CH ELM (R4)
1.5.0 - release
CH ELM (R4)
1.5.0 - release
CH ELM (R4), published by Federal Office of Public Health FOPH. This guide is not an authorized publication; it is the continuous build for version 1.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/ch-elm/ and changes regularly. See the Directory of published versions
The CH ELM exchange format defines a FHIR document representing a coherent set of information specific to the transmission of laboratory data. This FHIR document is based on the CH Lab report document which is part of the CH LAB-Report Project.
The exchange format expects a separate FHIR document per patient, organism and test performed.
The FHIR document consists of a bundle-resource of type "document" (the terms "FHIR document" and "Bundle" are synonymous in the context of the CH ELM project).
The bundle resource contains a consistent set of entries representing FHIR resources specific for the transmission of laboratory data:
| { | ||||||
| "resourceType": "Bundle", | ||||||
| "entry": [ | ||||||
| { "resourceType": "Composition" }, |
parameters like date, language, title, author, and referring to the different resources | |||||
| { "resourceType": "DiagnosticReport" }, |
represents the laboratory report as a result of a lab order, with references to all other resources | |||||
| { "resourceType": "Patient" }, |
the person from whom the specimen was taken | |||||
| { "resourceType": "Observation" }, |
defines the analyzed organism with the laboratory test result-values, interpretation, and test execution date | |||||
| { "resourceType": "Specimen" }, |
the specimen material with collection date | |||||
| { "resourceType": "ServiceRequest" }, |
the lab order with the laboratory order ID, the requester, and performer of the laboratory test | |||||
| { "resourceType": "PractitionerRole" }, |
the orderer of the laboratory test containing a practitioner and/or organization | |||||
| { "resourceType": "Practitioner" }, |
the person ordering the laboratory test | |||||
| { "resourceType": "Organization" }, |
the organization ordering the laboratory test | |||||
| { "resourceType": "Organization" } |
the performing laboratory | |||||
| ] | ||||||
| } | ||||||
The FHIR document is generic and applicable for all types of organisms and reporting scenarios (use cases). For each resource within the FHIR document, a resource profile is defined to meet specific data needs depending on the context and use case.
Resource profiles are a way to customize and constrain FHIR resources to meet specific requirements depending on a particular context. These rules might restrict the allowable values for certain elements, specify additional mandatory elements, or define extensions to capture additional data beyond the standard FHIR resources. In the CH ELM Implementation Guide multiple profiles can exist based on the same FHIR resource.
Example: the FHIR resource «organization» is used to map the sender of the FHIR Document, the performing laboratory and the orderer of the laboratory test – each of which having its own profile.
The diagram “Resource Overview” illustrates the connections between the individual resource-profiles of a FHIR document.
See the examples in chapter 2.2 to learn how to use the resource profiles for different use cases and data requirements.
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Campylobacteriosis | Campylobacter coli DNA [Presence] in Stool by NAA with probe detection | 101552-8 | JSON, XML |
| Chikungunya fever | Chikungunya virus RNA [Presence] in Urine by NAA with probe detection | 86515-4 | JSON, XML |
| Cholera | Vibrio cholerae toxin ctx gene [Presence] in Specimen by NAA with probe detection | 53942-9 | JSON, XML |
| Covid-19 | SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory system specimen by NAA with probe detection | 94500-6 | JSON, XML |
| Dengue - reporting of high-level titer result | Dengue virus IgG Ab [Titer] in Serum | 6811-4 | JSON, XML |
| Diphtheria | Corynebacterium diphtheriae DNA [Presence] in Specimen by NAA with probe detection | 67561-1 | JSON, XML |
| Gonorrhoea | Neisseria gonorrhoeae [Presence] in Urethra by Organism specific culture | 697-3 | JSON, XML |
| Haemophilus influenzae disease | Haemophilus influenzae B DNA [Presence] in Blood by NAA with probe detection | 53607-8 | JSON, XML |
| Hepatitis A | Hepatitis A virus IgM Ab [Presence] in Serum | 22314-9 | JSON, XML |
| Hepatitis B | Hepatitis B virus core IgM Ab [Presence] in Serum | 31204-1 | JSON, XML |
| Hepatitis C | Hepatitis C virus Ab [Presence] in Serum by Immunoblot | 5199-5 | JSON, XML |
| Hepatitis E | Hepatitis E virus RNA [Presence] in Stool by NAA with probe detection | 91071-1 | JSON, XML |
| Influenza | Influenza virus A RNA [Presence] in Nasopharynx by NAA with probe detection | 76078-5 | JSON, XML |
| Listeriosis | Listeria monocytogenes DNA [Presence] in Cerebral spinal fluid by NAA with non-probe detection | 82184-3 | JSON, XML |
| Malaria | Plasmodium knowlesi DNA [Presence] in Blood by NAA with probe detection | 70568-1 | JSON, XML |
| Measles - reporting of a seroconversion | Measles virus IgG and IgM [Interpretation] in Serum | 44012-3 | JSON, XML |
| Pneumococcal disease | Streptococcus pneumoniae Ag [Presence] in Cerebral spinal fluid | 20489-1 | JSON, XML |
| Rubella - reporting of a seroconversion | Rubella virus IgG Ab [Interpretation] in Serum | 20458-6 | JSON, XML |
| Tick - borne encephalitis | Tick - borne encephalitis virus RNA [Presence] in Specimen by NAA with probe detection | 97920-3 | JSON, XML |
| Disease | observation.code display | SNOMED CT observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Syphilis | Treponema pallidum (organism) | 72904005 | JSON, XML |
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Carbapenemase - producing enterobacteriaceae (CPE) | Carbapenem resistance bla OXA-48-like gene [Presence] by Molecular method | 85827-4 | JSON, XML |
| Legionellosis | Legionella sp Ag [Presence] in Urine | 32781-7 | JSON, XML |
| Shigellosis | Shigella sp DNA [Presence] in Stool by NAA with probe detection | 101427-3 | JSON, XML |
| Tularaemia - with optional organism specification | Francisella tularensis Ag [Presence] in Serum | 31828-7 | JSON, XML |
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Chlamydiosis | Chlamydia trachomatis [Presence] in Specimen by Organism specific culture | 6349-5 | JSON, XML |
| Monkeypox | Monkeypox virus DNA [Presence] in Specimen by NAA with probe detection | 100383-9 | JSON, XML |
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Chlamydiosis | Chlamydia trachomatis [Presence] in Specimen by Organism specific culture | 6349-5 | JSON, XML |
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Gonorrhoea | Neisseria gonorrhoeae [Presence] in Urethra by Organism specific culture | 697-3 | JSON, XML |
| Disease | observation.code display | LOINC observation.code (leading code) |
FHIR Document |
|---|---|---|---|
| Meningococcal disease - initial observation by primary laboratory | Microscopic observation [Identifier] in Cerebral spinal fluid by Gram stain | 14357-8 | JSON, XML |
| Meningococcal disease - confirmation test by reference laboratory | Neisseria meningitidis [Presence] in Cerebral spinal fluid by Organism specific culture | 86581-6 | JSON, XML |