Virtually Healthcare Implementation Guide, published by Virtually Healthcare. This guide is not an authorized publication; it is the continuous build for version 0.1.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/KevinMayfield/VirtuallyHealthcare/ and changes regularly. See the Directory of published versions
Data Model
Patient Diagnostics Data Capture Documents Orders «aggregate root» Patient identifier 1..* : PatientIdentifier name gender birthDate address telecom address HL7 FHIR Patient Hl7 v2 PD1 commonly supported in UK interoperabiity as HL7 ADT (often undocumented HL7 ADT support in primary care) «entity» PatientIdentifier NHSNumber 0..1 CHINumber 0..1 MedicalRecordNumber (EMIS, TPP, Hospital Number, etc) HL7 FHIR identifier HL7 v2 CX (in PID) DICOM (0010,0020) IHE XDS patientId and sourcePatientId commonly supported in UK EPR and interoperabiity often based on HL7 v2 PID «entity» Observation identifier 1..* subject 1..1: PatientIdentier code : UK SNOMED CT or LOINC effectiveDateTime value[x]: codes are UK SNOMED CT or LOINC encounter 0..1 HL7 FHIR Observation HL7 v2 OBX Commonly supported in UK EPR «entity» Observation Panel identifier 1..* subject 1..1: PatientIdentier code : UK SNOMED CT or LOINC effectiveDateTime hasMember: 1..*: Observation encounter 0..1 HL7 FHIR Observation HL7 v2 OBR extratced from Form defined by FormDefinition openEHR persisted archetype Often not supported in UK EPR «aggregate root» Diagnostic Report identifier 1..* basedOn 0..1: AccessionNumber subject: PatientIdentier code : UK SNOMED CT or LOINC effectiveDateTime result: ObservationPanel and Observation presentedForm 0..* : Attachment HL7 FHIR DiagnosticReport HL7 v2 ORU_R01 DHCW Laboratory Report (HL7 v2 ORU_R01) RCR Imaging Report (HL7 v2 ORU_R01) Often not supported in UK EPR commonly supported in UK interoperabiity as HL7 ORU (often undocumented HL7 ORU support in primary care) «data transfer object» Form identifier 1..1 subject questionnaire 0..1 : Questionnaire authored 1..1 : DateTime answers 1..* code : (in FHIR from Questionnaire) Is often used to capture data, so «data transfer object» for full coded forms, else «entity» HL7 FHIR QuestionnaireResponse openEHR persisted Archetype or Template commonly supported in UK EPR in a wide variety of forms rarely present in UK interoperabiity «aggregate root» Form Defintion identifier 1..1 url code : UK SNOMED CT or LOINC questions 1..* HL7 FHIR Questionnaire openEHR CKM i.e. Archetype or Template many UK EPR have ad-hoc definitions rarely present in UK interoperabiity LogicalModel PRSB «entity» Attachment title languageCode data: file contents contentType: (also mimeType and file extension) File HL7 FHIR Attacment Data Type HL7 v2 OBX IHE XDS Document Entry Commonly suported in UK EPR «aggregate root» Document Entry category: UK SNOMED CT type : UK SNOMED CT subject : PatientIdentifier attachment 1..* referenceIdList : AccessionNumber (FHIR context.related) HL7 FHIR DocumentReference IHE XDS Document Entry Digital Health and Care Scotland - CLINICAL DOCUMENT INDEXING STANDARDS IHE (Europe) Document Metadata Outside of IHE and national, not commonly supported in UK «aggregate root» Laboratory/Imaging Order accessionNumber 1..1 : AccessionNumber filerOrderNumber 1..1: Identifier placerOrderNumber 1..1 : Identifier subject: PatientIdentier code: Procedure code UK SNOMED CT, LOINC or NICIP HL7 FHIR ServiceRequest HL7 v2 OML_O21 «value» AccessionNumber «aggregate root» Prescription identifier 1..* subject: PatientIdentier medication: UK SNOMED CT (dm+d) HL7 FHIR MedicationeRequest «aggregate root» Referral identifier 1..* subject: PatientIdentier code: Procedure code UK SNOMED CT HL7 FHIR ServiceRequest HL7 v2 ORM_O01? identifier result hasMember FormDefinition are the physical models defintion url questionnaire attachment accessionNumber referenceIdList basedOn subject subject subject subject subject subject subject subject data extraction answers data extraction code and answers attachment
Repository Data Model
References
Patient
Encounter
NHS England HL7 v2 ADT and NHS England HL7 v2 ADT Reference Tables . Examples:
ADT_A05 Pre-admit a patient (Inpatient Admission Notification Event)
ADT_A01 Admit/visit notification (Admission/Visit Notification Event)
ADT_A03 Discharge/end visit (Dischage/Visit End Notification Event)
ADT_A04 Register a patient (Outpatient or Emergency Encounter (and Patient) Notification Event)
ADT_A08 Update patient information (Outpatient or Emergency Encounter (and Patient) Updated Notification Event)
Diagnostic Report, Observation Panel and Observation
Document Reference