CH ELM (R4)
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CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.3.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

FOPH CapabilityStatement for receiving laboratory reports

CapabilityStatement for receiving laboratory reports

Behavior: Search Parameters

These define the properties by which a RESTful server can be searched. They can also be used for sorting and including related resources.

SearchParameter-ch-elm-status

Status of the processing of the document referenced by the DocumentReference

Structures: Logical Models

These define data models that represent the domain covered by this implementation guide in more business-friendly terms than the underlying FHIR resources.

CH ELM Laboratory Report

The logical model represents the CH ELM laboratory report as an abstract data model. This data elements are defined by the ordinance of the Federal Office of Public Health (FOPH) and are then mapped to the FHIR document structure.

Cardinalities:

  • The cardinalities in the logical model show the so-called ‘best case’. This means that if these data are available, they must be submitted to the FOPH.
  • Since in reality the data is not always available, the CH ELM profiles define which elements are required or optional.
  • See also the concept ‘Must Support’, which is described on the ‘Home’ page of this implementation guide

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

CH ELM Composition: Laboratory Report

This CH ELM base profile constrains the Composition resource for the purpose of laboratory test reports.

CH ELM DiagnosticReport: Laboratory Report

This CH ELM base profile constrains the DiagnosticReport resource for the purpose of laboratory test reports.

CH ELM Document: Laboratory Report

This CH ELM base profile constrains the Bundle resource for the purpose of laboratory test reports.

CH ELM Document: Laboratory Report (strict)

CH ELM profile for the Bundle resource with a stricter validation mechanism than the base profile via binding strength reinforcement for the leading code element and checking patient name requirements if possible.

CH ELM Observation Results: Laboratory

This CH ELM base profile constrains the Observation resource for the purpose of laboratory test reports.

CH ELM Observation Results: Laboratory (strict)

CH ELM profile for the Observation resource with a stricter validation mechanism than the base profile via binding strength reinforcement for the leading code element.

CH ELM Organization: Author

This CH ELM base profile constrains the Organization resource for the author of the laboratory report.

CH ELM Organization: Lab

This CH ELM base profile constrains the Organization resource for the reporting laboratory.

CH ELM Organization: Orderer

This CH ELM base profile constrains the Organization resource for the orderer.

CH ELM Patient

This CH ELM base profile constrains the Patient resource for the purpose of laboratory orders and test reports.

CH ELM Patient HIV

Patient representation for HIV

CH ELM Patient Initials

Patient representation via Initials

CH ELM Patient VCT

Patient representation via a VCT Code

CH ELM Practitioner: Orderer

This CH ELM base profile constrains the Practitioner resource for the orderer.

CH ELM PractitionerRole: Orderer

This profile constrains the PractitionerRole resource for the orderer:

  • orderer organization and/or practitioner must be present
  • a postalCode and city must be present from organization and/or practitioner
CH ELM ServiceRequest: Laboratory Order

This CH ELM base profile constrains the ServiceRequest resource for the purpose of laboratory orders.

CH ELM Specimen: Laboratory

This CH ELM base profile constrains the Specimen resource for the purpose of laboratory test reports.

DocumentReference for Publish Response

A profile on the DocumentReference resource for the publication response:

  • must be status current
  • must have an identifier
DocumentReference for sending the report

A profile on the DocumentReference resource with publication constraints:

  • must be status current
  • must have an identifier
  • uses attachment.url to carry the document as a contained resource
  • validation according to http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document
DocumentReference for sending the report with strict validation

A profile on the DocumentReference resource with publication constraints:

  • must be status current
  • must have an identifier
  • uses attachment.url to carry the document as a contained resource
  • strict validation according to http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document-strict
Find Document References Response message

A profile on the Find Document References Response message

Structures: Data Type Profiles

These define constraints on FHIR data types for systems conforming to this implementation guide.

BER Identifier

Identifier holding a number for BER (Business and Enterprise Register), BUR (Betriebs- und Unternehmensregister), REE (Registre des entreprises et des établissements), RIS (Registro delle imprese e degli stabilimenti)

CH ELM CodeableConcept

This profile represents the constraint applied to the CodeableConcept data type by this IG to use the ‘CH ELM CodeableConcept’ data type profile.

