SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build
SGHI FHIR Profile Implementation Guide, published by Kathurima Kimathi. 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/savannahghi/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions
| Official URL: https://fhir.slade360.co.ke/fhir/StructureMap/ExtractChemotherapyProtocolCycles | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractChemotherapyProtocolCycles | |||
One laboratory Observation per value per cycle, each taking the cycle's own date rather than the form's, because the whole reason this sheet exists is to be read as a series: a neutrophil count means one thing on its own and another as the third fall in a row. The absolute neutrophil count carries an interpretation, low below 1.0 and critically low below 0.5, because those are the thresholds that defer a cycle.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractChemotherapyProtocolCycles' /// name = 'ExtractChemotherapyProtocolCycles' /// title = 'Chemotherapy Protocol Cycle Extraction' /// status = 'active' /// description = 'One laboratory Observation per value per cycle, each taking the cycle\'s own date rather than the form\'s, because the whole reason this sheet exists is to be read as a series: a neutrophil count means one thing on its own and another as the third fall in a row. The absolute neutrophil count carries an interpretation, low below 1.0 and critically low below 0.5, because those are the thresholds that defer a cycle.' uses "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" alias QR as source uses "http://hl7.org/fhir/StructureDefinition/Bundle" alias Bundle as target uses "http://hl7.org/fhir/StructureDefinition/Observation" alias Observation as target group ExtractChemotherapyProtocolCycles(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr.item as g where (linkId = 'protocol') then { g.item as it where ((linkId = 'protocol/regimen') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetSurveyCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; it -> cg.code = 'chemotherapy-regimen' "cd"; it -> cg.display = 'Chemotherapy regimen' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_chemotherapy_regimen"; g.item as it where ((linkId = 'protocol/weight') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '29463-7' "cd"; it -> cg.display = 'Body weight' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v "set"; }; } "measure_29463_7"; g.item as it where ((linkId = 'protocol/height') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '8302-2' "cd"; it -> cg.display = 'Body height' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v "set"; }; } "measure_8302_2"; g.item as it where ((linkId = 'protocol/body-surface-area') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '8277-6' "cd"; it -> cg.display = 'Body surface area' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = create('Quantity') as q then { v -> q.value = v "qValue"; v -> q.unit = 'm2' "qUnit"; v -> q.system = 'http://unitsofmeasure.org' "qSystem"; v -> q.code = 'm2' "qCode"; } "quantity"; }; } "measureq_8277_6"; } "protocolGroup"; // ── One cycle at a time ───────────────────────────────────────────────── qr.item as c where (linkId = 'cycle') then { c.item as it where ((linkId = 'cycle/haemoglobin') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetLaboratoryCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '718-7' "cd"; it -> cg.display = 'Hemoglobin [Mass/volume] in Blood' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cyclelab_haemoglobin"; c.item as it where ((linkId = 'cycle/platelets') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetLaboratoryCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '777-3' "cd"; it -> cg.display = 'Platelets [#/volume] in Blood by Automated count' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cyclelab_platelets"; c.item as it where ((linkId = 'cycle/creatinine') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetLaboratoryCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '2160-0' "cd"; it -> cg.display = 'Creatinine [Mass/volume] in Serum or Plasma' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cyclelab_creatinine"; c.item as it where ((linkId = 'cycle/urea') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetLaboratoryCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '3094-0' "cd"; it -> cg.display = 'Urea nitrogen [Mass/volume] in Serum or Plasma' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cyclelab_urea"; // The neutrophil