Medicolegal Death Investigation (MDI) FHIR Implementation Guide
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Medicolegal Death Investigation (MDI) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mdi-ig/ 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.

MDI Capability Statements

CapabilityStatement - Electronic Death Reporting System (EDRS) Server

This resource describes the expected capabilities of the Electronic Death Registration System (EDRS) server, which is responsible for providing responses to the queries submitted by a client. Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

CapabilityStatement - Forensic Toxicology Laboratory Server

This resource describes the expected minimum capabilities of the toxicology lab server.

CapabilityStatement - MDI CMS Server

This resource describes expected minimum capabilities of an MDI CMS server which is responsible for providing responses to the queries submitted by a client. Clients have the option of choosing from this list to access necessary data.

MDI Profiles

Bundle - Document MDI and EDRS

This Bundle profile represents a Document Bundle exchanged between an MDI CMS and EDRS. It can be used for bi-directional exchange. It contains a Composition - MDI and EDRS.

Bundle - Message Toxicology to MDI

This Bundle profile represents a Message Bundle from a forensic toxicology laboratory to an MDI information management system. It contains a Message Header and a DiagnosticReport - Toxicology Lab Result to MDI.

Composition - MDI and EDRS

This Composition profile represents data exchanged between an MDI CMS and an EDRS.

DiagnosticReport - Toxicology Lab Result to MDI

This profile contains constraints to the US Core Diagnostic Report Profile to address the use case for sending data from a forensic toxicology laboratory information management system to an MDI information management system. Each analyzed specimen, represented by a Specimen - Toxicology Lab resource, must be referenced by at least one Observation - Toxicology Lab Result and may be referenced by more than one Observation - Toxicology Lab Result. For specimens received but not analyzed, the laboratory should provide a reason for no analysis in the DiagnosticReport.conclusion and/or each unanalyzed specimen’s Specimen - Toxicology Lab Specimen.note.

DocumentReference - MDI Report

This DocumentReference profile constrains the US Core DocumentReference Profile to support exchanging death investigation documents, such as an Autopsy Report or Investigator’s Narrative. The content may be included as inline base64 encoded data or be provided by direct reference (e.g., URL). The document type is required and is constrained by US Core to a LOINC value whose SCALE is DOC in the LOINC database or is the HL7 v3 Code System NullFlavor concept 'unknown'.

MDI Cause Of Death Part 1

The Observation - MDI Cause of Death Part 1 profile places constraints on the VRDR profile CauseOfDeathPart1

MessageHeader - Toxicology to MDI

This MessageHeader identifies the DiagnosticReport being sent from a forensic toxicology laboratory information system to an MDI information management system.

Observation - Toxicology Lab Result

This Observation profile describes forensic toxicology laboratory test results from analysis of a specimen sent by a Medical Examiner, Coroner, or autopsy performer to the laboratory.

Specimen - Toxicology Lab

This Specimen profile identifies and describes the specimen sent by a Medical Examiner, Coroner, or autopsy performer to a toxicology lab for analysis. For specimens received but not analyzed, the laboratory should provide a reason for no analysis in the DiagnosticReport.conclusion and/or each unanalyzed specimen’s Specimen - Toxicology Lab Specimen.note. The laboratory may use the Specimen.condition to describe the state of the specimen via codes from the extensible value set hl7VS-specimenCondition and/or use the Specimen.note to describe details or issues about the specimen.

MDI Extensions

Extension - Tracking Number

This Extension contains a tracking number, such as a case number or file number assigned by an MDI information management system or EDRS, and can represent other tracking numbers, if required.

MDI CodeSystems

CodeSystem - MDI

This code system contains codes for use in death investigations and reporting.

MDI Value Set

ValueSet - Tracking Number Type

This value set contains codes to that identify the type of tracking number.

MDI Parameters

Parameters - SNOMED US Version

Parameters - SNOMED US Version

Examples of MDI-defined resources

Bundle - MDI and EDRS - Freeman

Bundle - MDI and EDRS: Freeman example

Bundle - Message Toxicology to MDI - Freeman

Bundle - Message Toxicology to MDI: Freeman example

DiagnosticReport - Toxicology Lab Result to MDI - Freeman

DiagnosticReport - Toxicology Lab Result to MDI: Freeman example

DocumentReference - MDI Report - Autopsy Report example

DocumentReference - MDI Report: Autopsy Report example

DocumentReference - MDI Report - Investigator's Narrative example

DocumentReference - MDI Report: Investigator's Narrative example

MDI and EDRS Composition - draft

Composition - MDI and EDRS: draft example with status=preliminary, author & attester using data-absent-reason extension

MDI and EDRS Composition - Freeman

MDI and EDRS Composition: Freeman example

Message Definition Toxicology System

This resource defines the characteristics of a message that can be shared between a forensic toxicology system and a medical examiner/coroner system.

