Virtually Healthcare HL7 FHIR R4 Implementation Guide
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Virtually Healthcare HL7 FHIR R4 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/Virtually-Healthcare/HL7-FHIR-Implementation-Guide/ and changes regularly. See the Directory of published versions

Structured Data Capture

The aim of this is to:

  • Provide support for a wide variety of forms in use within the NHS and social sector.
    • This can also be used to support for new forms in applications via code, see Advanced Form Rendering for more details.
  • Support pre population of forms by reusing existing data which will save clinicians and patients considerable time.
  • It will simplify storage of clinical data in both internal and external clinical data repositories.
  • It improves our data standards.
Data Capture ApplicationThe data capture must conform to the definition in a FHIR QuestionnaireArchetypes/templates definitions must be converted to HL7 FHIRExisting Clinical Data ServiceRetrieve existing data from connected CDR's.FollowsHL7 SDC Form PopulationTesting ServiceHL7 FHIR ValidationChecks clinical coding is correct,using NHS England Ontology ServiceClinical Data Extraction ServiceFollowsHL7 SDC Form Extractionand converts coded questions and answers into Observations.Perform any SNOMED/LOINC mappingsClinical Data RepositoryEither local and/or external (GP systems) CDR Observations persisted for reuse in other forms.Form RepositoryForm/template persisted for reference.Can potentially convert this into archetype/templatefor external repositoriesHL7 FHIR QuesionnaireResponseFHIR Questionnaire and patient idHL7 FHIR QuesionnaireResponseHL7 FHIR QuestionnaireResponseHL7 FHIR Observations

Structured Data Capture


Data Capture Application

This would often be implemented as form in an application. This should follow a FHIR Questionnaire which defines data types to be used and valuesets that can be used with picklists.

Idea is to implement on AWS FHIR-Works/Health-Lake first and then incorporate in writebacks if wanted.

Examples Form Definitions

The clinical data repositories (EMIS IM1 and AWS FhirWorks/Healthlake) can be used to retrieve existing data and prepopulate the form. This saves clinicians and patients time when completing the form. Only coded questions can be used for pre-population.

Example Existing Data Query

On AWS FhirWorks/Healthlake, patient weight can be retrieved by

GET /Observation?patient={id}&code=http://snomed.info/sct|27113001

On EMIS this would be and the response would need to be searched for the body weight (the code query can be built into the API - it's quite simple)

GET /Observation?patient={id}

Testing Service

Checks the FHIR QuestionnaireResponse meets the requirements defined in the FHIR Questionnaire. This is new experimental feature and can be found at FHIR Validation

This service can check all data going into CDR's meet our domain model requirements.

Clinical Data Extraction Service

This converts the FHIR QuestionnaireResponse into Observations.

Example

Completed vital signs form Vital Signs. The extraction results in entries such as: