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/ExtractImagingRequest | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractImagingRequest | |||
The X-ray and ultrasound request forms out as ServiceRequests: one per scan type ticked on an ultrasound request, or a single one carrying the region and view for an X-ray. The clinical question rides as a supporting Observation the request points at, because the SGHI ServiceRequest profile binds reason required to LOINC and the form takes free text – so the indication cannot go in reason without inventing a code for it.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractImagingRequest' /// name = 'ExtractImagingRequest' /// title = 'Imaging Request Extraction' /// status = 'active' /// description = 'The X-ray and ultrasound request forms out as ServiceRequests: one per scan type ticked on an ultrasound request, or a single one carrying the region and view for an X-ray. The clinical question rides as a supporting Observation the request points at, because the SGHI ServiceRequest profile binds `reason` required to LOINC and the form takes free text -- so the indication cannot go in `reason` without inventing a code for it.' 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/ServiceRequest" alias ServiceRequest as target uses "http://hl7.org/fhir/StructureDefinition/Observation" alias Observation as target group ExtractImagingRequest(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; // ── The indication, as a supporting Observation ───────────────────────── // Built first so the ServiceRequests below can point at it. It carries the // indication, the clinical summary and the provisional diagnosis: everything // the radiographer needs in order to tailor the study, which is the whole // reason the form asks for them. qr where (item.where(linkId = 'indication').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"; qr -> obs.code as cc then { qr -> cc.coding as cg then { qr -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; qr -> cg.code = 'imaging-indication' "cd"; qr -> cg.display = 'Indication for imaging' "dsp"; } "coding"; } "code"; qr.item as it where (linkId = 'indication') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note"; qr.item as it where (linkId = 'clinical-summary') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note2"; qr.item as it where (linkId = 'provisional-diagnosis') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note3"; } "indicationObservation"; // ── Last menstrual period ─────────────────────────────────────────────── // Extracted as its own Observation. The X-ray form asks for it so a woman of // childbearing age is not irradiated unknowingly in early pregnancy; that is // a safety check, and a safety check buried in a request's free text is not // one anybody can audit. qr.item as it where ((linkId = 'last-menstrual-period') 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 = 'http://loinc.org' "sys"; it -> cg.code = '8665-2' "cd"; it -> cg.display = 'Last menstrual period start date' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = cast(v, 'dateTime') "set"; }; } "measure_8665_2"; // ── The ultrasound requests, one per scan ticked ───────────────────────── // The scan type answer's own coding travels, so a request for a lower limb // venous Doppler is coded as exactly that rather than as "ultrasound". qr.item as it where (linkId = 'scan-type') then { it.answer as a -> bundle.entry as entry, entry.resource = create('ServiceRequest') as sr then { qr -> sr, entry then BuildServiceRequestBase(qr, sr, entry) "base"; a -> sr.status = 'active' "status"; a -> sr.intent = 'order' "intent"; a -> sr.category as cat then { a -> cat.coding as cg then { a -> cg.system = 'http://snomed.info/sct' "sys"; a -> cg.code = '363679005' "cd"; a -> cg.display = 'Imaging' "dsp"; } "coding"; } "category"; a.value as cv -> sr.code as cr, cr.concept as cc then { cv -> cc.coding = cv "coding"; cv.display as d -> cc.text = d "text"; } "codeFromAnswer"; qr -> sr then SetImagingRequestCommon(qr, sr) "common"; } "createUltrasoundRequest"; } "scanTypeGroup"; // ── The X-ray request ─────────────────────────────────────────────────── // One request, coded by its free text. Guarded on the modality being X-ray so // an ultrasound request does not also produce a second, uncoded request for // whatever was typed in the investigation line. qr where (item.where(linkId = 'request').item.where(linkId = 'request/modality').answer.value.ofType(Coding).code = 'modality-x-ray') then { qr.item as it where ((linkId = 'investigation-requested') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('ServiceRequest') as sr then { qr -> sr, entry then BuildServiceRequestBase(qr, sr, entry) "base"; it -> sr.status = 'active' "status"; it -> sr.intent = 'order' "intent"; it -> sr.category as cat then { it -> cat.coding as cg then { it -> cg.system = 'http://snomed.info/sct' "sys"; it -> cg.code = '363679005' "cd"; it -> cg.display = 'Imaging' "dsp"; } "coding"; } "category"; it.answer first as a then { a.value as txt -> sr.code as cr, cr.concept as cc, cc.text = txt "codeText"; }; qr -> sr then SetImagingRequestCommon(qr, sr) "common"; } "createXrayRequest"; } "xrayGroup"; } // Everything both request shapes share: who asked, when, how urgently, from // which department, and the clinical summary as a note. Factored into a group // because it is identical for an X-ray and an ultrasound and drifting copies is // how one of them silently loses its priority. group SetImagingRequestCommon(source qr : QR, target sr : ServiceRequest) { qr.authored as t -> sr.authoredOn = t "authoredOn"; qr.encounter as e -> sr.encounter = e; qr.item as g where (linkId = 'request') then { g.item as rq where ((linkId = 'request/requester') and answer.value.exists()) then { rq.answer first as a then { a.value as ref -> sr.requester = ref "requester"; }; } "requesterRule"; // Priority is a code on ServiceRequest, not a Coding: it takes the code // alone and has nowhere to record the system it came from. g.item as pr where ((linkId = 'request/priority') and answer.value.exists()) then { pr.answer first as a then { a.value as cv then { cv.code as c -> sr.priority = c "priorityCode"; } "coding"; }; } "priorityRule"; g.item as dp where ((linkId = 'request/department') and answer.value.exists()) then { dp.answer first as a then { a.value as txt -> sr.note as n, n.text = txt "departmentNote"; }; } "departmentRule"; } "requestGroup"; qr.item as ind where (linkId = 'indication') then { ind.answer first as a then { a.value as txt -> sr.note as n, n.text = txt "indicationNote"; }; } "indicationRule"; qr.item as cs where (linkId = 'clinical-summary') then { cs.answer first as a then { a.value as txt -> sr.note as n, n.text = txt "clinicalSummaryNote"; }; } "clinicalSummaryRule"; } // ───────────────────────────────────────────────────────────────────────────── // 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 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"; } group BuildServiceRequestBase(source qr : QR, target r : ServiceRequest, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetServiceRequestFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'ServiceRequest' "requestUrl"; } "entryRequest"; qr.subject as s -> r.subject = s; } group SetServiceRequestFullUrl(source r : ServiceRequest, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/ServiceRequest/', 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 = 'imaging-request' "provenanceCode"; qr -> t.display = 'Imaging request' "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"; }