CH ELM Coding

This profile represents the constraints applied to the Coding data type by this IG used in the ‘CH ELM Coding’ data type profile.

Human Name

Name with extensions for data-absent-reason

IDN Identifier

Identifier holding the IDN Liechtenstein. It is a 13-digit number without check digit and without special characters.

UIDB Identifier

Identifier holding a number for UIDB (Unique Identification Business), UID (Verwendung der Unternehmens-Identifikationsnummer), IDE (Utilisation du numéro d’identification des entreprises), IDI (Utilizzo del numero d’identificazione delle imprese)

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

CH ELM Extension: Department

This CH ELM extension enables the representation of a department (name) of an organization directly in the resource Organization itself.

CH ELM Extension: HIV code

This CH ELM extension enables to proivde the HIV Code.

CH ELM Extension: VCT code

This CH ELM extension enables to proivde the VCT Code.

Status of the processing of the document

Extension to define the status of the processing of the document

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

CH ELM Expecting Organism Specification

This CH ELM value set includes the leading codes for the laboratory test results, which have to be completed by another code for the expecting organism.

CH ELM Expecting Specimen Specification

This CH ELM value set includes the leading codes for the laboratory test results, which have to be completed by another code for the expecting specimen.

CH ELM FOPH Patient Name Representation

This CH ELM resource defines the codes which identify possible patient name schemas to be used.

CH ELM Interpretation Codes Positive

This CH ELM value set includes the code for positive interpretation code.

CH ELM Interpretation Codes Positive and Negative

This CH ELM value set includes the code for positive and negative interpretation codes.

CH ELM Interpretation Codes Resistant and Susceptible

This CH ELM value set includes the code for resistant and susceptible interpretation codes.

CH ELM Interpretation Codes Vs

This CH ELM value set includes the value set URLs as interpretation codes to map in the concept maps the leading codes.

CH ELM Lab Study Types

This CH ELM value set includes the codes for the laboratory specialties.

CH ELM Observation Interpretation Codes

This CH ELM value set includes the codes for the qualitative interpretation of the observation values (susceptible/resistant).

CH ELM Results Camp Diar Org

The “CH ELM Results Camp Diar Org” organism group provides a curated set of codes representing specific organisms. Each code within this group has been selected to ensure precise representation and consistency in relation to the primary LOINC codes. Clients utilizing the “CH ELM Results Camp Diar Org” group should refer to the provided codes to accurately and uniformly capture and report organism-related information.

CH ELM Results Camp Org

The “CH ELM Results Camp Org” organism group provides a curated set of codes representing specific organisms. Each code within this group has been selected to ensure precise representation and consistency in relation to the primary LOINC codes. Clients utilizing the “CH ELM Results Camp Org” group should refer to the provided codes to accurately and uniformly capture and report organism-related information.

CH ELM Results Coded Values Laboratory

This CH ELM value set includes the codes for the laboratory test results (presence/absence).

CH ELM Results Complete Spec

The “CH ELM Results Complete Spec” material group provides a curated set of codes representing specific materials. Each code within this group is selected to ensure consistency and accuracy for medical coding related to the primary LOINC codes. Clients using the “CH ELM Results Complete Spec” group should refer to the provided codes to ensure they capture and report material information correctly and consistently.

CH ELM Results Completion Vs

This CH ELM value set includes the value set URLs as codes to map in the concept maps the leading codes, which must be completed with additional codes.

CH ELM Results Cpe Org

The “CH ELM Results Cpe Org” organism group provides a curated set of codes representing specific organisms. Each code within this group has been selected to ensure precise representation and consistency in relation to the primary LOINC codes. Clients utilizing the “CH ELM Results Cpe Org” group should refer to the provided codes to accurately and uniformly capture and report organism-related information.

CH ELM Results Geni Spec

The “CH ELM Results Geni Spec” material group provides a curated set of codes representing specific materials. Each code within this group is selected to ensure consistency and accuracy for medical coding related to the primary LOINC codes. Clients using the “CH ELM Results Geni Spec” group should refer to the provided codes to ensure they capture and report material information correctly and consistently.

