IDEA4RC FHIR Implementation Guide
0.1.0 - CI Build 150

IDEA4RC FHIR Implementation Guide, published by IDEA4RC 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/idea4rc/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

IDEA4RC Common Models

Logical models representing the IDEA4RC Common Models

Adverse Event

IDEA4RC Adverse Event common model

Cancer Episode

IDEA4RC Cancer Episode common model

Episode Event

IDEA4RC Episode Event common model

Genetic Test Expression

IDEA4RC Genetic Test Expression common model

Head and Neck Stage

IDEA4RC Head and Neck Stage common model

Hospital Patient Records

IDEA4RC Hospital Patient Records common model. This includes also the HospitalData model.

Other Local Treatment

IDEA4RC Patient Other Local Treatment common model

Pathological Report Info

IDEA4RC Pathological Report Info common model

Patient

IDEA4RC Patient common model

Patient Follow-Up

IDEA4RC Patient Follow Up common model

Radiotherapy

IDEA4RC Radiotherapy common model

Sarcoma Stage

IDEA4RC Sarcoma Stage common model

Surgery

IDEA4RC Surgery common model

Systemic Treatment

IDEA4RC Systemic Treatment common model

Treatment Response

IDEA4RC Treatment Response common model

IDEA4RC Common Models Maps

Model Mapping from the IDEA4RC Logical models and this guide

Cancer Episode Model to this guide Map

It shows how the Cancer Episode model is mapped into this guide

Episode Event Model to this guide Map

It shows how the Episode Event model is mapped into this guide

Genetic Test Expression Model to this guide Map

It shows how the Genetic Test Expression model is mapped into this guide

Genetic Test to this guide Map

Genetic Test to this guide Map

Head and Neck Stage Model to this guide Map

It shows how the Head and Neck model is mapped into this guide

Hospital Patient Records Model to this guide Map

It shows how the Hospital Patient Records model is mapped into this guide

Patient (Subject) Model to this guide Map

It shows how the Patient (Subject) model is mapped into this guide

Patient Follow up Model to this guide Map

It shows how the Patient Follow up model is mapped into this guide

Radiotherapy Model to this guide Map

It shows how the Radiotherapy model is mapped into this guide

Sarcoma Stage Model to this guide Map

It shows how the Sarcoma Stage model is mapped into this guide

Surgery Model to this guide Map

It shows how the Surgery model is mapped into this guide

HL7 FHIR Profile implementing the Subject (Patient) model

HL7 FHIR Profile implementing the Subject (Patient) model

Observation: Alcohol use

This profile constrains the Observation resource to represent alcohol use assessment for the purpose of the IDEA4RC project.

Observation: Cancer Treatment

This profile constrains the Observation resource to represent the assertion that a cancer treatment occurred, specifying the type.

Observation: Charlson Comorbidity Index

The Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

Observation: Comorbidities

This profile constrains the Observation resource to represent Comorbidities for the purpose of the IDEA4RC project. This profiles is adapted from the mCode FHIR Implementation Guide

Observation: ECOG Performance Status

The Eastern Cooperative Oncology Group (ECOG) Performance Status represents the patient's functional status and is used to determine their ability to tolerate therapies in serious illness, specifically for chemotherapy. (Definition from: LOINC)

Observation: Karnofsky Performance Status

The Karnofsky Performance Status (KPS) is a tool used to measure a patient's functional status. It can be used to compare the effectiveness of different therapies and to help assess the prognosis of certain patients, such as those with certain cancers. The KPS score ranges from 0 to 100 in intervals of 10. Higher scores are associated with better functional status, with 100 representing no symptoms or evidence of disease, and 0 representing death.

Observation: Occurrence of the other cancer

This profile constrains the Observation resource to represent the occurrence of the other cancer.

Observation: Tobacco use

This profile constrains the Observation resource to represent Tobacco use assessment for the purpose of the IDEA4RC project.

Patient: IDEA4RC

This profile defines how to represent Patient in FHIR for the purpose of the IDEA4RC project.

HL7 FHIR Profile implementing the Cancer Episode and Episode Event models

HL7 FHIR Profile implementing the Cancer Episode and Episode Event models

Condition: Metastatic Cancer

This profile defines how to represent metastatic cancer in FHIR for the purpose of the IDEA4RC project. This profile is inspired from the mCode IG. Records the history of secondary neoplasms, including location(s) and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

Condition: Primary Cancer

This profile defines how to represent Primary Cancer Condition in HL7 FHIR for the purpose of the IDEA4RC project. This profile is inspired from the mCode IG. A primary cancer condition, the original or first tumor in the body (Definition from: NCI Dictionary of Cancer Terms). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary. This profile should be also used for documenting primary cancer relapses during or after FLT.