MessageHeader - Toxicology to MDI - Freeman

MessageHeader - Toxicology to MDI: Freeman example

Observation - Cause of Death Part 1 - Freeman

Observation - Cause of Death Part 1: Freeman example

Observation - MDI Cause of Death Part 1 - Freeman - quantity interval

Observation - Cause of Death Part 1: Freeman example, specifying interval quantity (days)

Examples of resources defined elsewhere included in MDI examples

Location - Death - Atlanta GA Freeman

Location - Death: Atlanta GA Freeman example

Location - Death - Freeman address string

Location - Death: address as string example

Location - Death - Lat/Long

Location - Death: latitude & longitude example

Location - Injury - Atlanta GA Freeman

Location - Injury: Atlanta GA Freeman example

Observation - Autopsy Performed Indicator - Freeman

Observation - Autopsy Performed Indicator: Freeman example

Observation - Contributing Cause of Death Part 2 - Freeman

Observation - Contributing Cause of Death Part 2: Freeman example

Observation - Death Date - Freeman

Observation - Death Date: Freeman death date, location, death pronouncer example

Observation - Decedent Pregnancy - Freeman

Observation - Decedent Pregnancy: Freeman example

Observation - Disposition Method - Freeman

Observation - Disposition Method: Freeman example

Observation - How Death Injury Occurred - Freeman - Medication ingestion

Observation - How Death Injury Occurred: Freeman - Medication ingestion (fentanyl) example

Observation - Manner of Death - Freeman

Observation - Manner of Death: Freeman - accidental example

Observation - Tobacco Use - Freeman

Observation - Tobacco Use: Freeman example

Observation - Toxicology Lab Result - 4-anpp Blood Freeman

Observation - Toxicology Lab Result: 4-anpp Blood Freeman example

Observation - Toxicology Lab Result - 4-anpp Urine Freeman

Observation - Toxicology Lab Result: 4-anpp Urine Freeman example

Observation - Toxicology Lab Result - Acetylfentanyl Blood Freeman

Observation - Toxicology Lab Result: Acetylfentanyl Blood Freeman example

Observation - Toxicology Lab Result - Acetylfentanyl Urine Freeman

Observation - Toxicology Lab Result: Acetylfentanyl Urine Freeman example

Observation - Toxicology Lab Result - Ethanol Blood Freeman

Observation - Toxicology Lab Result: Ethanol Blood Freeman example

Observation - Toxicology Lab Result - Ethanol Urine Freeman

Observation - Toxicology Lab Result: Ethanol Urine Freeman example

Observation - Toxicology Lab Result - Ethanol Vitreous Humor Freeman

Observation - Toxicology Lab Result: Ethanol Vitreous Humor Freeman

Observation - Toxicology Lab Result - Fentanyl Blood Freeman

Observation - Toxicology Lab Result: Fentanyl Blood Freeman example

Observation - Toxicology Lab Result - Fentanyl Urine Freeman

Observation - Toxicology Lab Result: Fentanyl Urine Freeman example

Observation - Toxicology Lab Result - Norfentanyl Urine Freeman

Observation - Toxicology Lab Result: Norfentanyl Urine Freeman example

Observation - Toxicology Lab Result - Xylazine Urine Freeman

Observation - Toxicology Lab Result: Xylazine Urine Freeman example

Procedure - Death Certification - Freeman

Procedure - Death Certification: Freeman example

Specimen - Toxicology Lab - Freeman Bile

Specimen - Toxicology Lab: Freeman Bile example

Specimen - Toxicology Lab - Freeman Blood

Specimen - Toxicology Lab: Freeman Blood examples

Specimen - Toxicology Lab - Freeman Liver

Specimen - Toxicology Lab: Freeman Liver example

Specimen - Toxicology Lab - Freeman Stomach Contents

Specimen - Toxicology Lab: Freeman Stomach Contents example

Specimen - Toxicology Lab - Freeman Urine

Specimen - Toxicology Lab: Freeman Urine example

Specimen - Toxicology Lab - Freeman Vitreous Humor

Specimen - Toxicology Lab: Freeman Vitreous Humor example

US Core Organization - UF Health Pathology Labs, Forensic Toxicology Laboratory

Example of US Core Organization - UF Health Pathology Labs, Forensic Toxicology Laboratory

US Core Patient - Alice J. Freeman

Example of US Core Patient - Alice J. Freeman, decedent

US Core Patient - Unknown Name

US Core Patient: Unknown Name - Decedent where there is no information known about the patient. Assume that the system will assign a tracking number (e.g., medical record number, case number, or other).

