This document provides an introduction to FHIR (Fast Healthcare Interoperability Resources). It discusses how FHIR resources like Patient, Observation, and DiagnosticReport can be exchanged using RESTful HTTP operations. Resources have defined meanings and can reference each other to link related clinical information. Extensions allow adding custom elements to resources. FHIR supports bundling multiple resources together in a transaction using the Bundle resource. The specification and additional documentation provide help for implementing FHIR-based systems and applications.

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GETTING STARTED WITH
FHIR
INTERNATIONAL DEVDAYS 2015 – Beginners Track

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Relative – No technology can make integration as fast as we’d like
That’s why we’re here
Building blocks – more on these to follow
The Acronym

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FHIR – DSTU2
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FHIR – Nightly build

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F..H..I..Resources
 Have defined behaviour and meaning
 Are FHIR’s unit of exchange
 Known identity / location
Examples
 Administrative: Patient, Location, Encounter, Organization, Episode
 Clinical Concepts: AllergyIntolerance, Questionnaire, Observation
 Devices: Metric, DeviceComponent
 Scheduling: Appointment, Availability, Slot
 Financial: Claim, Account, Coverage

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Defined meaning
Let’s look at Resources in the spec….

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(Complex) Datatypes

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Extensions
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Yes, but where are:
• citizenship
• mothersmaidenname,
• us-core-race
Don’t worry, you can add extensions: your own
elements – FHIR even defines a few favorite
ones!

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The Case for Extensions
 Simple choice
 design for absolutely everything
 Or go for “the 80%” and allow extensions
 Everyone needs extensions, everyone
hates them
 Define, publish, find extensions
 Repository
 Documented just like resources
 Can be fetched & interpreted by clients

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Standard extensions
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Community Registry
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Unit of Exchange
(XML example)
<Patient xmlns="http://hl7.org/fhir">
<id value="patient1"/>
<meta>
<versionId value="v2"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>Henry Levin the 7th</p>
</div>
</text>
<extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
<valueDateTime value="1932-09-24T14:35:45-05:00"/>
</extension>
<identifier>
<use value="usual"/>
<system value="http://acme.org/identifiers/mrn"/>
<value value="12345"/>
</identifier>
<name>
<family value="Levin"/>
<given value="Henry"/>
</name>
<gender value="male"/>
<birthDate value="1932-09-24"/>
<managingOrganization>
<reference value="Organization/123xyz"/>
<display value="Good Health Clinic"/>
</managingOrganization>
<active value="true"/>
</Patient>

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A Resource’s identity
 In fact: a URL
http://server.org/fhir/Patient/example
endpoint
resource type
logical id
Can even paste this in a browser!
http://spark-dstu2.furore.com/fhir/Patient/example

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Just a quick GET
GET /fhir/Patient/1 HTTP/1.1
HTTP/1.1 200 OK
Content-Type: application/xml+fhir;charset=utf-8
Content-Length: 787
Content-Location:
http://spark.furore.com/fhir/Patient/1/_history/12
Last-Modified: Tue, 29 May 2012 23:45:32 GMT
<?xml version="1.0" encoding="UTF-8"?>
<Patient xmlns="http://hl7.org/fhir"><identifier><label>SSN</label><identifier><system>
http://hl7.org/fhir/sid/usssn</system><id>444222222</id></identifier></identifier><name><use>official
</use><family>Everywoman</family><given>Eve</given></name><telecom><system>phone</system><value>555-
555 2003</value><use>work</use></telecom><gender><system>http://hl7.org/fhir/sid/v2-0001</system>
<code>F</code></gender><birthDate>1973-05-31</birthDate><address><use>home</use><line>2222 Home
Street</line></address><text><status>generated</status><div
xmlns="http://www.w3.org/1999/xhtml">Everywoman, Eve. SSN:444222222</div></text></Patient>
UTF-8
encoded
HTTP Verb + path

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Diagnostic
Report Patient
Practitioner
Observation

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Resource Reference
Example: part of DiagnosticReport

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It’s all about combining
resources . . .
Diagnostic
Report
Patient
Practitioner
Observation
mpi.hospitalA.org/Practitioner/87
lab.hospitalA.org/DiagRep/4445
lab.hospitalA.org/Observation/3ff27
On the same
lab system
Organizational MPI
National patient
registry

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REST:“Repository”
model of healthcare
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Hospital System
POST
Patient
POST
Order
Notify new
Lab results
UPDATE
Patient
Lab System
POST
Lab resultGET
Orders
FHIR server
Observation
Patient Observation
Observation
Diagnostic
Report
Order
Order

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REST in the spec…
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Bundling resources
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FHIR server
Obs
Dx
Report
Lab System
Post
Lab resultQuery
Orders
Order OrderOrder
Practitioner Practitioner
Order
Obs
Obs
“searchset Bundle” “transaction Bundle”

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Bundle..is a resource!
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On the wire…
 http://spark-dstu2.furore.com/fhir/Patient
 _format = xml, _format = json
 Notice the <link>
 And then <entry>, <entry>, ….
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Summary
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Read
Search
FHIR server
Observation
Patient
Diagnostic
Report
Update
Order
DeleteCreate
Bundle
Resource
ElementsMetadata
Narrative
Extension
Data Types
History
Transaction

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Help!!
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The cast…
 http://hl7.org/fhir/
 http://hl7.org/fhir/resourcelist.html
 http://hl7.org/fhir/datatypes.html
 http://hl7.org/fhir/patient-extensions.html
 http://simplifier.net
 http://hl7.org/fhir/http.html
 http://hl7.org/fhir/bundle.html
 http://fhir.furore.com/cheatsheet
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Questions?
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