Observation: Diagnosis details

This profile defines how to represent diagnosis details (when the diagnosis was made; who made it;…) in FHIR for the purpose of the IDEA4RC project.

HL7 FHIR Profile implementing the Stage models

HL7 FHIR Profile implementing the Stage models

Observation: Head Neck Cancer Stage Group

The extent of the cancer in the body, according to a given cancer staging classification system, based on evidence such as physical examination, imaging, and/or biopsy or based on pathologic analysis of a specimen.

Observation: Localized Category (Stage, Sarcoma)

Category describing the stage at diagnosis (before any treatments) Localised (yes/no). No of lesions if Localised

Observation: LocoRegional Category (Stage, Sarcoma)

Category describing the LocoRegional

Observation: Radiological Extra-nodal extension (rENE)

This profile constrains the Observation resource to represent Radiological Extra-nodal extension (rENE) for the purpose of the IDEA4RC project. It describes the presence or absence of radiological signs of extracapsular extension, as defined in the AJCC 8th Ed

Observation: Sarcoma Cancer Stage Group

The extent of the cancer in the body, according to a given cancer staging classification system, based on evidence such as physical examination, imaging, and/or biopsy or based on pathologic analysis of a specimen.

Observation: TNM Distant Metastases Category

Category describing the extent of a tumor metastasis in remote anatomical locations, based on evidence such as physical examination, imaging, and/or biopsy.

Observation: TNM Primary Tumor Category

Category of the primary tumor, based on its size and extent, based on evidence such as physical examination, imaging, and/or biopsy.

Observation: TNM Regional Nodes Category

Category of the presence or absence of metastases in regional lymph nodes, based on evidence such as physical examination, imaging, and/or biopsy.

HL7 FHIR Profile implementing the Patient Follow Up model

HL7 FHIR Profile implementing the Patient Follow models

Encounter: IDEA4RC

This profile defines how to represent the Patient follow-up model and when needed the treatmement center in FHIR for the purpose of the IDEA4RC project.

Observation: date of the last contact

This profile constrains the Observation resource to represent the date of the last contact.

Observation: Status at the Last Follow Up

This profile constrains the Observation resource to represent the status at the Last Follow Up.

HL7 FHIR Profile implementing the Surgery model

HL7 FHIR Profile implementing the Surgery model

Procedure: Surgery

This profile defines how to represent Procedures in FHIR for describing a set of Surgery data required by the IDEA4RC project. This porfiles is adapted from the PanCareSurPass Procedure Surgery profile.

HL7 FHIR Profile implementing the Radiotherapy model

HL7 FHIR Profile implementing the Radiotherapy model

Procedure: Radiotherapy

This profile defines how to represent Procedures in FHIR for describing a set of Radiotherapy data required by the PanCareSurPass algorithm to generate the care plan.

HL7 FHIR Profile implementing the Systemic Treatment model

HL7 FHIR Profile implementing the Systemic Treatment model (mapping to be further analyzed)

MedicationAdministration: Chemotherapy

This profile defines how to represent MedicationAdministration in HL7 FHIR for describing Chemotherapy data for the purpose of the IDEA4RC project.

HL7 FHIR Profile implementing the Hospital Patient Records model

HL7 FHIR Profile implementing the Hospital Patient Records model

EpisodeOfCare: IDEA4RC

This profile defines how to represent the Hospital Patient Records model in FHIR for the purpose of the IDEA4RC project.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

AdverseEvent: IDEA4RC

This profile defines how to represent the Adverse vent model in FHIR for the purpose of the IDEA4RC project.

Bundle: IDEA4RC

This profile defines how to represent a Bundle in FHIR for the purpose of the IDEA4RC project.

Observation: Yes / No assertions

This profile constrains the Observation resource to represent the situations where a Yes/No answer is captured for the purpose of the IDEA4RC project.

Observation: test results

This profile constrains the Observation resource to represent test results for the purpose of the IDEA4RC project.

Procedure: Other Treatment

This profile defines how to represent Other Treatment procedures in FHIR for describing a set of Surgery data required by the IDEA4RC project. This porfiles is adapted from the PanCareSurPass Procedure Surgery profile.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Body Location Qualifier

Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

Condition related to resource

The resource has an unspecified relationship with a Condition.

