Virtually Healthcare HL7 FHIR Implementation Guide
0.1.0-current - ci-build
Virtually Healthcare HL7 FHIR 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/Virtually-Healthcare-FHIR-Implementation-Guide/ and changes regularly. See the Directory of published versions
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
The following artifacts define the types of individuals and/or systems that will interact as part of the use cases covered by this implementation guide.
Clinical Data Consumer |
The Clinical Data Consumer sends FHIR-based queries to the Clinical Data Repository which exposes data in a clinical data repository |
Clinical Data Repository |
The Clinical Data Repository is responsible for the persistent storage of clinical data items (observations, conditions, immunisations, etc). E.g. PHR, EHR and EPR Links to detailed elaboration on this actor can be found in:
|
Directory Service |
Provides lookup or query services for master Organisation, Facility, Location, Practitioner, Healthcare Service, OrganisationAffiliation, and Endpoint records which meet specific criteria. |
Event Consumer |
The Event Consumer Actor receives events. |
Event Service |
The Event Service is an Event Messaging Endpoint for Trust Integration Engine (TIE) or similar Messaging Systems. |
Event Source |
The Event Source Actor produces events based event triggers which occur during clinical activity (e.g. patient discharged). |
Form Registry |
Repository for form definitions. Links to detailed elaboration on this actor can be found in:
|
Form Repository |
The Form Repository is responsible for both the persistent storage of forms (and many archetypes). Links to detailed elaboration on this actor can be found in: |
Form Service |
Provides pre-population and data extraction services Links to detailed elaboration on this actor can be found in:
|
Service Facade |
This is a facade service. This acts as an Anti-Corruption-Layer which transforms data models in external services to an enterprise canonical data model/domain model. |
Terminology Repository |
Central repository of codesystems (e.g. UK SNOMED CT), valuesets and concept maps. Links to detailed elaboration on this actor can be found in:
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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.
Facade - IM1 Patient EMIS |
This is a Service Facade to IM1 Patient This is influenced by HL7 International Patient Access This is not a complete description of the API and so does not represent the actual implemented API or capabilities of the GP provider. This is a facade to the GP System IM1, this is not the API provided by the GP System. |
Facade - IM1 Transaction EMIS |
This is a Service Facade to IM1 Transaction This is not a complete description of the API and so does not represent the actual implemented API or capabilities of the GP provider. This is a facade to the GP System IM1, this is not the API provided by the GP System. |
Facade - IM1 Transaction TPP |
This is a Service Facade to IM1 Transaction This is not a complete description of the API and so does not represent the actual implemented API or capabilities of the GP provider. This is a facade to the GP System IM1, this is not the API provided by the GP System. |
Facade - Organisation Data Service - FHIR API |
This is a Service Facade to Organisation Data Service - FHIR API This facade is related to IHE Mobile Care Services Discovery (mCSD) |
Facade - Personal Demographics Service - FHIR API |
This is a Service Facade to Personal Demographics Service - FHIR API This facade is related to IHE Patient Demographics Query for Mobile (PDQm) |
Virtually Healthcare - Clinical Data Repository |
The CDR adheres to the following standards:
The CDR closely follows: |
These define forms used by systems conforming to this implementation guide to capture or expose data to end users.
Pharmacy Nomination (for EMIS PFS) | |
Questionnaire-DailyPhysicalActivity |
Questionnaire Daily Physical Activity based on time based measures from HL7 Physical Activity Implementation Guide |
Questionnaire-ExerciseActivity |
Questionnaire Exercise Activity based on activity based measures from HL7 Physical Activity Implementation Guide |
Questionnaire-VitalSigns |
Questionnaire Vital Signs Definitions based on NHS England Clinical Observations |
Questionnaire-eRSReferralRequest |
Data capture definition for A011 Create Referral (Deprecated) |
These define constraints on FHIR resources for systems conforming to this implementation guide.
AllergyIntolerance |
Extension to UKCore AllergyIntolerance and includes elements from HL7 International Patient Access |
Composition |
Extension of UKCore-Composition |
Condition |
Extension to UKCore Condition and includes elements from HL7 International Patient Access |
DiagnosticReport |
Extension of UKCore-DiagnosticReport |
DocumentReference |
Extension to future UKCore DocumentReference and includes elements from HL7 International Patient Access |
Encounter |
Extension of UKCore-Encounter |
Immunization |
Extension to UKCore Immunization and includes elements from HL7 International Patient Access |
MedicationRequest |
Extension of UKCore-MedicationRequest and includes elements from HL7 International Patient Access |
Observation |
Extension of UKCore-Observation and includes elements from HL7 International Patient Access |
Organization |
Extension of UKCore Organization and includes elements from IHE Mobile Care Services Discovery (mCSD) |
Patient |
Extension of UKCore-Patient and includes elements from HL7 International Access |
Practitioner |
Extension of UKCore Practitioner and includes elements from IHE Mobile Care Services Discovery (mCSD) |
Questionnaire |
Based on HL7 Structured Data Capture |
QuestionnaireResponse |
Based on HL7 Structured Data Capture |
ServiceRequest |
Extension of UKCore-ServiceRequest |
ServiceRequestReferral |
Is based on requirements present in e-Referral Service - FHIR API, converted to HL7 FHIR R4. |
Task |
Based on FHIR Workflow |
These define constraints on FHIR data types for systems conforming to this implementation guide.
Codeable Reference |
Backport of CodeableReference in HL7 FHIR R4 to support coded Conditions rather than resource references. |
Common Resource Identifiers |
Common Resource Identifiers This is aimed at being HL7 v2 compatible, in particular HL7 v2 OBX and HL7 FHIR Observation, see Segment OBX to Observation Map for detailed mapping. |
Medical Record Number |
Only use in FHIR Reference if the NHS Number is not known or unverified. |
NHS, HCSN and CHI Numbers |
NHS Data Dictionary: NHS NUMBER, COMMUNITY HEALTH INDEX NUMBER and HEALTH AND CARE NUMBER |
Organisation Code |
NHS Data Dictionary ORGANISATION_CODE |
Organisation Site Identifier |
NHS Data Dictionary ORGANISATION SITE IDENTIFIER Use ODS Site code relevant for organisation. E.g. Use Mid Yorkshire Hospitals NHS Trust (RXF) version of Pinderfields Hospital (RXF05) when referring to Mid Yorks, not others in the director |
Reference - RESTful |
A Reference data type where the referenced resource is expected to be resolvable RESTfully. |
Reference - RESTful or Logical |
A Reference data type where the referenced resource could be resolvable RESTfully or pointed to logically. |
SDS User Profile Id |
In NHS Englands Spine Directory Service this is the uniqueIdentifier in the nhsOrgPerson and nhsOrgPersonRole object (confirm this is true). This MISSING formal definition of this type HL7 v3/OID: 1.2.826.0.1285.0.2.0.67 |
Staff Enterprise Number |
UK Professional Licence should take precedence over staff numbers (i.e. SDS User Id) in HL7 FHIR Reference and other interoperability standards. E.g. SDS User ID and Ministry of Defence Doctor. |
UK Professional License |
NHS Data Dictionary CONSULTANT CODE and GENERAL MEDICAL PRACTITIONER PPD CODE. |
These define constraints on FHIR data types for systems conforming to this implementation guide.
ExtCodeableReference |
Replace with R5 backport or UKCore extension if they exist |
These define sets of codes used by systems conforming to this implementation guide.
Medical Record System |
A list of medical record systems. |
SmokingStatus |
Virtually Smoking Status |
UK Common Resource Identifiers |
UK Common Resource Identifiers |
UK National Insurance Identifiers |
UK NHS National Insurance Identifier E.g. NHS Number (England and Wales) and CHI Number (Scotland) |
UK Professional License |
UK Professional License E.g. GMC, HCPC, GMP, etc numbers. |
UK StaffNumber |
UK StaffNumber E.g. SDS User Id and Ministry of Defence Doctor Number |
These define new code systems used by systems conforming to this implementation guide.
Medical Record System |
Medical Record Systems |
Staff Number |
UK Staff Numbers |
UK Professional License |
UK Professional License |
UKCommonResourceIdentifiers |
UK Common Resource Identifiers |
UKNationalIdentifier |
UK National Insurance Provider Identifier |
These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.
243 | |
93d2c059-a934-4796-827b-dee1158cc4dc | |
Bundle `Document` - Referral Letter |
FHIR Document Referral Letter for Jack Dawkins |
Condition - Dyspnoea |
Condition Dyspnoea Jack Dawkins NHS Number: 9912003888 Loosely based on NHS Digital End of Life Care FHIR STU3 - Advance Treatment Preferences Atomic Unit |
Condition-EMIS-IM1-Cardiovascular-event-risk |
Condition EMIS IM1 Cardiovascular event-risk |
Condition-EMIS-IM1-Hypertension-monitoring |
Condition EMIS IM1 Hypertension monitoring |
Condition-EMIS-PFS-Cardiovascular-event-risk |
Condition EMIS PFS Cardiovascular event-risk |
DocumentReference-EMIS-IM1-Letter |
DocumentReference EMIS IM1 Letter encounter |
DocumentReference-EMIS-PFS-Letter |
DocumentReference EMIS PFS Letter encounter |
Example QuestionnaireResponse - QuestionnaireResponse-EMIS-PFS-patient-3-pharmacy-nomination | |
Immunization-EMIS-IM1-Influenza vaccination |
Immunization EMIS IM1 Influenza vaccination |
Immunization-EMIS-IM1-Pneumococcal-vaccination-declined |
Immunization EMIS IM1 Pneumococcal vaccination declined |
Main Building | |
MedicationRequest-EMIS-IM1-Amoxicillin-125mg/5ml-oral-suspension-sugar-free |
MedicationRequest EMIS IM1 Amoxicillin 125mg/5ml oral suspension sugar free |
MedicationRequest-EMIS-PFS-Atorvastatin-10mg-tablets |
MedicationRequest EMIS PFS Atorvastatin 10mg tablets |
Observation CDR - Activity Duration |
Patient Held Device Data Capture - Activity Duration |
Observation CDR - Average Heart Rate |
Patient Held Device Data Capture - Average Heart Rate |
Observation CDR - Average Resting Heart Rate |
Patient Held Device Data Capture - Average Resting Heart Rate |
Observation CDR - Blood pressure |
Form based Data Capture - Blood pressure See also HL7 Blood pressure For Device based data capture populate device instead of derivedFrom |
Observation CDR - Body Mass Index |
Form based Data Capture - Body Mass Index See also HL7 FHIR Body Mass Index For Device based data capture populate device instead of derivedFrom |
Observation CDR - Body height |
Form based Data Capture - Body height See also HL7 FHIR Body height For Device based data capture populate device instead of derivedFrom |
Observation CDR - Body temperature |
Form based Data Capture - Body temperature See also HL7 FHIR Body temperature For Device based data capture populate device instead of derivedFrom |
Observation CDR - Body weight |
Form based Data Capture - Body weight See also HL7 FHIR Body weight For Device based data capture populate device instead of derivedFrom |
Observation CDR - Calories per Day |
Patient Held Device Data Capture - Calories per Day |
Observation CDR - Calories per activity |
Patient Held Device Data Capture - Calories per activity |
Observation CDR - Daily Step Count |
Patient Held Device Data Capture - Daily Step Count |
Observation CDR - Exercise Activity Walking |
Patient Held Device Data Capture - Exercise Activity Walking |
Observation CDR - Head circumference |
Form based Data Capture - Head circumference See also HL7 FHIR Head circumference For Device based data capture populate device instead of derivedFrom |