US Core Practitioner - Dr. Bruce Goldberger

Example of US Core Practitioner - Dr. Bruce Goldberger, toxicologist

US Core Practitioner - Dr. J.M. Lehz

Example of US Core Practitioner - Dr. J.M. Lehz, autopsy performer

US Core Practitioner - Dr. Sam Jones

Example of US Core Practitioner - Dr. Sam Jones, death pronouncer

Structures: Resource Profiles

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

Bundle - Document Death Certificate Review

This profile represents a Document Bundle from an EDRS for a Death Certificate Review.

Composition - Death Certificate Review

This Composition contains information for a request to review death certificate data, for death data quality improvement, cremation clearance, and other workflows. It can contain EDRS death certificate structured data.

Observation - Certified Workflow

This Observation profile describes the Death Certificate certification workflow status.

Observation - Communicable Disease

This Observation profile describes TBD.

Observation - Embalmed

This Observation profile indicates if the decedent body was embalmed.

Observation - Medical Information Data Quality

This Observation profile describes TBD.

Observation - Personal Information Data Quality

This Observation profile describes TBD.

Observation - Registration

This Observation profile describes Death Certificate registration status.

Structures: Extension Definitions

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

Extension - Cremation Clearance Authorization Status

This Extension indicates the authorization status of the Cremation Clearance.

Extension - Cremation Clearance Coroner Status

This Extension indicates whether the Cremation Clearance is a Cononer workflow or not.

Extension - Cremation Clearance Signature Status

This Extension indicates whether the Cremation Clearance has been signed or not.

Extension - Death Certificate Review Reason

This Extension indicates the reason for the death certificate review.

Extension - Death Certificate Status

This Extension indicates Death Certificate workflow status.

Extension - Medical Examiner Certification Affirmation

This Extension indicates whether the Medical Examiner certification has been affirmed or not.

Terminology: Value Sets

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

ValueSet - Certified Workflow example

This value set contains example codes for Death Certificate certification workflow status.

ValueSet - Cremation Clearance Observations example

This value set contains example codes for Cremation Clearance Observations.

ValueSet - Cremation Clearance Signed example

This value set contains example codes for the signature status of the Cremation Clearance.

ValueSet - Cremation Clearance Status example

This value set contains example codes for Cremation Clearance status.

ValueSet - Death Certificate Review Observations example

This value set contains example codes for Death Certificate Review Observations.

ValueSet - Death Certificate Review Reason example

This value set contains example codes for the reason for a death certificate review.

ValueSet - Embalmed example

This value set contains example codes for embalmed status of the Decedent.

ValueSet - Medical Data Quality Review example

This value set contains example codes for medical data quality review.

ValueSet - Medical Examiner Certification Affirmation example

This value set contains example codes for the status of Medical Examiner Certification Affirmation.

ValueSet - Personal Data Quality Review example

This value set contains example codes for personal data quality review.

ValueSet - Registration example

This value set contains example codes for Death Certificate registration status.

Terminology: Code Systems

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

CodeSystem - Death Certificate Review - example

This code system contains example codes for death certificate review.

Example: Example Instances

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

Composition - Death Certificate Revirew for Cremation Clearance Request - Example 3

Death Certificate Revirew for Cremation Clearance Request Composition: example 3

Death Certificate for review for cremation clearance request

Death Certificate - CCR example 1

autopsy-performed-ccr-ex1
cause-of-death-ccr-ex1
certifier-ccr-ex1
contributing-to-death-ccr-ex1
death-certification-procedure-ccr-ex1
death-date-ccr-ex1
death-location-ccr-ex1
death-pronouncement-performer-ccr-ex1
decedent-age-ccr-ex1
decedent-ccr-ex1
decedent-education-level-ccr-ex1
decedent-father-ccr-ex1
decedent-military-service-ccr-ex1
decedent-mother-ccr-ex1
decedent-pregnancy-ccr-ex1
decedent-usual-work-ccr-ex1
disposition-location-ccr-ex1
disposition-method-ccr-ex1
examiner-contacted-ccr-ex1
funeral-home-ccr-ex1
injury-incident-ccr-ex1
injury-location-ccr-ex1
interested-party-ccr-ex1
manner-of-death-ccr-ex1
mortician-ccr-ex1
observation-certified-workflow-ccr-ex1
observation-communicable-disease-ccr-ex1
observation-embalmed-ccr-ex1
observation-medical-information-data-quality-ccr-ex1
observation-personal-information-data-quality-ccr-ex1
observation-registration-ccr-ex1
tobacco-use-ccr-ex1