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/ExtractInpatientAdultGeneralAdmissionAssessment | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractInpatientAdultGeneralAdmissionAssessment | |||
Turns a response to the adult general admission assessment into a chief-complaint Observation, one Observation per vital, and a Composition that files the assessment and carries the allergies and medication the assessor reviewed. Nothing is copied: the allergies and medication are already AllergyIntolerance and MedicationRequest resources – the form loads them off the server – so they become section entries. The Composition exists for exactly that reason; without a container those two rows of the assessment extract to nothing at all.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractInpatientAdultGeneralAdmissionAssessment' /// name = 'ExtractInpatientAdultGeneralAdmissionAssessment' /// title = 'Inpatient Adult General Admission Assessment Extraction' /// status = 'active' /// description = 'Turns a response to the adult general admission assessment into a chief-complaint Observation, one Observation per vital, and a Composition that files the assessment and carries the allergies and medication the assessor reviewed. Nothing is copied: the allergies and medication are already AllergyIntolerance and MedicationRequest resources -- the form loads them off the server -- so they become section entries. The Composition exists for exactly that reason; without a container those two rows of the assessment extract to nothing at all.' 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/Composition" alias Composition as target group ExtractInpatientAdultGeneralAdmissionAssessment(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; // ── Presenting complaint ─────────────────────────────────────────────────── // Category `social-history` and code 10154-3 match what extract-vital-signs // already produces for a chief complaint, so a consumer querying // category=social-history&code=10154-3 gets both without knowing which form // the complaint came from. qr.item as itC where ((linkId = 'complaint') and answer.value.exists()) then { itC.answer first as aC then { aC -> bundle.entry as entryC, entryC.resource = create('Observation') as obsC then { qr -> obsC, entryC then BuildObsBase(qr, obsC, entryC) "complaintBase"; qr -> obsC then SetSocialHistoryCategory(qr, obsC) "complaintCategory"; qr -> obsC.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '10154-3' "codeCode"; qr -> coding.display = 'Chief complaint Narrative - Reported' "codeDisplay"; } "codeCoding"; } "complaintCode"; aC.value as v -> obsC.value = v "complaintValue"; } "complaintObservation"; } "complaintAnswer"; } "complaintRule"; // ── Vitals on admission ──────────────────────────────────────────────────── // Six items, six Observations, exactly as the form extracted before it had a // map. Each answer is already a Quantity -- the item is type `quantity` with // a questionnaire-unitOption pinning the unit -- so it is copied through // whole. Rebuilding it here would mean restating a unit the client actually // sent, which turns a wrong unit into a wrong reading. qr.item as gV where (linkId = 'vitals') then { gV.item as itS where ((linkId = 'vitals.bpSys') and answer.value.exists()) then { itS.answer first as aS then { aS -> bundle.entry as entryS, entryS.resource = create('Observation') as obsS then { qr -> obsS, entryS then BuildObsBase(qr, obsS, entryS) "bpSysBase"; qr -> obsS then SetVitalSignsCategory(qr, obsS) "bpSysCategory"; qr -> obsS.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '8480-6' "codeCode"; qr -> coding.display = 'Systolic blood pressure' "codeDisplay"; } "codeCoding"; } "bpSysCode"; aS.value as v -> obsS.value = v "bpSysValue"; } "bpSysObservation"; } "bpSysAnswer"; } "bpSysRule"; gV.item as itD where ((linkId = 'vitals.bpDia') and answer.value.exists()) then { itD.answer first as aD then { aD -> bundle.entry as entryD, entryD.resource = create('Observation') as obsD then { qr -> obsD, entryD then BuildObsBase(qr, obsD, entryD) "bpDiaBase"; qr -> obsD then SetVitalSignsCategory(qr, obsD) "bpDiaCategory"; qr -> obsD.