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/ExtractInpatientDischargeNote | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractInpatientDischargeNote | |||
Turns a response to the inpatient discharge note into a discharge-summary Composition and a ServiceRequest for the follow-up. Medication on discharge is referenced, never copied: those MedicationRequests already exist on the server – the form picks them from it – so they become section entries rather than new resources. The follow-up is intent plan rather than an Appointment because the form captures it as free text with no date to book against; give the item a date and an Appointment becomes the truer target. The Encounter is deliberately untouched: closing the stay – Encounter.status and the discharge disposition – belongs to the EMR's discharge workflow, which knows about bed release, billing and the actual moment the patient left. Writing a note is not the same event as being discharged, and a map that conflated them would close stays early.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractInpatientDischargeNote' /// name = 'ExtractInpatientDischargeNote' /// title = 'Inpatient Discharge Note Extraction' /// status = 'active' /// description = 'Turns a response to the inpatient discharge note into a discharge-summary Composition and a ServiceRequest for the follow-up. Medication on discharge is referenced, never copied: those MedicationRequests already exist on the server -- the form picks them from it -- so they become section entries rather than new resources. The follow-up is intent `plan` rather than an Appointment because the form captures it as free text with no date to book against; give the item a date and an Appointment becomes the truer target. The Encounter is deliberately untouched: closing the stay -- Encounter.status and the discharge disposition -- belongs to the EMR\'s discharge workflow, which knows about bed release, billing and the actual moment the patient left. Writing a note is not the same event as being discharged, and a map that conflated them would close stays early.' 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/Composition" alias Composition as target uses "http://hl7.org/fhir/StructureDefinition/ServiceRequest" alias ServiceRequest as target group ExtractInpatientDischargeNote(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr -> bundle.entry as entry, entry.resource = create('Composition') as comp then { qr -> comp, entry then BuildNoteBase(qr, comp, entry) "noteBase"; qr -> comp.name = 'InpatientDischargeNote' "noteName"; qr -> comp.title = 'Discharge note' "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 = 'discharge-note' "sghiCode"; qr -> sghi.display = 'Discharge note' "sghiDisplay"; } "sghiCoding"; qr -> ty.coding as loinc then { qr -> loinc.system = 'http://loinc.org' "loincSystem"; qr -> loinc.code = '18842-5' "loincCode"; qr -> loinc.display = 'Discharge summary' "loincDisplay"; } "loincCoding"; qr -> ty.text = 'Discharge summary' "typeText"; } "noteType"; qr.item as it where ((linkId = 'summary') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Admission summary' "summaryTitle"; it -> sec then AddSectionText(it, sec) "summaryText"; } "summaryRule"; // One section, one entry per medication. No MedicationRequest is created: // the form picked these off the server, and minting copies would double the // patient's prescription list. qr.item as itM where ((linkId = 'medsOnDischarge') and answer.value.exists()) -> comp.section as secM then { itM -> secM.title = 'Medication on discharge' "medsTitle"; itM.answer as aM then { aM.value as mv -> secM.entry = mv "medsEntry"; } "medsAnswers"; } "medsRule"; qr.item as it where ((linkId = 'followUp') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Follow-up' "followUpTitle"; it -> sec then AddSectionText(it, sec) "followUpText"; } "followUpSectionRule"; qr.item as it where ((linkId = 'adviceGiven') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Advice given' "adviceTitle"; it -> sec then AddSectionText(it, sec) "adviceText"; } "adviceRule"; } "composition"; // The follow-up also leaves the document, so it can be worked rather than read. qr.item as itF where ((linkId = 'followUp') and answer.value.exists()) then { itF.answer first as aF then { aF -> bundle.entry as entryS, entryS.resource = create('ServiceRequest') as sr then { qr -> sr.id = uuid() then SetServiceRequestFullUrl(sr, entryS) "idAndFullUrl"; qr -> entryS.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'ServiceRequest' "requestUrl"; } "entryRequest"; qr -> sr.status = 'active' "status"; qr -> sr.intent = 'plan' "intent"; qr -> sr.priority = 'routine' "priority"; // R5 ServiceRequest.code is a CodeableReference, so the concept sits one // level down. aF.value as v -> sr.code as codeRef then { aF -> codeRef.concept as concept then { aF -> concept.coding as coding then { aF -> coding.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/inpatient-clinical-concept-codesystem' "codeSystem"; aF -> coding.code = 'discharge-follow-up' "codeCode"; aF -> coding.display = 'Follow-up arranged on discharge' "codeDisplay"; } "codeCoding"; v -> concept.text = v "codeText"; } "codeConcept"; } "serviceRequestCode"; qr.subject as s -> sr.subject = s; qr.encounter as e -> sr.encounter = e; qr.authored as t -> sr.authoredOn = t "authoredOn"; qr.author as a -> sr.requester = a "requesterFromAuthor"; qr where (author.exists().not()) then { qr.source as src -> sr.requester = src "requesterFromSource"; } "requesterFallback"; qr -> sr.supportingInfo as si then { qr -> si.reference = create('Reference') as ref then { qr.id as qid -> ref.reference = qid "supportingInfoRef"; } "supportingInfoTarget"; } "linkQuestionnaireResponse"; } "serviceRequest"; } "followUpAnswer"; } "followUpRequestRule"; } // ───────────────────────────────────────────────────────────────────────────── // Shared note scaffolding. Repeated in each note map rather than imported: the // transform engine resolves `imports` against whatever StructureMaps happen to // be on the server, and a note 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 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"; } group SetServiceRequestFullUrl(source sr : ServiceRequest, target entry) { sr.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/ServiceRequest/', id) "assignFullUrl"; }