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

StructureMap: Family Conference Extraction

Official URL: https://fhir.slade360.co.ke/fhir/StructureMap/ExtractFamilyConference Version: 0.1.0
Active as of 2026-09-14 Computable Name: ExtractFamilyConference

The conference record as a Composition, and the resuscitation decision as its own Consent – decision 'deny' for do-not-resuscitate, 'permit' where the conference agreed resuscitation should be attempted. A Consent and not a note, because the team on the next shift has to be able to find it without reading a conference narrative, and because an absent decision and a decision to resuscitate are not the same thing.

/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractFamilyConference'
/// name = 'ExtractFamilyConference'
/// title = 'Family Conference Extraction'
/// status = 'active'
/// description = 'The conference record as a Composition, and the resuscitation decision as its own Consent -- decision \'deny\' for do-not-resuscitate, \'permit\' where the conference agreed resuscitation should be attempted. A Consent and not a note, because the team on the next shift has to be able to find it without reading a conference narrative, and because an absent decision and a decision to resuscitate are not the same thing.'

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
uses "http://hl7.org/fhir/StructureDefinition/Consent" alias Consent as target
uses "http://hl7.org/fhir/StructureDefinition/Composition" alias Composition as target

group ExtractFamilyConference(source qr : QR, target bundle : Bundle) {
  qr -> bundle.type = 'transaction' "setBundleType";
  // ── The resuscitation decision ──────────────────────────────────────────
  qr.item as g where (linkId = 'resuscitation') then {
    g.item as it where ((linkId = 'resuscitation/decision') and answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('Consent') as con then {
      qr ->  con,  entry then BuildConsentBase(qr, con, entry) "base";
      it -> con.status = 'active' "status";
      it -> con.category as cat then {
        it -> cat.coding as cg then {
          it -> cg.system = 'http://terminology.hl7.org/CodeSystem/consentcategorycodes' "sys";
          it -> cg.code = 'dnr' "cd";
          it -> cg.display = 'Do Not Resuscitate' "dsp";
        } "coding";
      } "category";
      qr.authored as t ->  con.period as per,  per.start = t "periodStart";
      it.answer first as a then {
        a.value as cv where (code = 'resus-dnr') -> con.decision = 'deny' "deny";
      } "dnrRule";
      it.answer first as a then {
        a.value as cv where (code = 'resus-full') -> con.decision = 'permit' "permit";
      } "fullRule";
      it -> con.provision as prov then {
        it -> prov.code as pc then {
          it -> pc.coding as cg then {
            it -> cg.system = 'http://snomed.info/sct' "sys";
            it -> cg.code = '89666000' "cd";
            it -> cg.display = 'Cardiopulmonary resuscitation' "dsp";
          } "coding";
          it -> pc.text = 'Attempted cardiopulmonary resuscitation' "provText";
        } "provCode";
      } "provision";
      g.item as b where ((linkId = 'resuscitation/basis') and answer.value.exists()) then {
        b.answer first as a then {
          a.value as txt ->  con.provision as prov,  prov.code as pc,  pc.text = txt "basisText";
        };
      } "basisRule";
      qr.item as s where (linkId = 'sign-off') then {
        s.item as rb where ((linkId = 'sign-off/recorded-by') and answer.value.exists()) then {
          rb.answer first as a then {
            a.value as ref -> con.grantee = ref "grantee";
          };
        } "recordedByRule";
      } "signOffGroup";
    } "resuscitationConsent";
  } "resuscitationGroup";
  // ── The conference record ───────────────────────────────────────────────
  qr ->  bundle.entry as entry,  entry.resource = create('Composition') as comp then {
    qr ->  comp,  entry then BuildCompositionBase(qr, comp, entry) "base";
    qr -> comp.status = 'final' "status";
    qr -> comp.title = 'Patient, family and doctors conference' "title";
    qr.authored as t -> comp.date = t "date";
    qr.encounter as e -> comp.encounter = e;
    qr -> comp.type as tp then {
      qr -> tp.coding as cg then {
        qr -> cg.system = 'http://loinc.org' "sys";
        qr -> cg.code = '34133-9' "cd";
        qr -> cg.display = 'Summary of episode note' "dsp";
      } "coding";
    } "type";
    qr -> comp.category as cat then {
      qr -> cat.coding as cg then {
        qr -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/document-type-codesystem' "sys";
        qr -> cg.code = 'family-conference' "cd";
        qr -> cg.display = 'Patient, family and doctors conference record' "dsp";
      } "coding";
    } "category";
    qr.item as g where (linkId = 'conference') then {
      g.item as it where ((linkId = 'conference/primary-doctor') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as ref -> comp.author = ref "author";
        };
      } "doctorRule";
      g.item as it where ((linkId = 'conference/held-at') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as v ->  comp.event as ev,  ev.period as per,  per.start = v "eventStart";
        };
      } "heldAtRule";
      g.item as it where ((linkId = 'conference/venue') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as txt ->  comp.note as n,  n.text = txt "venueNote";
        };
      } "venueRule";
    } "conferenceGroup";
    qr.item as it where ((linkId = 'reason') and answer.value.exists()) -> comp.section as sec then {
      it -> sec.title = 'Reason for the conference' "title";
      it -> sec.code as sc then {
        it -> sc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '51848-0' "cd";
          it -> cg.display = 'Evaluation note' "dsp";
        } "coding";
      } "code";
      it ->  bundle.entry as sentry,  sentry.resource = create('Observation') as sobs then {
        qr ->  sobs,  sentry then BuildObsBase(qr, sobs, sentry) "base";
        qr -> sobs then SetSurveyCategory(qr, sobs) "category";
        it -> sobs.code as scc then {
          it -> scc.coding as scg then {
            it -> scg.system = 'http://loinc.org' "sys";
            it -> scg.code = '51848-0' "cd";
            it -> scg.display = 'Evaluation note' "dsp";
          } "coding";
          it -> scc.text = 'Reason for the conference at a family conference' "codeText";
        } "code";
        it.answer first as a then {
          a.value as txt ->  sobs.note as n,  n.text = txt "text";
        };
        it ->  sec.entry = create('Reference') as sref,  sref.reference = reference(sobs) "linkEntry";
      } "sectionObservation";
    } "section_reason";
    qr.item as it where ((linkId = 'medical-directive') and answer.value.exists()) -> comp.section as sec then {
      it -> sec.title = 'Medical directive' "title";
      it -> sec.code as sc then {
        it -> sc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '42348-3' "cd";
          it -> cg.display = 'Advance healthcare directives' "dsp";
        } "coding";
      } "code";
      it ->  bundle.entry as sentry,  sentry.resource = create('Observation') as sobs then {
        qr ->  sobs,  sentry then BuildObsBase(qr, sobs, sentry) "base";
        qr -> sobs then SetSurveyCategory(qr, sobs) "category";
        it -> sobs.code as scc then {
          it -> scc.coding as scg then {
            it -> scg.system = 'http://loinc.org' "sys";
            it -> scg.code = '42348-3' "cd";
            it -> scg.display = 'Advance healthcare directives' "dsp";
          } "coding";
          it -> scc.text = 'Medical directive at a family conference' "codeText";
        } "code";
        it.answer first as a then {
          a.value as txt ->  sobs.note as n,  n.text = txt "text";
        };
        it ->  sec.entry = create('Reference') as sref,  sref.reference = reference(sobs) "linkEntry";
      } "sectionObservation";
    } "section_medical_directive";
    qr.item as it where ((linkId = 'family-concerns') and answer.value.exists()) -> comp.section as sec then {
      it -> sec.title = 'Family concerns' "title";
      it -> sec.code as sc then {
        it -> sc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '51848-0' "cd";
          it -> cg.display = 'Evaluation note' "dsp";
        } "coding";
      } "code";
      it ->  bundle.entry as sentry,  sentry.resource = create('Observation') as sobs then {
        qr ->  sobs,  sentry then BuildObsBase(qr, sobs, sentry) "base";
        qr -> sobs then SetSurveyCategory(qr, sobs) "category";
        it -> sobs.code as scc then {
          it -> scc.coding as scg then {
            it -> scg.system = 'http://loinc.org' "sys";
            it -> scg.code = '51848-0' "cd";
            it -> scg.display = 'Evaluation note' "dsp";
          } "coding";
          it -> scc.text = 'Family concerns at a family conference' "codeText";
        } "code";
        it.answer first as a then {
          a.value as txt ->  sobs.note as n,  n.text = txt "text";
        };
        it ->  sec.entry = create('Reference') as sref,  sref.reference = reference(sobs) "linkEntry";
      } "sectionObservation";
    } "section_family_concerns";
  } "conferenceComposition";
}

