50+ "atomic" structures

5. What is FHIR? Datatypes
(Common structures for core meaning)

6. e.g. GET
All patients named "amy"
/Patient?name=amy
All combined systolic+diastolic measurements
/Observation?name:text=systolic+and+diastolic
/Observation?name=55284-4
/Observation?name=http://loinc.org|55284-4
What is FHIR? REST API

7. Chaining
"All blood pressures from females"
/Observation?name=55284-4&
subject:Patient.gender=F
Inclusion paths
"BP measurements with their component parts"
/Observation?name=55284-4&
_include=Observation.related.target
What is FHIR? REST API

8. What is FHIR? Profiles
("Meta" models used to describe resources)

9. Not required for individual patient data…
But a consistent way to host vocabs
Live demo
What is FHIR? ValueSet

10. 80/20 principle for "core"
So everything is extensible (even primitives!)
"extension" vs. "modifierExtension"
"Note that, unlike in many other specifications, there can be no stigma
associated with the use of extensions by any application, project, or
standard - regardless of the institution or jurisdiction that uses or
defines the extensions. The use of extensions is what allows the FHIR
specification to retain a core simplicity for everyone."
What is FHIR? Extensibility

11. Data and reference material in one place
Rich query environment
Automated reasoning
● Clinical care
● Research
● Data quality analysis
FHIR in RDF. Why?

12. CodeableConcept → Coding
<name>
<coding>
<system value="http://loinc.org"/>
<code value="55284-4"/>
<display value="Blood pressure systolic and diastolic"/>
</coding>
</name>
FHIR in RDF. URIs

13. CodeableConcept → Coding
<name>
<text>BP</text>
<coding>
<system value="http://loinc.org"/>
<code value="55284-4"/>
<display value="Blood pressure systolic and diastolic"/>
</coding>
</name>
FHIR in RDF. URIs
http://loinc.org|55284-4

14. <birthDate value="1982-10-26"/>
Could express as
_:me fhirPatient:birthDate "1982-10-26".
FHIR in RDF. Dates, strings, etc.
<birthDate value="1982-10-26">
<extension url="http://myvocab/with-days">
<valueInteger="5"/>
</extension
</birthDate>

15. Explicit relations modeled… and extensible
FHIR in RDF. Relations
<Observation>
<subject value="Patient/123">
</Observation>
_:bp [
a fhir:Observation
Observation:subject [
a fhir:Reference;
Reference:reference <Patient/123>
]
].

16. Generate automated, simple transformations
Transparent syntactic manipulation
Verbose but comprehensive
FHIR in RDF. "Idiomatic RDF"?
→ Eventually we need
● idiomatic RDF
● readable ontology
● some automated reasoning