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Fhir basics session4_conformance_and_terminology
The presentation by Kumar Satyam on June 5, 2021, focuses on HL7 FHIR conformance and terminology, outlining key concepts such as resources, their behaviors, the FHIR RESTful paradigm, and community activities. It emphasizes the importance of interoperable healthcare systems, the use of profiles for resource constraints, and categorizes conformance resources into terminology, content, behavior, and management. Attendees are encouraged to engage through social media, the FHIR India community, and preparatory work for future sessions.
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Fhir basics session4_conformance_and_terminology
- 1. HL7 FHIR BASICS– SESSION 4 Conformance & Terminology Kumar Satyam https://www.linkedin.com/in/kumarsatyam/ https://twitter.com/kr_satyam 5-June-2021 Presentation by Kumar Satyam
- 2. Acknowledgements & Credits ThisPresentation borrows from the content of presentations by ➢Grahame Grieve ➢Lloyd McKenzie ➢Ewout Kramer ➢David Hay ➢Michel Rutten ➢ and other members of HL7 FHIR Community. 5-June-2021 Presentation by Kumar Satyam
- 3. Agenda ➢Recap ➢Conformance ➢Terminology ➢Exercise ➢Pre-work for nextsession 5-June-2021 Presentation by Kumar Satyam
- 4. FHIR India Community •Open community of HL7 FHIR & Interoperability enthusiasts. • #fhirIndia – social media tag. • https://fhirindia.zulipchat.com/ - Discussion forum • https://www.linkedin.com/groups/13932672/ - LinkedIn Group 10K by Dec 2021. 5-June-2021 Presentation by Kumar Satyam
- 5. Glimpse of someof the community activities ✓Review and feedback digital healthcare initiatives like NDHB ✓FHIR India Connectathon – July 2020 ✓NDHM FHIR Profiles ✓Concept papers ✓Education & Implementer support ✓Connect with global community ✓Projects of common interest 5-June-2021 Presentation by Kumar Satyam
- 6. House Keeping • Pleasebe on mute while the session is in progress • Please use your full name in zoom participant's profile. • Ask questions on zoom chat . • Follow up & discussions on zulip. • Everyone please ensure that you are on zulip. https://fhirindia.zulipchat.com/#narrow/stream/272723-Training-.26.20Conferences/topic/FHIR.20Basics.20Training 5-June-2021 Presentation by Kumar Satyam
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- 8. Fast Healthcare InteroperabilityResources 5-June-2021 Presentation by Kumar Satyam
- 9. FHIR RESTFul Paradigm ➢“REpresentationalState Transfer” ➢Represent your data as “resources” ➢Make “Resource” URI addressable ➢Use HTTP methods to perform CRUD operations ➢FHIR extends the HTTP methods for additional base operations ➢Resources may be exchanged using different formatted representations ▪ XML, JSON, RDF,ND-JSON . *RESTFul because loosely follows REST. 5-June-2021 Presentation by Kumar Satyam
- 10. Instance Level Allows aclient to retrieve the current content of a resource, to update the content to a new state, to delete the resource, or to see its modification history Type Level Allows a client to search through the existing resources that already exist, create a new instance of a resource, or get the history of all changes to resource of the type. System Level Allows a client to determine what functionality is provided by the system, perform batches and transactions across multiple resource types, and get the history of all changes to all resources. 5-June-2021 Presentation by Kumar Satyam FHIR Base Services
- 11. Resources in FHIR •“Resources” are: • Small logically discrete units of exchange • Defined behavior and meaning • Known identity / location • Smallest unit of transaction A resource is an entity that: • has a known identity (a URL) by which it can be addressed • identifies itself as one of the types of resource defined in this specification • contains a set of structured data items as described by the definition of the resource type • has an identified version that changes if the contents of the resource change 29-May-2021 Presentation by Kumar Satyam
- 12. What is aResource Examples •Patient, Practitioner, Organization •Location, Coverage, Invoice •AllergyIntolerance, Condition, FamilyHistory, CarePlan •Bundle, Binary, Composition 29-May-2021 Presentation by Kumar Satyam
- 13. Resource Definitions • Allresources have following : • An identity • Meta data • A base language • A reference to "Implicit Rules“ 29-May-2021 Presentation by Kumar Satyam
- 14. Domain Resource A domainresource is a resource that: • has a human-readable XHTML representation of the content of the resource (see Human Narrative in resources) • can contain additional related resources inside the resource (see Contained Resources) • can have additional extensions and modifierExtensions as well as the defined data (See Extensibility) As an abstract resource, this resource is never created directly; instead, one of its descendant resources (see List of Resources) is created. This resource extends the base Resource. All of the listed Resources except Bundle, Parameters and Binary extend this resource. 29-May-2021 Presentation by Kumar Satyam
