Argo CGM Write
0.1.0 - ci-build International flag

Argo CGM Write, published by Argonaut. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cgm/ and changes regularly. See the Directory of published versions

Artifacts Summary

Contents:

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.

CGM Data Receiver Capability Statement

The data receiver is a software system that receives and stores the CGM data submitted by the data submitter.

This IG also refers to Data Receivers as "EHRs".

Any CGM Data Receiver SHALL populate its /metadata response to ensure that CapabilityStatement.instantiates includes "http://hl7.org/uv/cgm/CapabilityStatement/cgm-data-receiver".

Structures: Resource Profiles

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

CGM Data Submission Bundle

Once a Data Submitter is connected to the EHR, it can write data by submitting a batch Bundle to the EHR FHIR sever's / submission endpoint. The submission bundle includes a Bundle.meta.tag value of cgm-data-submission-bundle to support ingestion workflows on servers with limited data ingestion capabilities. The tag has no impact on the meaning of the bundle, and can safely be ignored by servers that offer a general-purpose POST / endpoint.

The Bundle entry array includes any combination of
CGM Data Submission Standing Order

The Data Receiver can expose a standing order indicating:

  • What data a Data Submitter should include in each CGM Data Submission Bundle
  • How often a Data Submitter should submit CGM data
  • What lookback period should each submission cover

Guiding Data Submission

This standing order is modeled as a FHIR ServiceRequest resource, which Data Submitters can query to guide their future submissions. The standing order specifyies the patient, the type of data to be submitted, and the desired frequency of submission.

DataSubmissionSchedule

The DataSubmissionSchedule extension contains:

  • submissionPeriod: Quantity with unit d for days, wk for weeks, mo for months, or a for years. This indicates how often the data should be submitted.
  • submissionDataProfile (1..*): canonical reference to FHIR profiles that represent the types of data to be submitted according to the specified schedule.
  • lookbackPeriod (optional): Quantity with unit d for days, wk for weeks, mo for months, or a for years. This indicates the period of time the data submission should cover.

Multiple DataSubmissionSchedule extensions can be included in a single DataSubmissionRequest resource if the Data Recipient prefers a different schedule for different data types.

It's important to note that submissions can also be manually triggered by a patient or provider within an app. For example, if there is an upcoming appointment, the provider can click a button to manually trigger submission of the most up-to-date results. Out-of-band communication between the app developer and the clinical provider system can also be used to establish preferred submission schedules.
CGM Device

A continuous glucose monitoring (CGM) sensor device. This corresponds to the CGM sensor, not a reader or app used to capture or transmit the data.
CGM Sensor Reading (Mass)

A continuous glucose monitoring (CGM) sensor reading represented in mass units.
CGM Sensor Reading (Molar)

A continuous glucose monitoring (CGM) sensor reading represented in molar units.
CGM Summary Observation

An observation representing a summary of continuous glucose monitoring (CGM) data.
CGM Summary PDF Report

A PDF report containing a summary of continuous glucose monitoring (CGM) data.
CGM Summary Times in Ranges

An observation representing the times in various ranges from a continuous glucose monitoring (CGM) summary. Value: Percent of time, with at least two decimal places of precision.
Coefficient of Variation (CV)

The Coefficient of Variation (CV) value from a continuous glucose monitoring (CGM) summary.
Data Submission Standing Order

A base profile for standing orders that indicate data submission requirements. This profile can be used as-is for general data submissions or inherited by more specific data submission profiles.

Key aspects of this profile:

  • Specifies what data should be included in each submission
  • Defines how often data should be submitted
  • Indicates the lookback period each submission should cover

This profile uses the DataSubmissionSchedule extension to capture detailed submission requirements.
Days of Wear

The number of days the continuous glucose monitoring (CGM) device was worn during the reporting period.
Glucose Management Indicator (GMI)

The Glucose Management Indicator (GMI) value from a continuous glucose monitoring (CGM) summary.
Mean Glucose (Mass)

The mean glucose value from a continuous glucose monitoring (CGM) summary, represented in mass units.
Mean Glucose (Molar)

The mean glucose value from a continuous glucose monitoring (CGM) summary, represented in molar units.
Sensor Active Percentage

The percentage of time the continuous glucose monitoring (CGM) sensor was active during the reporting period.

Structures: Extension Definitions

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

Data Submission Schedule

Schedule and type of data to be submitted

Terminology: Code Systems

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

CGM Summary Code System

Temporary code system for CGM summary observations.
Codes for CGM

Codes to identify content associated with this IG

Terminology: Concept Maps

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

Mapping from CGM Temporary Codes to LOINC

Mapping concepts from the CGM Summary code system to LOINC codes.

Example: Example Instances

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

CGM Data Submission Bundle Example
CGM Device Example
CGM Sensor Reading (Mass) Example
CGM Sensor Reading (Molar) Example
CGM Summary Example
CGM Summary PDF Report Example
CGM Summary Times in Ranges Example
Coefficient of Variation Example
Days of Wear Example
Example CGM Data Submission Standing Order

This example represents a standing order for continuous glucose monitoring (CGM) data submission. It specifies an order to submit data about Patient 123 once every two weeks, with each data submission including a summary of the CGM data and a PDF report of the CGM summary. This ensures the patient's CGM data is routinely available for clinical review.
Example Patient
GMI Example
Mean Glucose (Mass) Example
Mean Glucose (Molar) Example
Sensor Active Percentage Example