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '8462-4' "codeCode"; qr -> coding.display = 'Diastolic blood pressure' "codeDisplay"; } "codeCoding"; } "bpDiaCode"; aD.value as v -> obsD.value = v "bpDiaValue"; } "bpDiaObservation"; } "bpDiaAnswer"; } "bpDiaRule"; gV.item as itP where ((linkId = 'vitals.pulse') and answer.value.exists()) then { itP.answer first as aP then { aP -> bundle.entry as entryP, entryP.resource = create('Observation') as obsP then { qr -> obsP, entryP then BuildObsBase(qr, obsP, entryP) "pulseBase"; qr -> obsP then SetVitalSignsCategory(qr, obsP) "pulseCategory"; qr -> obsP.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '8867-4' "codeCode"; qr -> coding.display = 'Heart rate' "codeDisplay"; } "codeCoding"; } "pulseCode"; aP.value as v -> obsP.value = v "pulseValue"; } "pulseObservation"; } "pulseAnswer"; } "pulseRule"; gV.item as itT where ((linkId = 'vitals.temp') and answer.value.exists()) then { itT.answer first as aT then { aT -> bundle.entry as entryT, entryT.resource = create('Observation') as obsT then { qr -> obsT, entryT then BuildObsBase(qr, obsT, entryT) "tempBase"; qr -> obsT then SetVitalSignsCategory(qr, obsT) "tempCategory"; qr -> obsT.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '8310-5' "codeCode"; qr -> coding.display = 'Body temperature' "codeDisplay"; } "codeCoding"; } "tempCode"; aT.value as v -> obsT.value = v "tempValue"; } "tempObservation"; } "tempAnswer"; } "tempRule"; gV.item as itR where ((linkId = 'vitals.resp') and answer.value.exists()) then { itR.answer first as aR then { aR -> bundle.entry as entryR, entryR.resource = create('Observation') as obsR then { qr -> obsR, entryR then BuildObsBase(qr, obsR, entryR) "respBase"; qr -> obsR then SetVitalSignsCategory(qr, obsR) "respCategory"; qr -> obsR.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '9279-1' "codeCode"; qr -> coding.display = 'Respiratory rate' "codeDisplay"; } "codeCoding"; } "respCode"; aR.value as v -> obsR.value = v "respValue"; } "respObservation"; } "respAnswer"; } "respRule"; gV.item as itO where ((linkId = 'vitals.spo2') and answer.value.exists()) then { itO.answer first as aO then { aO -> bundle.entry as entryO, entryO.resource = create('Observation') as obsO then { qr -> obsO, entryO then BuildObsBase(qr, obsO, entryO) "spo2Base"; qr -> obsO then SetVitalSignsCategory(qr, obsO) "spo2Category"; qr -> obsO.code as code then { qr -> code.coding as coding then { qr -> coding.system = 'http://loinc.org' "codeSystem"; qr -> coding.code = '59408-5' "codeCode"; qr -> coding.display = 'Oxygen saturation in Arterial blood by Pulse oximetry' "codeDisplay"; } "codeCoding"; } "spo2Code"; aO.value as v -> obsO.value = v "spo2Value"; } "spo2Observation"; } "spo2Answer"; } "spo2Rule"; } "vitalsGroupRule"; // ── The assessment as a filed document ───────────────────────────────────── qr -> bundle.entry as entry, entry.resource = create('Composition') as comp then { qr -> comp, entry then BuildNoteBase(qr, comp, entry) "noteBase"; qr -> comp.name = 'InpatientAdultGeneralAdmissionAssessment' "noteName"; qr -> comp.title = 'Adult general admission assessment' "noteTitle"; qr -> comp.type as ty then { qr -> ty.coding as sghi then { qr -> sghi.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/inpatient-document-type-codesystem' "sghiSystem"; qr -> sghi.code = 'adult-general-admission-assessment' "sghiCode"; qr -> sghi.display = 'Adult general admission assessment' "sghiDisplay"; } "sghiCoding"; qr -> ty.text = 'Adult general admission assessment' "typeText"; } "noteType"; qr.item as it where ((linkId = 'complaint') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Presenting complaint' "complaintTitle"; it -> sec then AddSectionText(it, sec) "complaintSectionText"; } "complaintSectionRule"; qr.item as itA where ((linkId = 'allergies') and answer.value.exists()) -> comp.section as secA then { itA -> secA.title = 