FHIR Examples For Driving FHIR Ontology Development

To coordinate and speed our efforts, it will be helpful to choose some initial FHIR examples that we can use to drive our FHIR ontology development effort. This would not be to the exclusion of other examples, but merely to act as a common starting point, such as a very simple clinical resource. We will eventually need to use a variety of examples that exercise different features.

Clinical / Observation: Body Weight Measurement

From http://www.hl7.org/implement/standards/fhir/observation-example.html

XML 31 lines excluding comments:

<Observation xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Jan 30 2014: Body Weight = 185 lbs</div>
  </text>
  <name>
    <coding>
      <system value="http://loinc.org"/>
      <code value="3141-9"/>
      <display value="Weight Measured"/>
    </coding>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="27113001"/>
      <display value="Body weight"/>
    </coding>
    <coding>
      <system value="http://acme.org/devices/clinical-codes"/>
      <code value="body-weight"/>
      <display value="Body Weight"/>
    </coding>
  </name>
  <valueQuantity>
    <value value="185"/>
    <units value="lbs"/>
    <system value="http://unitsofmeasure.org"/>
    <code value="[lb_av]"/>
  </valueQuantity>
  <status value="final"/>
  <reliability value="ok"/>
</Observation>

Comments:

• (DBooth) This example is small (which is good), but not ideal because: (a) it is only moderately medically oriented -- body weight is used in many non-medical settings; and (b) body weight is an emotionally charged sensitive topic to many people, which is not so good for slide presentations.

Clinical / Observation: Blood Pressure

JSON 156 lines: http://www.hl7.org/implement/standards/fhir/observation-example-bloodpressure.json.html

Comments:

• (DBooth) This example would be excellent for slide use if it were smaller. Although this example is for a single blood pressure measurement pair (107/60), it is very bloated because it duplicates the information. First it has an Observation that includes both systolic and diastolic values (107/60), but only in human-readable free text -- not in structured data suitable for machine processing. Then it has two more Observations, one for systolic and one for diastolic, which each contain both a human-oriented description in free text and the values in structured data. Could another version be made that is much smaller?

Clinical / AllergyIntolerance: Bee Sting

JSON 30 lines: http://www.hl7.org/implement/standards/fhir/allergyintolerance-examples.html

<AllergyIntolerance xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Sensitivity to Bee Stings</div>
  </text>
  <criticality value="fatal"/>
  <sensitivityType value="allergy"/>
  <recordedDate value="2012-09-17"/>
  <status value="confirmed"/>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <recorder>
    <reference value="Practitioner/example"/>
  </recorder>
  <substance>
    <reference value="Substance/example"/>
  </substance>
  <reaction>
    <reference value="AdverseReaction/example"/>
  </reaction>
  <sensitivityTest>
    <reference value="Observation/example"/>
  </sensitivityTest>
</AllergyIntolerance>

Comments:

• (DBooth) For slide use, this example is very good except that it is confusingly similar to the next example (AdverseReaction: Bee Sting). (One is documenting the patient's propensity to a bee sting allergy; the other is documenting an actual occurrence of that allergic reaction.)

Clinical / AdverseReaction: Bee Sting

JSON 41 lines: http://www.hl7.org/implement/standards/fhir/adversereaction-example.json.html

<AdverseReaction xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Anaphylaxis Reaction to a bee sting</div>
  </text>
  <date value="2012-09-17"/>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <didNotOccurFlag value="false"/>
  <recorder>
    <reference value="Practitioner/example"/>
  </recorder>
  <symptom>
    <code>
      <coding>
        <system value="http://hl7.org/fhir/sid/icd-10"/>
        <code value="T78.2"/>
        <display value="Anaphylactic shock, unspecified"/>
      </coding>
      <text value="Anaphylaxis reaction"/>
    </code>
    <severity value="moderate"/>
  </symptom>
  <exposure>
    <date value="2012-09-17"/>
    <type value="coincidental"/>
    <substance>
      <reference value="Substance/example"/>
    </substance>
  </exposure>
</AdverseReaction>

Comments:

• (DBooth) For slide use, this example is very good except that it is confusingly similar to the previous example (AllergyIntolerance: Bee Sting). (One is documenting the patient's propensity to a bee sting allergy; the other is documenting an actual occurrence of that allergic reaction.)

Administrative / Patient: example-xcda

JSON 39 lines: http://www.hl7.org/implement/standards/fhir/patient-example-xcda.json.html

Comments:

• (DBooth) This example is simple enough for slide use, but not clinically oriented.

Administrative / Substance: Bee Venom

JSON 10 lines: http://www.hl7.org/implement/standards/fhir/substance-example.json.html

Administrative / Practitioner: CCDA Example Author

JSON 18 lines: http://www.hl7.org/implement/standards/fhir/practitioner-example-xcda-author.json.html