Gravitate Health FHIR Implementation Guide, published by Gravitate Health Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/gravitate-health/ and changes regularly. See the Directory of published versions

ePI Processing

Adapting information to the context and preferences of the end user for effective and optimal understanding of the information.

The definition of the several steps in the processing pipeline:

1. Raw ePI: The ePI as is, without changes
2. p(ePI): the preprocessed ePI, with semmnantic annotation
3. f(ePI): the focused ePI format, rendered with personalized data

The focusing mechanism is complex and can be understood as a multistep process:

1. first the lenses are attached - x(ePI)
2. the persona vector and IPS and consulted/consumed - x'(ePI)
3. the necessary data elements are attached (CSS classes to certain DIVs) - f(ePI)

This will create a focused ePI that can be used to show personalized information to the user.

Diagram:

FHIR Considerations

1. The raw ePI: This artifact composed of several FHIR resources, being the composition the central piece. It can already have additional data in it from the get go such as multimedia in the format of binary or HtmlElementLink extension.

2. The preprocessed ePI: The annotation is done through the linkage of sentences, paragraphs or words to concepts, through the HtmlElementLink.

3. The focused ePI: After the focusing, the focused version should contain the information from the previous two, personalized for the patient. The applied lenses that made any change will be mentioned in the extension https://build.fhir.org/ig/hl7-eu/gravitate-health/StructureDefinition-LensesApplied.html The lens that made any change will be added to the tag as well.

Current developments

The current definition for the FOSPS is here:

https://fosps.gravitatehealth.eu/swagger-fosps/?urls.primaryName=Focusing%20Manager#/Lenses/post_focusing_focus__epiId

Example requests in the github.

Pregnancy

IF gender==female and age>18, highlight section about pregnancy. IF gender==male, collapse those sections

Conditions

IF IPS has conditions and ePI has sections related to any code of the condition(s), then highlight section;

Allergies

IF IPS has allergies and intollerances and ePI has sections related to any code of the allergy, then highlight section;

Interaction

1. check all medication on the IPS
2. check the ingredient of all of them
3. check any preprocessed section in the epi
4. highlight if related to any ingredient or medication.

Summary

IF IPS has age, gender and conditions and medication, use that and ePI to summarize in a personalized way; IF no IPS, then just summarize the ePI.

Plain Language

IF word or sentence is difficult - translate to plain language.

RMM

Add RMM in specific sections for better understanding

Other examples

1. FOR ALL <injectable> add multimedia video
2. FOR ALL <oral intake> IF patient.literacy is not high THEN add hover overlay with oral intake advice
3. FOR ALL <injectable> IF patient.literacy is low THEN add icon
4. FOR ALL <oral intake> IF patient.literacy is low THEN add icon