count, interpreted. Below 1.0 x10^9/L most protocols // defer the cycle and below 0.5 the patient is neutropenic and at risk // from an infection they cannot mount a response to. Leaving a reader to // notice the number is not good enough on the one value that stops // treatment. c.item as it where ((linkId = 'cycle/anc') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetLaboratoryCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '751-8' "cd"; it -> cg.display = 'Neutrophils [#/volume] in Blood by Automated count' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; it -> obs.interpretation as interp then { it -> interp.coding as icg then { it -> icg.system = 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation' "sys"; it -> icg.code = evaluate(it, iif(answer.value.ofType(Quantity).value < 0.5, 'LL', iif(answer.value.ofType(Quantity).value < 1.0, 'L', 'N'))) "cd"; } "coding"; } "interpretation"; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cycleAnc"; c.item as it where ((linkId = 'cycle/pulse') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '8867-4' "cd"; it -> cg.display = 'Heart rate' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cyclePulse"; c.item as it where ((linkId = 'cycle/weight') and answer.value.ofType(Quantity).exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '29463-7' "cd"; it -> cg.display = 'Body weight' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cycleWeight"; // Blood pressure travels as typed -- "128/76" on one line. Split into a // systolic and a diastolic component it would have to be parsed, and a // mis-parsed blood pressure is worse than a legible string. c.item as it where ((linkId = 'cycle/blood-pressure') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetVitalSignsCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '85354-9' "cd"; it -> cg.display = 'Blood pressure panel with all children optional' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "bpText"; }; c -> obs then SetCycleContext(c, obs) "cycleContext"; } "cycleBloodPressure"; c.item as it where ((linkId = 'cycle/remarks') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Observation') as obs then { qr -> obs, entry then BuildObsBase(qr, obs, entry) "base"; qr -> obs then SetSurveyCategory(qr, obs) "category"; it -> obs.code as cc then { it -> cc.coding as cg then { it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; it -> cg.code = 'chemo-remarks-on-a-chemotherapy-cycle' "cd"; it -> cg.display = 'Remarks on a chemotherapy cycle' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_chemo_remarks_on_a_chemotherapy_cycle"; } "cycleRows"; } // The cycle's own date and number, on every Observation from that cycle. The // date overrides the response's authored time: a sheet written up at the end of // six cycles would otherwise collapse all six onto one instant and the series // -- which is the entire point of the sheet -- would be gone. group SetCycleContext(source c, target obs : Observation) { c.item as it where ((linkId = 'cycle/date') and answer.value.exists()) then { it.answer first as a then { a.value as v -> obs.effective = cast(v, 'dateTime') "effectiveFromCycle"; }; } "cycleDateRule"; c.item as it where ((linkId = 'cycle/number') and answer.value.exists()) then { it.answer first as a then { a.value as n -> obs.note as note, note.text = 'Recorded against a numbered cycle on the chemotherapy protocol sheet' "cycleNote"; }; } "cycleNumberRule"; c.item as it where ((linkId = 'cycle/signed-by') and answer.value.exists()) then { it.answer first as a then { a.value as ref -> obs.performer = ref "performer"; }; } "signedByRule"; } // ───────────────────────────────────────────────────────────────────────────── // Shared scaffolding. Repeated in each map rather than imported: the transform // engine resolves `imports` against whatever StructureMaps happen to be on the // server, and a form that stops extracting because a shared map was not // uploaded is a worse failure than a duplicated group. // Two notes on what the publisher's StructureMap validator says about this file. // Source parameters below are left untyped on purpose. Writing `: Element` makes // the validator compare QuestionnaireResponse.item against the literal 'Element' // and report them as incompatible with each other, which is noise, not a finding. // `evaluate(context, expression)` is flagged as "takes 1 parameter but 2 were // found". Leave it. The FML parser in the same jar refuses the one-argument form // outright -- it wants a parameter, a