CH ELM Results Laboratory Observation

This CH ELM value set includes the codes for the laboratory test results (organism).

CH ELM Results Leg Org

The “CH ELM Results Leg Org” organism group provides a curated set of codes representing specific organisms. Each code within this group has been selected to ensure precise representation and consistency in relation to the primary LOINC codes. Clients utilizing the “CH ELM Results Leg Org” group should refer to the provided codes to accurately and uniformly capture and report organism-related information.

CH ELM Results Shi Org

The “CH ELM Results Shi Org” organism group provides a curated set of codes representing specific organisms. Each code within this group has been selected to ensure precise representation and consistency in relation to the primary LOINC codes. Clients utilizing the “CH ELM Results Shi Org” group should refer to the provided codes to accurately and uniformly capture and report organism-related information.

CH ELM Status

This CH ELM value set includes the codes for the laboratory specialities.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

CH ELM FOPH Business Rules

This CH ELM code system describes specific business rules of the FOPH, which are applied during processing. Please note that the set of rules detailed herein only covers processes explicitly declared by the FOPH. Additional rules, not included in this code system, are applied by the FHIR validation logic, resulting in further codes. For more information about these additional codes, consult the official FHIR documentation and the implementation guideline.

CH ELM FOPH Patient Name Representation

This CH ELM resource defines the codes which identify possible patient name schemas to be used.

CH ELM Interpretation Codes Vs

The codes contained in this code system represent URLs of value sets that can be used as target codes in ConceptMaps. These value sets define the codes that are permitted to indicate the observation interpretation in relation to the leading code.

CH ELM Results Completion Vs

The codes contained in this code system represent URLs of value sets that can be used as target codes in ConceptMaps. These value sets define the codes that are permitted for specifying the organism or specimen in relation to the leading code.

Terminology: Naming Systems

These define identifier and/or code system identities used by systems conforming to this implementation guide.

IDN Liechtenstein

The IDN is a unique identification number generated for each person with health insurance in Liechtenstein. For more details please visit https://www.llv.li/de/privatpersonen/gesundheit-vorsorge-und-pflege/elektronisches-gesundheitsdossier/datenschutzhinweis.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

CH ELM Expecting Organism Specification To Results Completion Vs

This CH ELM concept map shows which leading codes have to be completed by an additional code to specify the organism. The target code shows the URL of the value set containing the permitted codes for the organism specification.

CH ELM Expecting Specimen Specification To Results Completion Vs

This CH ELM concept map shows which leading codes have to be completed by an additional code to specify the specimen. The target code shows the URL of the value set containing the permitted codes for the specimen specification.

CH ELM Results To FOPH Patient Name Representation

This CH ELM concept map specifies the required mode of patient representation for each leading code. It determines whether the full name, initials, or a unique code (e.g., for HIV patients) should be used, based on the specific LOINC code associated with the laboratory data. This ensures consistent and appropriate handling of patient identity in accordance with the type of pathogen reported.

CH ELM Results To Interpretation Code

This CH ELM concept map specifies the interpretation codes for each leading code. E.g. if positive, positive and negative or resistant-susceptible values are allowed

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

1Comp - Neisseria Gonorrhoeae

Example for a CH ELM Composition: Laboratory Report

1DR - Neisseria Gonorrhoeae

Example for a CH ELM DiagnosticReport: Laboratory Report

1Doc - Neisseria Gonorrhoeae

Example for a CH ELM Document: Laboratory Report (where the ‘Lab’ is the same as the ‘Author’)

1Obs - Neisseria Gonorrhoeae

Example for a CH ELM Observation Results: Laboratory

1Org - Kantonsspital ABC

Example for a CH ELM Organization: Orderer

1Org - Labor

Example for a CH ELM Organization: Lab and Author

1PR - Monika Giacometti @ Kantonsspital ABC

Example for a CH ELM PractitionerRole: Orderer

1Pat - DM

Example for a CH ELM Patient (only with initials)

