introduction to fhir by ewout kramer

© 2012 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

GETTING STARTED WITH FHIR

INTERNATIONAL DEVDAYS 2015 – Beginners Track


Fast Relative – No technology can make integration as fast as we’d like

HealthcareInteroperabilityThat’s why we’re here

ResourcesBuilding blocks – more on these to follow

The Acronym


FHIR – DSTU2

3


4

FHIR – Nightly build


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


Defined meaning

Let’s look at Resources in the spec….


(Complex) Datatypes


8

Extensions

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!


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


10

Standard extensions


11

Community Registry


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>


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


Just a quick GETGET /fhir/Patient/1 HTTP/1.1

HTTP/1.1 200 OKContent-Type: application/xml+fhir;charset=utf-8Content-Length: 787Content-Location: http://spark.furore.com/fhir/Patient/1/_history/12Last-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


Patient

Practitioner

Observation


Resource ReferenceExample: part of DiagnosticReport


It’s all about combining resources . . .

Patient

Practitioner

Observation

pat.registry.org/Patient/223

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


18

REST:“Repository” model of healthcare

Hospital System

POSTPatient

POSTOrder

Notify newLab results

UPDATEPatient

Lab System

POSTLab resultGET

Orders

FHIR server

ObservationPatient Observation

Observation

OrderOrder


19

REST in the spec…


20

Bundling resources

FHIR server

Obs

Lab System

PostLab resultQuery

Orders

Order OrderOrder

Practitioner Practitioner

Order

Obs

Obs

“searchset Bundle” “transaction Bundle”


21

Bundle..is a resource!


22

On the wire…

http://spark-dstu2.furore.com/fhir/Patient _format = xml, _format = json

Notice the <link> And then <entry>, <entry>, ….

http://spark-dstu2.furore.com/fhir/Patient

http://spark-dstu2.furore.com/fhir/Patient


23

Summary

Read Search

FHIR server

ObservationPatient

Update

Order

DeleteCreate

Bundle

Resource

ElementsMetadata

Narrative

Extension

Data Types

HistoryTransaction


24

Help!!


25

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

http://hl7.org/fhir/

http://hl7.org/fhir/

http://hl7.org/fhir/resourcelist.html

http://hl7.org/fhir/resourcelist.html

http://hl7.org/fhir/datatypes.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/http.html

http://hl7.org/fhir/bundle.html



http://fhir.furore.com/cheatsheet

http://fhir.furore.com/cheatsheet


26

Questions?