Laterality Qualifier

Qualifier to specify laterality.

Performed Timing

This extension allows to indicate when the procedure was performed as Timing.

Previous Status

This extension provides a mean to indicate the previous clinicalStatus of a condition. It might be used for example to indicate if a relapse is now in remission.

Race Extension

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. Derived by the US core Race extensions.

Radiotherapy Dose Delivered To Volume Extension

Dose delivered to a given radiotherapy volume.

Radiotherapy Energy or Isotope

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope. This extension is based on the CodeX™ Radiation Therapy RadiotherapyEnergyOrIsotope extension

Radiotherapy Modality And Technique Extension

Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality.

Radiotherapy Modality Extension

Extension capturing a modality of external beam or brachytherapy radiation procedures.

Radiotherapy Number of Sessions Extension

The number of sessions in a course of radiotherapy.

Radiotherapy Technique Extension

Extension capturing a technique of external beam or brachytherapy radiation procedures.

Relapse Type

This extension is used to indicate if a relapse/progression is local, remote or combined.

Same custodian flag

This extension is temporary included in the guide for covering the request of tracking if this information has been captured and maintained by the same or other organizations. It is envisioned that this kind of requirements could be covered by recording where specific act are taking place.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Affected Organs (surgery)

Affected Organs (surgery)

Alcohol Usage Status: Athena

Alcohol Usage Status: Athena

Alcohol Usage Status: SNOMED CT

Alcohol Usage Status: SNOMED CT

Antineoplastic and immunostimulating agents

List of WHO ATC codes for antineoplastic and immunostimulating agents.

Beam Quality

describes the type of radiation therapy given

Body site qualifier

It describes the body site qualifier (e.g. localized)

Calculated|Estimated
Calculated Estimated Value Set
Cancer Chondro Osseous Tumours: Athena

Codes identifying codindins beloging to the Chondro Osseous Tumours group.

Cancer Endometrial stromal and related Tumors: Athena

Codes identifying codindins beloging to the Endometrial stromal and related Tumors group.

Cancer Event Type: Athena

Codes identifying the type of cancenr event: e.g. Progression, Stable Disease,…

Cancer Histology Adenocarcinoma: Athena

Codes identifying codindins beloging to the Histology Adenocarcinoma group.

Cancer Histology Neuroendocrine: Athena

Codes identifying codindins beloging to the Histology Neuroendocrine group.

Cancer Histology Odontogenic Carcinoma: Athena

Codes identifying codindins beloging to the Histology Odontogenic Carcinoma group.

Cancer Histology SNUC: Athena

Codes identifying codindins beloging to the Histology SNUC group.

Cancer Histology Squamous: Athena

Codes identifying codindins beloging to the Histology Squamous group.

Cancer Histology Subgroup Adipocytic Tumours: Athena

Codes identifying codindins beloging to the Histology Subgroup Adipocytic Tumours group.

Cancer Histology Subgroup Fmt Tumours: Athena

Codes identifying codindins beloging to the Histology Subgroup Fmt Tumours group.

Cancer Histology Subgroup So called Fibrohistiocytic Tumours: Athena

Codes identifying codindins beloging to the Histology Subgroup So called Fibrohistiocytic Tumours.

Cancer Miscellanious mesenchimal tumors: Athena

Codes identifying codindins beloging to the Miscellanious mesenchimal tumors group.

Cancer Mixed epithelial and mesenchymal tumours: Athena

Codes identifying codindins beloging to the Mixed epithelial and mesenchymal tumours group.

Cancer Pericytic Perivascular Tumours: Athena

Codes identifying codindins beloging to the Pericytic Perivascular Tumours group.

Cancer Peripheral Nerve Sheath Tumors: Athena

Codes identifying codindins beloging to the Peripheral Nerve Sheath Tumors group.

Cancer Skeletal Muscle Tumours: Athena

Codes identifying codindins beloging to the Skeletal Muscle Tumours group.

Cancer Smooth Muscle Tumours: Athena

Codes identifying codindins beloging to the Smooth Muscle Tumours group.

Cancer Stage Grading: Athena

Identifying codes based on the timing of classification for stage group observations.

Cancer Stage Group Value: Athena

Identifying value for the TNM stage grouping.

Cancer Stage Group: Athena

Identifying codes based on the timing of classification for stage group observations.