// ─────────────────────────────────────────────────────────────────────────────
// 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 BuildConsentBase(source qr : QR, target r : Consent, target entry) {
  qr -> r then SetResponseProvenance(qr, r) "responseProvenance";
  qr -> r.id = uuid() then SetConsentFullUrl(r, entry) "idAndFullUrl";
  qr -> entry.request as request then {
    qr -> request.method = 'POST' "requestMethod";
    qr -> request.url = 'Consent' "requestUrl";
  } "entryRequest";
  qr.subject as s -> r.subject = s;
}

group SetConsentFullUrl(source r : Consent, target entry) {
  r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Consent/', id) "assignFullUrl";
}

group BuildCompositionBase(source qr : QR, target r : Composition, target entry) {
  qr -> r then SetResponseProvenance(qr, r) "responseProvenance";
  qr -> r.id = uuid() then SetCompositionFullUrl(r, entry) "idAndFullUrl";
  qr -> entry.request as request then {
    qr -> request.method = 'POST' "requestMethod";
    qr -> request.url = 'Composition' "requestUrl";
  } "entryRequest";
  qr.subject as s -> r.subject = s;
}

group SetCompositionFullUrl(source r : Composition, target entry) {
  r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Composition/', id) "assignFullUrl";
}

// ── 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 = 'family-conference' "provenanceCode";
      qr -> t.display = 'Patient, family and doctors’ conference 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";
}