DAF FHIR Profile Proposal

Data Access Framework (DAF) FHIR Profile Proposal

This project aims to create Fast Healthcare Interoperability Resources (FHIR) Profiles for access to discrete meaningful-use information as FHIR resource instances. In some cases, the profiles will extend beyond meaningful use data requirements based on stakeholder feedback. This project will not create a profile for document access since this is covered by the Integrating Healthcare Enterprise Mobile access to Health Documents (IHE MHDv2).

The Artifacts to be produced as part of this project include:

• Define profiles on selected FHIR resources that define additional search criteria for retrieving those resources.
• Define a conformance resource instance that defines expectant system behavior on server side, client side for DAF conformant systems. Project expects one for client, and one for servers.
• Create profiles on selected FHIR resources identifying minimum data and corresponding constraints and value sets for query response.This activity may overlap with C-CDA on FHIR activities to some extent. See notes below on coordination with C-CDA on FHIR project.
• Define a DAF implementation guide that organizes and provides context for the above artifacts.

Coordination with CCDA on FHIR project: This project will coordinate with the C-CDA on FHIR project to minimize duplicate profiles on common resources. An additional profile will only be created if the C-CDA profile doesn’t already exist for the resource, or the C-CDA profile doesn’t include required data elements in a current resource to support DAF. Coordination with the C-CDA on FHIR will be done by engagement with the work groups responsible for FHIR resources. Where multiple profiles are required on the same resource, common data elements will be kept in alignment; Where different profiles require different scope in near term, additional work will be done in future to bring back into alignment.The DAF Profile(s) will build from the existing work of the Standards & Interoperability (S&I) Data Access Framework (DAF) Initiative.

Profile Details

The following FHIR resources will be profiled.

• Patient
• Encounter
• Observation
• Condition
• Medication
• MedicationPrescription
• MedicationAdministration
• MedicationDispense
• AllergyIntolerance
• DiagnosticOrder
• DiagnosticReport
• Procedure
• Immunization
• FamilyHistory
• Practitioner
• List

Constraints to be Applied

The following constraints will be applied to the FHIR resources as necessary.

• Constrain the cardinality of the data elements within the resource.
• Constrain the mustSupport attribute of the data elements within the resource.
• Define searchParameters as necessary for the resource.
• Constrain vocabularies to Meaningful Use Stage 2 specific vocabularies for the resources as applicable.

Extensions to be Applied

The following extensions may be applied to resources as appropriate.

• US Realm specific extensions for the various FHIR resources.

Example Scenarios

• Query Examples for each resource
• Query Result Examples for each resource

Scope of coverage

• Subject: Patient
• Disciplines: Patient Care, Clinical Research, Public Health
• Delivery Environment: Inpatient, Ambulatory, Community, Emergency etc.
• Locale: United States

Ownership

Owning committee name

Infrastructure and Messaging

Contributing or Reviewing Work Groups

• Structured Documents
• Orders and Observations
• Templates
• Conformance Guidance for Implementation and Testing
• Patient Administration
• Patient Care
• Pharmacy
• Public Health Emergency Response

Expected implementations

• ONC S&I Framework DAF Pilots
• ONC Standards Implementation and Testing Environment

gForge Users

• Nagesh Bashyam (a.k.a Dragon)
• Brett Marquard

FHIR Profile Development Project Insight ID

• Pending

Plans

Timelines

• October 2014

Balloting Requirements

• Ballot independently as DSTU
• US Realm Specific Ballot as appropriate

Desired Ballot Date

• Submit Draft for Comment - December 2014
• Submit for DSTU - March 2015
• Ballot Reconcilation - May 2015
• DSTU Period - June 2015