comma, then the FHIRPath -- so the // publisher is objecting to what its own compiler emits. Two arguments is the // only form that compiles, and it is what the R5 transform engine executes. // ───────────────────────────────────────────────────────────────────────────── group BuildObsBase(source qr : QR, target obs : Observation, target entry) { qr -> obs then SetResponseProvenance(qr, obs) "responseProvenance"; qr -> obs.id = uuid() then SetObservationFullUrl(obs, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'Observation' "requestUrl"; } "entryRequest"; qr -> obs.status = 'final' "status"; qr.subject as s -> obs.subject = s; qr.encounter as e -> obs.encounter = e; qr.authored as t -> obs.effective = t "effective"; qr.source as src -> obs.performer = src "performerFromSource"; qr where (source.exists().not()) then { qr.author as a -> obs.performer = a "performerFromAuthor"; } "performerFallback"; // A stored response's id already reads "QuestionnaireResponse/<id>", so it is // a relative reference as it stands. The hasValue() guard is what stops an // unsaved response -- one posted straight to $extract rather than saved first // -- from writing "QuestionnaireResponse/null" into the record. qr.id as qid where ($this.hasValue()) -> obs.derivedFrom = create('Reference') as ref, ref.reference = qid "linkQuestionnaireResponse"; } group SetObservationFullUrl(source obs : Observation, target entry) { obs.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Observation/', id) "assignFullUrl"; } // The two answer shapes a component can carry. Both read the answer through the // untyped `.value` accessor: reading `valueCoding` or `valueQuantity` by its // typed property name fails at transform time on HAPI R5 with "Attempt to read // invalid property ... on QuestionnaireResponse.item.answer". group SetComponentCodedValue(source it, target comp) { it.answer first as a then { a.value as cv -> comp.value = create('CodeableConcept') as cc then { cv -> cc.coding = cv "valueCoding"; cv.display as d -> cc.text = d "valueText"; } "codedValue"; } "componentAnswer"; } group SetComponentValue(source it, target comp) { it.answer first as a then { a.value as v -> comp.value = v "plainValue"; } "componentAnswer"; } group SetSurveyCategory(source qr : QR, target obs : Observation) { qr -> obs.category as cat then { qr -> cat.coding as coding then { qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem"; qr -> coding.code = 'survey' "categoryCode"; qr -> coding.display = 'Survey' "categoryDisplay"; } "categoryCoding"; } "category"; } group SetLaboratoryCategory(source qr : QR, target obs : Observation) { qr -> obs.category as cat then { qr -> cat.coding as coding then { qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem"; qr -> coding.code = 'laboratory' "categoryCode"; qr -> coding.display = 'Laboratory' "categoryDisplay"; } "categoryCoding"; } "category"; } group SetVitalSignsCategory(source qr : QR, target obs : Observation) { qr -> obs.category as cat then { qr -> cat.coding as coding then { qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem"; qr -> coding.code = 'vital-signs' "categoryCode"; qr -> coding.display = 'Vital Signs' "categoryDisplay"; } "categoryCoding"; } "category"; } // ── Provenance and tenancy ─────────────────────────────────────────────────── // Two tags on everything this map creates. The first says which questionnaire // produced it, so a form that reopens mid-admission recalls its own earlier // entries and not another form's. The second copies the tenant tags off the // response, because nothing else on the path puts them there. // The code is the form's document type, not the questionnaire's id: every // environment mints its own ids, and there is only one set of maps, so an id // here would tie the tag to whichever environment stamped it. // ── Provenance and tenancy ─────────────────────────────────────────────────── group SetResponseProvenance(source qr : QR, target r) { qr -> r.meta as m then { qr -> m.tag as t then { qr -> t.system = 'http://slade360edi.com/questionnaire-provenance' "provenanceSystem"; qr -> t.code = 'chemotherapy-protocol-cycles' "provenanceCode"; qr -> t.display = 'Chemotherapy protocol cycle record' "provenanceDisplay"; } "provenanceTag"; } "provenanceMeta"; // Every tag the response carries, onto the resource. `meta` is 0..1, so this // lands on the same meta the rule above created rather than a second one. qr.meta as qm then { qm.tag as qt -> r.meta as m, m.tag = qt "copyTag"; } "tenantTags"; }