Observation CDR - Heart rate |
Form based Data Capture - Heart rate See also HL7 FHIR Heart rate For Device based data capture populate device instead of derivedFrom |
Observation CDR - Oxygen Saturation |
Form based Data Capture - Oxygen Saturation See also Hl7 FHIR Oxygen Saturation For Device based data capture populate device instead of derivedFrom |
Observation CDR - Peak Activity Heart Rate |
Patient Held Device Data Capture - Peak Activity Heart Rate |
Observation CDR - Peak daily heart rate |
Patient Held Device Data Capture - Peak daily heart rate |
Observation CDR - Physical Activity Panel |
Patient Held Device Data Capture - Physical Activity Panel |
Observation CDR - Respiratory rate |
Form based Data Capture - Respiratory rate See also HL7 FHIR Respiratory rate For Device based data capture populate device instead of derivedFrom |
Observation CDR - Vital Signs Panel |
See also HL7 FHIR Vital Signs |
Observation-EMIS-IM1-Plasma-glucose-level |
Observation EMIS IM1 Plasma glucose level |
Observation-EMIS-IM1-Systolic-blood-pressure |
Observation EMIS IM1 Systolic blood pressure |
Observation-EMIS-IM1-Urine-protein-test-not-done |
Observation EMIS IM1 Urine protein test not done |
Observation-EMIS-IM1-Weight |
Observation EMIS IM1 Weight |
Observation-EMIS-PFS-Plasma-glucose-level |
Observation EMIS PFS Plasma glucose level |
Observation-EMIS-PFS-Systolic-blood-pressure |
Observation EMIS PFS Systolic blood pressure |
Observation-EMIS-PFS-Urine-protein-test-not-done |
Observation EMIS PFS Urine protein test not done |
Observation-EMIS-PFS-Weight |
Observation EMIS PFS Weight |
Organization CDR - The Moir Medical Centre (C81010) |
Organisation The Moir Medical Centre (C81010), imported from ODS CSV Downloads |
Organization NHS England - Leeds Teaching Trust (RR8) |
Organization NHS England ODS FHIR Api - Leeds Teaching Trust (RR8) |
Organization NHS England - The Moir Medical Centre (C81010) |
Organization NHS England ODS FHIR Api - The Moir Medical Centre (C81010) |
Patient - Jack Dawkins NHS Number: 9912003888 |
Loosely based on NHS Digital End of Life Care FHIR STU3 - Demographics Atomic Unit |
Patient CDR - Rachel Kanfeld |
Clinical Data Reposotory Rachel Kanfeld |
Patient NHSEngland - Matthew Sheppard (9876543210) |
Patient NHS England PDS FHIR Api - Int Environment Matthew Sheppard (9876543210) |
Patient-EMIS-IM1-Arthur-Thomas |
EMIS IM1 Patient Arthur Thomas |
Patient-EMIS-IM1-Daniel-ODonnell |
EMIS IM1 Patient Daniel O'Donnell |
Patient-EMIS-IM1-William-Dyer |
EMIS IM1 Patient William Dyer |
Patient-EMIS-PFS-Daniel-ODonnell |
EMIS PFS Patient Daniel O'Donnell |
Patient-TPP-IM1-Anne-Smith |
TPP IM1 Anne Smith |
Patient-TPP-IM1-Anthony-Avocet |
TPP IM1 Anthony Avocet |
Practitioner-EMIS-IM1-Pauline-Steele |
Practitioner EMIS IM1 Pauline Steele |
Practitioner-TPP-IM1-Amit-Chawla |
Practitioner TPP IM1 Amit Chawla |
Referral Letter |
Referral Letter |
ServiceRequest - Create |
Example conversion of $ers.createReferral multishortlist to FHIR R4 ServiceRequest in a Clinical Data Repository |
Task-EMIS-IM1-Elderly-health-assessment |
Task-EMIS IM1 Elderly health assessment |
Task-EMIS-IM1-Medication-review |
Task EMIS IM1 Medication review |
Task-EMIS-PFS-Prescription-Refill |
Task EMIS PFS Prescription Refill |
ers-Referral-Request | |
questionnaireresponse-daily-physical-activity | |
questionnaireresponse-exercise-activity | |
questionnaireresponse-vital-signs |