Cancer Tumors Of Uncertain Differentiation: Athena

Codes identifying codindins beloging to the Tumors Of Uncertain Differentiation group.

Cancer Vascular Tumours: Athena

Codes identifying codindins beloging to the Vascular Tumours group.

Cancer diagnosis: Athena

Codes identifying the type of cancer.

Cancer undif. small round cell sarcomas of bone and soft tissue: Athena

Codes identifying codindins beloging to the Undifferentiated small round cell sarcomas of bone and soft tissue group.

Chemotherapy cumulative dose units

Chemotherapy cumulative dose units

Comorbidities: Athena

Comorbidities: Athena

Comorbidities: SNOMED

Comorbidities: SNOMED CT

Country: athena

Country: athena

Current Smoking Status: Athena

Current Smoking Status: Athena

ECOG Performance Status

Eastern Cooperative Oncology Group (ECOG) Performance Status

Event Type

Type of event registered

Extranodal Extension

Describes extent of extranodal extension. This number must be explicitly referred to in the pathological report, otherwise it is unknown

Gender: Athena

Gender value set based on the Athena system

Genetic Tests performed (Yes/no/Unk)

Genetic Tests performed (Yes/no/Unk)

Genito urinary subsite: Athena

Specifies the subsite for cancers occurred in Genito urinary : Athena

Hypopharynx subsite: Athena

Specifies the subsite for cancers occured in hypopharynx: Athena

Hypopharynx subsite: Snomed CT

Specifies the subsite for cancers occured in hypopharynx: Snomed CT

Intra abdominal subsite: Athena

Specifies the subsite for cancers occurred in Intra abdominal: Athena

Intra thoracic subsite : Athena

Specifies the subsite for cancers occurred in Intra thoracic: Athena

Larynx subsite: Athena

Specifies the subsite for cancers occured in Larynx: Athena

Larynx subsite: Snomed CT

Specifies the subsite for cancers occured in Larynx: Snomed CT

Lip subsite: Athena

Specifies the subsite for cancers occured in lip: Athena

Lip subsite: Snomed CT

Specifies the subsite for cancers occured in lip: Snomed CT

Margins After Surgery

margins after surgery

Metastatis: Athena

Codes identifying the type of metastasis.

Nasal cavity and paranasal sinuses subsite: Athena

Specifies the subsite for cancers occured in nasal cavity and paranasal sinusess: Athena

Nasal cavity and paranasal sinuses subsite: Snomed CT

Specifies the subsite for cancers occured in nasal cavity and paranasal sinusess: Snomed CT

Nasopharynx subsite: Athena

Specifies the subsite for cancers occured in nasopharynx: Athena

Nasopharynx subsite: Snomed CT

Specifies the subsite for cancers occured in nasopharynx: Snomed CT

Not Performed|Unknown

Not Performed/Unknown Value Set

Observation Codes for Distant Metastases Category

Identifying codes based on the timing of classification for distant metastases (M) staging observations.

Observation Codes for Primary Tumor Category

Identifying codes based on the timing of classification for primary tumor (T) staging observations.

Observation Codes for Regional Node Category

Identifying codes based on the timing of classification for regional node (N) staging observations.

Occurrence of other cancer

Occurrence of other cancer

Oral cavity subsite: Athena

Specifies the subsite for cancers occured in oral cavity: Athena

Oral cavity subsite: Snomed CT

Specifies the subsite for cancers occured in oral cavity: Snomed CT

Oropharynx subsite: Athena

Specifies the subsite for cancers occured in Oropharynx: Athena

Oropharynx subsite: Snomed CT

Specifies the subsite for cancers occured in Oropharynx: Snomed CT

Pathological M

Describes whether capsular extension is present by histopathologic examination or not

Pathological N

Pathological N

Pathological T

Pathological T (Primary Tumor)

Positive-Negative-No Test: Athena

Laboratory test results: Positive-Negative-Not tested: Athena

Race

Race value set based on the Athena system

Radiotherapy Device Type

Radiotherapy device type this procedure is referring to. TO BE UPDATED

Reason For End Of Treatment

Clarifies the reasons why the treatment ended or was interrupted

Sarcoma Staging: localized disease

This value set includes values indicating if the disease is confined or metastatic.

Sarcoma Staging: loco-regional category

This value set includes values indicating if the disease is multi-focal or in-trasit metastatis.