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- 16. The FHIR Manifesto •Focus on Implementers. • Target support for common scenarios. • Leverage cross- industry web technologies. • Require human readability as base level of interoperability. • Make content freely available. • Support multiple paradigms & architectures Source : Principles of Health Interoperability_ SNOMED CT, HL7 and FHIR 3rd edition
- 17. Support “Common” Scenarios •Inclusion of content in core specification is based on “80%” rule • Only include data elements we are confident that most (~80%) of normal implementations using that resource will make use of • Other content in extensions • Easy to say, governance challenge to achieve • Resources are simple and easy to understand & use
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- 19. Conformance How a systemworks, or how it should work Document / Describe 5-June-2021 Presentation by Kumar Satyam
- 20. Context •FHIR is astandard for interoperability Therefore: If two systems both comply with FHIR, they’ll fully interoperate •True or false? •Why not? 5-June-2021 Presentation by Kumar Satyam
- 21. Context 5-June-2021 Presentation by KumarSatyam • 140+ resources • Do all systems support all resources ? Most Resource elements are optional Data type components optional Terminologies unconstrained Then there are operations and behaviors.
- 22. The Need Need tobe able to describe adaptations based on use and context. • What resources and elements are used? • What API features are used? • What terminologies are used? • How to map these to local requirements/implementations? In a structured computable way that can be basis for validation, code, report and UI generation etc. 5-June-2021 Presentation by Kumar Satyam
- 23. Use of conformance •To create implementation guides that document expected behavior • To test that systems conform to a set of documented behavior • To generate code for reading and writing resources, or search forms or input screens • Comparing implementations to see if they are compatible 5-June-2021 Presentation by Kumar Satyam
- 24. Categories of conformanceresources • Terminology – these resources deal with describing how terminologies are used. • Content – these resources describe the content of other resources. In other specifi cations, these are sometimes called ‘profiles’ or ‘ templates’. • Behavior – these resources describe the system operations that can or will be used. • Management – these resources deal with publishing an implementation guide (a set of conformance resource.es) and specifying testable behavior. 5-June-2021 Presentation by Kumar Satyam
- 25. Profiling FHIR 5-June-2021 Presentation byKumar Satyam
- 26. Profiling FHIR 5-June-2021 Presentation byKumar Satyam
- 27. FHIR Profile •A setof constraints on a FHIR resource •A set of constraints on another FHIR profile 5-June-2021 Presentation by Kumar Satyam
- 28. Profiling a resource 5-June-2021 Presentationby Kumar Satyam Demand that the identifier uses your national patient identifier Limit names to just 1 (instead of 0..*) Limit maritalStatus to another set of codes that extends the one from HL7 international Add an extension to support “RaceCode”
- 29. Profiling Terminology •Terminology Bindings •BindingStrengths 5-June-2021 Presentation by Kumar Satyam
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- 31. FHIR Terminology Module 5-June-2021 Presentationby Kumar Satyam http://hl7.org/fhir/terminology-module.html
- 32. CodeSystem vs ValueSet 5-June-2021 Presentationby Kumar Satyam “Code System” “Dante’s deadly sins” Pride Envy Wrath Sloth Avarice Gluttony Lust “ValueSet” Takes concepts from… An enumeration of terms Definition of terms Example: SNOMED-CT Example: “Childhood diseases”
- 33. FHIR Terminology Module 5-June-2021 Presentationby Kumar Satyam
- 34. Coded Datatypes • Code •Just the ‘code’ itself - code system and value set are fixed • Coding • ‘code’ + ‘system’ (both are optional, but are both generally present) • Plus ‘display’, ‘version’, ‘userSelected’ (also optional) • CodeableConcept • One or more Coding instances plus optional text 5-June-2021 Presentation by Kumar Satyam
- 35. Use in Resource Let’stake a look at Patient Resource 5-June-2021 Presentation by Kumar Satyam
- 36. Conformance Resources • CapabilityStatement • OperationDefinition • StructureDefinition • Value Set • Concept Map • NamingSystem 5-June-2021 Presentation by Kumar Satyam
- 37. Pre-work for nextsession 5-June-2021 Presentation by Kumar Satyam http://hl7.org/fhir/conformance-rules.html