FHIR Clinical Resources - PCWG

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This wiki page contains information related to a set of activities initiated March 2014 to facilitate contributions by PCWG members for continuous improvements of FHIR clinical DSTU resources, and to develop new FHIR clinical resources to meet stakeholder requirements.

Introduction

FHIR® – Fast Health Interoperable Resources (hl7.org/fhir) – is a next generation standards framework created by HL7. FHIR combines the best features of HL7’s Version 2, Version 3 and CDA® product lines while leveraging the latest web standards and applying a tight focus on implementability.

FHIR solutions are built from a set of modular components called “Resources”. These resources can easily be assembled into working systems that solve real world clinical and administrative problems at a fraction of the price of existing alternatives. FHIR is suitable for use in a wide variety of contexts – mobile phone apps, cloud communications, EHR-based data sharing, server communication in large institutional healthcare providers, and much more
http://www.hl7.org/implement/standards/fhir/summary.html

A number of FHIR clinical resources were developed, passed ballots and reached DSTU status in January 2014.
http://www.hl7.org/implement/standards/fhir/clinical.html

PCWG works closely with FHIR team to provide clinical and clinical informatics (and where appropriate, engineering) inputs to help continuous improvement of these resources

PCWG members also work closely with FHIR team to develop new FHIR clinical resources

This is the landing page providing interested parties with relevant information on these activities

Leadership

• Clinical Leads and Contributions:

Stephen Chu

Elaine Ayres

Russ Leftwich

Laura Heermann-Langford

Emma Jones

Rob Hausam

Kevin Coonan

• FHIR liaison for PCWG:

Lloyd McKenzie

David Hay

Viet Ngyuen

Conference Call Details and Minutes

Conference call: Audio and Webex

• Audio details:

Phone Number: +1 770-657-9270

Participant Passcode: 943377

• WebEx details:

(to be inserted here)

PCWG FHIR Conference Calls and Meeting Minutes

PCWG FHIR Resource Projects and Discussion Topics

PCWG is collaborating with FHIR team to develop a set of PCWG domain specific FHIR resources that are intended to meet the requirements of its stakeholders.

New PCWG FHIR Resource Proposals

Place holder for other PCWG specific FHIR Resources

FHIR Clinical Resources Topics

• Representing Negation

• Observation vs Condition

• Observation, Clinical Assessment and Clinical Annotation

• Clinical Status:

- Background: Discussion on "Clinical Status" were initiated in 2014 in an attempt to restore two deprecated templates in C-CDA Release 2.1. The lengthy, multiple rounds of discussions result in the PCWG group being asked by Structured Document WG to create a harmonised clinical status value set for use in C-CDA and also FHIR clinical resources

- Status: Discussion at the 2017-03-23 PCWG-FHIR conference call resolve to endorse a final value set for Clinical Status to be incorporated into FHIR clinical resources (primarily Condtion.clinicalStatus) post FHIR Release 3

- The follow two slide decks represent the final outcome of the long journey of discussions (key decisions/conclusions are captured in Slides 7-10 of both slide decks):

- ClinicalStatus valueset-Final-LongVersion 2017-05-23

- ClinicalStatus valueset-Final-ShortVersion 2017-05-23

- This spreadsheet contains clinical scenario walk-through illustrating the changes in clinical status values over the clinical courses of a number of common clinical conditions:

- ClinicalStatus-common clinical scenarios walkthrough version 2017-03-23

PCWG FHIR Resource Projects

• Referral and Transition/Transfer of Care

• Clinical Assessment

Clinicians on FHIR

The Clinicians on FHIR events are a set of clinician led activities designed to test the clinical validity, accuracy, usuability ... of FHIR Clinical Resources

The idea was suggested by the FHIR team to co-chairs of Patient Care Workgroup. It was well received and a small "Clinicians on FHIR Group" was form.

The following link provides more details about this initiative.

• Clinicians on FHIR

History and Evolution-

• The FHIR Clinical Connectathon has been renamed to FHIR Clinician Connectathon as of November 2014
• And renamed to Clinicians on FHIR post May 2015 Paris WGM

FHIR Clinical Resources

These clinical resources are under stewardship of PCWG:

1. Adverse Reaction (http://www.hl7.org/implement/standards/fhir/adversereaction.html)

2. Allergy Intolerance (http://www.hl7.org/implement/standards/fhir/allergyintolerance.html)

3. Care Plan (http://www.hl7.org/implement/standards/fhir/careplan.html)

4. Condition (http://www.hl7.org/implement/standards/fhir/condition.html)

5. Family History (http://www.hl7.org/implement/standards/fhir/familyhistory.html)

6. Procedure (http://www.hl7.org/implement/standards/fhir/procedure.html)

7. Questionnaire (http://www.hl7.org/implement/standards/fhir/questionnaire.html)

8. QuestionnairAnswer (http://hl7-fhir.github.io/questionnaireanswers.html)

Other Clinical-Related FHIR Resources: (under stewardship of other HL7 WGs)

http://hl7-fhir.github.io/riskassessment.html

http://hl7-fhir.github.io/contraindication.html

FHIR Processes & Tooling Learning Resources

The FHIR team has produced a number of resources that are useful for those who are interested in learning about FHIR, to explore and develop domain specific FHIR resources

Here are the links to some very useful resources:

• FHIR Learning and Tooling Resources

• FHIR Profiles

• FHIR Mappings

• Creating Examples in FHIR:

http://fhirblog.com/2014/08/08/creating-examples-in-fhir/

• HL7/FHIR and openEHR joint review of "Adverse Reaction" clinical model

- HL7/FHIR and openEHR have set up a joint review process to review an "Adverse Reaction" clinical model (archetype)

- The steps for signing up and review through the openEHR clinical knowledge manager (CKM) collaborative environment are summerised in this ppt file:

- openEHR CKM "Adverse Reaction" clinical model review sign up and review process steps

FHIR ValueSets

Value sets are an integral part of any resource which communicates coded patient information. Draft/candidate value sets can be located at DRAFT FHIR ValueSets.