'Known allergies' "allergiesTitle"; itA.answer as aA then { aA.value as av -> secA.entry = av "allergiesEntry"; } "allergiesAnswers"; } "allergiesRule"; qr.item as itM where ((linkId = 'meds') and answer.value.exists()) -> comp.section as secM then { itM -> secM.title = 'Current medication' "medsTitle"; itM.answer as aM then { aM.value as mv -> secM.entry = mv "medsEntry"; } "medsAnswers"; } "medsRule"; } "composition"; } // ───────────────────────────────────────────────────────────────────────────── // 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. // Untyped, it says only that it cannot check the paths. // `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.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; // `effective`, not `effectiveDateTime`: the R5 transform engine writes choice // elements by their base name and rejects the typed form. This form asks for // no time of its own, so the moment the response was authored is the best // available. 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"; // `qr.id` already resolves to the type-qualified relative reference under this // engine, so it is used unprefixed. qr -> obs.derivedFrom = create('Reference') as ref then { qr.id as qid -> ref.reference = qid "derivedFromRef"; } "linkQuestionnaireResponse"; } 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 SetSocialHistoryCategory(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 = 'social-history' "categoryCode"; qr -> coding.display = 'Social History' "categoryDisplay"; } "categoryCoding"; } "category"; } group SetObservationFullUrl(source obs : Observation, target entry) { obs.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Observation/', id) "assignFullUrl"; } group BuildNoteBase(source qr : QR, target comp : Composition, target entry) { qr -> comp.id = uuid() then SetCompositionFullUrl(comp, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'Composition' "requestUrl"; } "entryRequest"; qr -> comp.status = 'final' "status"; qr.subject as s -> comp.subject = s; qr.encounter as e -> comp.encounter = e; // Composition.date is 1..1. `authored` is only 0..1 on the response, so when a // client sends none the extraction time stands in. It is a poor substitute for // when the note was written, but a document with no date at all is worse, and // extraction happens moments after submission in practice. qr.authored as t -> comp.date = t "date"; qr where (authored.exists().not()) then { qr -> comp.date = evaluate(qr, now()) "dateFromExtractionTime"; } "dateFallback"; // Composition.author is 1..1 minimum. R5 QuestionnaireResponse carries both // `author` (who recorded the answers) and `source` (who supplied them); the // author is the one who wrote the note, so it wins, and `source` only stands // in when the client did not send an author. If the response carries neither, // the note comes out unauthored -- there is nothing on a QuestionnaireResponse // to invent one from, and guessing at who wrote a clinical note is not a thing // a map should do. qr.author as a -> comp.author = a "authorFromAuthor"; qr where (author.exists().not()) then { qr.source as src -> comp.author = src "authorFromSource"; } "authorFallback"; qr -> comp.relatesTo as rel then { qr -> rel.type = 'derived-from' "relatesToType"; qr -> rel.resourceReference = create('Reference') as ref then { qr.id as qid -> ref.reference = qid "relatesToRef"; } "relatesToTarget"; } "linkQuestionnaireResponse"; } group AddSectionText(source it, target sec) { it.answer first as a then { a.value as v -> sec.text as narrative then { v -> narrative.status = 'generated' "narrativeStatus"; v -> narrative.div = create('xhtml') as xhtml then { v -> xhtml.value = evaluate(a, '<div xmlns="http://www.w3.org/1999/xhtml"><p>' + value.toString().escape('html') + '</p></div>') "narrativeDiv"; } "narrativeXhtml"; } "sectionText"; } "sectionAnswer"; } group SetCompositionFullUrl(source comp : Composition, target entry) { comp.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Composition/', id) "assignFullUrl"; }