1Pract - Monika Giacometti

Example for a CH ELM Practitioner: Orderer

1SR - Order

Example for a CH ELM ServiceRequest: Laboratory Order

1Spec - Neisseria Gonorrhoeae

Example for a CH ELM Specimen: Laboratory

1bComp - Neisseria Gonorrhoeae

Example for a CH ELM Composition: Laboratory Report

1bDR - Neisseria Gonorrhoeae

Example for a CH ELM DiagnosticReport: Laboratory Report

1bDoc - Neisseria Gonorrhoeae

Example for a CH ELM Document: Laboratory Report (where the ‘Lab’ is NOT the same as the ‘Author’ -> Broker Scenario)

1bObs - Neisseria Gonorrhoeae

Example for a CH ELM Observation Results: Laboratory

1bOrg - Broker

Example for a CH ELM Organization: Author

1bOrg - Labor

Example for a CH ELM Organization: Lab

1bSR - Order

Example for a CH ELM ServiceRequest: Laboratory Order

1bSpec - Neisseria Gonorrhoeae

Example for a CH ELM Specimen: Laboratory

2Doc - Chlamydia Trachomatis

Example for a CH ELM Document: Laboratory Report (collection material in addition to the leading LOINC code, with references/fullUrls as UUIDs)

2Doc - Chlamydia Trachomatis (VCT)

Example for a CH ELM Document: Laboratory Report collection material in addition to the leading LOINC code and Patient with Patient VCT code

3Doc - Carbapenemase-producing Enterobacteriaceae (CPE)

Example for a CH ELM Document: Laboratory Report (organism in addition to the leading LOINC code)

4Doc - Campylobacter spp.

Example for a CH ELM Document: Laboratory Report

5Doc - Treponema pallidum

Example for a CH ELM Document: Laboratory Report (SNOMED CT as leading code)

6Doc - Influenza

Example for a CH ELM Document: Laboratory Report

7Doc - SARS-CoV-2

Example for a CH ELM Document: Laboratory Report (document in French, patient with full name)

DocumentReference Response for Neisseria Gonorhoeae completed

Example for a CH ELM DocumentReference: Laboratory Report - completed

DocumentReference Response for Neisseria Gonorhoeae in progress

Example for a CH ELM DocumentReference: Laboratory Report - in-progress

DocumentReference for Neisseria Gonorhoeae - falied

Example for a CH ELM DocumentReference: Laboratory Report - failed

DocumentReference for reporting Chlamydia Trachomatis

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting Chlamydia Trachomatis

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting Chlamydia Trachomatis with Patient VCT Code

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting Chlamydia Trachomatis with Patient VCT Code

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting Neisseria Gonorhoeae

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting Neisseria Gonorhoeae

Example for a CH ELM DocumentReference: Laboratory Report

DocumentReference for reporting SARSCoV2

Example for a CH ELM DocumentReference: Laboratory Report

Example of a Find Document References Response Message

Example of a Find Document References Bundle Search Set with a single DocumentReference

Org - Hôpital régional soleil

Example for a CH ELM Organization: Orderer

Org - Praxis Dr. Hauser

Example for a CH ELM Organization: Orderer

Org: Orderer with BER and UIDB

Example for a CH ELM Organization: Orderer

PR - Jeanne Moreau @ Hôpital régional soleil

Example for a CH ELM PractitionerRole: Orderer

PR - Peter Hauser @ Praxis Dr. Hauser

Example for a CH ELM PractitionerRole: Orderer

Pat - Antoine Dupont

Example for a CH ELM Patient - full name

Pat - E5

Example for a CH ELM Patient - special case HIV/AIDS

Pat - ET

Example for a CH ELM Patient - initials

Pat - Ernst Karl Tanner

Example for a CH ELM Patient - full name (and full address)

Pat - Lilly Liechtenstein

Example for a CH ELM Patient - IDN Liechtenstein

Pat - VCT

Example for a CH ELM Patient with VCT Code

Pract - Jeanne Moreau

Example for a CH ELM Practitioner: Orderer

Pract - Peter Hauser

Example for a CH ELM Practitioner: Orderer