Setting Radiotherapy

Radiotherapy setting

Simple measures

Test results:

  • EBV DNA plasma testing before treatment in NPC type II and III (WHO)
  • HPV tumor testing in oral carcinoma
  • C reactive protein testing.
  • Biopsy Mitotic Count
  • Tumor Size
Site of metastasis

describes the site of metastasis

Site rare (IDEA4RC)

Describe the primary tumor site

Smoking Status: LOINC

Derived from the HL7 LOINC value set for smoking status. Based on the HL7 Vocab and Structured Doc WG (formerly TC) consensus - per US CDC submission 7/12/2012 for smoking status terms.

Status at the Last Follow Up

Status at the Last Follow Up

Subsites: Athena

Specifies the subsites where cancers occured: Athena

Subsites: SNOMED CT

Specifies the subsites where cancers occured: SNOMED CT

Surgery Complication

Surgery Complication

Surgery Intention

Surgery Intention

Surgery Outcome

Surgery Outcome

Surgical Complications

describes presence and grade of complications after a surgical procedure

Surgical Procedure Category

Category of surgical procedure this resource is referring to

Surgical Procedure Type

Types of surgical procedure this resource is referring to (to be updated)

TNM Distant Metastases Category Value Set

This value set is intended to contain allowable values for the M category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Primary Tumor Category Value Set

This value set is intended to contain allowable values for the T category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Regional Nodes Category Value Set

This value set is intended to contain allowable values for the N category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

Tobacco Product

Tobacco Product based on the Athena system

Treatment Response

treatment response

Treatment Setting

Treatment Setting

Treatment Technique

It refers to the type of radiotherapy treatment delivered

Treatment completed as planned

refers to whether patient completed all treatment as planned or if it had to be interrupted due to several reasons

Trunk wall subsite: Athena

Specifies the subsite for cancers occurred in Trunk wall: Athena

Type of Biopsy

type of Biopsy

Type of Diagnosis

type of Diagnosis

Type of Systemic Treatment

type of systemic treatment administered

Type of Treatment

type of treatment

Type of surgical approach

type of surgical approach on tumour

Types of Yes/No observations

Types of Yes/No observations

Upper and Lower limbs subsite: Athena

Specifies the subsite for cancers occured in Upper and Lower limbs : Athena

Yes-No-Unk: Athena

Laboratory test results: Yes-No-Unkwnon: Athena

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

IDEA4RC Code System

Temporary coded concepts to be used by this Project waiting for the assignement from international terminologies.

Terminology: Concept Maps

These define transformations to convert between codes by systems conforming with this implementation guide.

Other Treatment to this guide Map

Other Treatment to this guide Map

Radiotherapy Model to this guide Map

Radiotherapy Model to this guide Map

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Actor: Head and Neck

An actor dealing with head and neck cancer data.

Actor: Sarcoma

An actor dealing with sarcoma data.

Condition: Grade 2 tumor with several body sites and evidences
Condition: Metastasis bone and pleura
Condition: NOT CLEAR WHAT IT REPRESENTS..TO BE DISCUSSED
Condition: Stable Disease
EpisodeOfCare
GOFSH-GENERATED-id-28
GOFSH-GENERATED-id-30
GOFSH-GENERATED-id-36
Observation: Alcohol use
Observation: BMI
Observation: C reactive protein Positive
Observation: Charlson Comorbidity Index
Observation: Diagnosis
Observation: Dimension of Tumor
Observation: Distant metastases clinical M1
Observation: Distant metastases pathology M1
Observation: ECOG Performance Status score
Observation: Epstein Barr virus DNA Negative
Observation: Human papilloma virus Negative
Observation: Karnofsky Performance Status score
Observation: Number of mitoses per HPF
Observation: Occurrence of other Cancer: Hamartoma
Observation: Primary tumor clinical T0
Observation: Primary tumor pathological T0
Observation: Radiological Extra-nodal extension
Observation: Regional lymph nodes Clinical N1
Observation: Regional lymph nodes pathology N3b
Observation: Surgery treatment occurred
Observation: TNM clinical stage grouping
Observation: TNM pathology stage grouping
Observation: Tobacco use panel

Observation: Tobacco use panel, Former smoker. 5 packs/year

Observation: comorbidity
Observation: date of the last contact
Observation: gene Mutation Analysis Performed yes
Observation: immunohiostochemestry analysis performed
Patient: race extension
Procedure: Isolated limb perfusion

Procedure: Isolated limb perfusion. With Macroscopic residual tumor and Grade III complication

encounter-id-14