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/ExtractIntakeOutputRecord | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractIntakeOutputRecord | |||
The 24-hour totals under LOINC 9108-2 fluid intake and 9192-6 urine output, plus the balance and each hourly row as its own pair of panels. The sheet's own instruction is to add the columns and circle the figure; the form computes it instead, because that circled number at the end of a twelve-hour shift is the most error-prone arithmetic on any ward chart – and the hourly rows are still extracted so the total can be audited against them.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractIntakeOutputRecord' /// name = 'ExtractIntakeOutputRecord' /// title = 'Intake and Output Record Extraction' /// status = 'active' /// description = 'The 24-hour totals under LOINC 9108-2 fluid intake and 9192-6 urine output, plus the balance and each hourly row as its own pair of panels. The sheet\'s own instruction is to add the columns and circle the figure; the form computes it instead, because that circled number at the end of a twelve-hour shift is the most error-prone arithmetic on any ward chart -- and the hourly rows are still extracted so the total can be audited against them.' 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 ExtractIntakeOutputRecord(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr.item as g where (linkId = 'totals') then { g.item as it where ((linkId = 'totals/intake') 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 = '9108-2' "cd"; it -> cg.display = 'Fluid intake total 24 hour' "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 = 'mL' "qUnit"; v -> q.system = 'http://unitsofmeasure.org' "qSystem"; v -> q.code = 'mL' "qCode"; } "quantity"; }; it -> obs.note as n, n.text = 'Computed from the hourly rows rather than added by hand.' "note"; } "measureq_9108_2"; g.item as it where ((linkId = 'totals/output') 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 = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; it -> cg.code = 'fluid-balance-fluid-output-total-24-hours' "cd"; it -> cg.display = 'Fluid output total 24 hours' "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 = 'mL' "qUnit"; v -> q.system = 'http://unitsofmeasure.org' "qSystem"; v -> q.code = 'mL' "qCode"; } "quantity"; }; } "measureq_fluid_balance"; g.item as it where ((linkId = 'totals/balance') 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 = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; it -> cg.code = 'fluid-balance-over-24-hours' "cd"; it -> cg.display = 'Fluid balance over 24 hours' "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 = 'mL' "qUnit"; v -> q.system = 'http://unitsofmeasure.org' "qSystem"; v -> q.code = 'mL' "qCode"; } "quantity"; }; } "measureq_fluid_balance2"; g.item as it where ((linkId = 'totals/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 = 'fluid-balance-remarks-on-the-intake-and-output-record' "cd"; it -> cg.display = 'Remarks on the intake and output record' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_fluid_balance_remarks_on_the_intake_and_output_record"; } "totalsGroup"; // The urine output on its own, under its own LOINC code and summed from the // rows. Urine output is what says whether a kidney is still working and it // is asked for on its own, not as half of a balance. qr where (item.where(linkId = 'hour').item.where(linkId = 'hour/output').item.where(linkId = 'hour/output/urine').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"; qr -> obs.code as cc then { qr -> cc.coding as cg then { qr -> cg.system = 'http://loinc.org' "sys"; qr -> cg.code = '9192-6' "cd"; qr -> cg.display = 'Urine output 24 hour' "dsp"; } "coding"; } "code"; qr -> obs.value = create('Quantity') as q then { qr -> q.value = evaluate(qr, item.where(linkId = 'hour').item.where(linkId = 'hour/output').item.where(linkId = 'hour/output/urine').answer.value.ofType(Quantity).value.aggregate($this + $total, 0)) "qValue"; qr -> q.unit = 'mL' "qUnit"; qr -> q.system = 'http://unitsofmeasure.org' "qSystem"; qr -> q.code = 'mL' "qCode"; } "quantity"; qr -> obs.note as n, n.text = 'Summed from the hourly rows on the intake and output record' "sumNote"; } "urineOutputTotal"; // ── One hourly row ────────────────────────────────────────────────────── qr.item as row where (linkId = 'hour') then { row.item as i where ((linkId = 'hour/intake') and item.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"; i -> obs.code as cc then { i -> cc.coding as cg then { i -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; i -> cg.code = 'fluid-balance-hourly-fluid-intake' "cd"; i -> cg.display = 'Hourly fluid intake' "dsp"; } "coding"; } "code"; i.item as it where ((linkId = 'hour/intake/oral') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-oral-fluid-volume' "cd"; it -> cg.display = 'Oral fluid volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_oral_fluid_volume"; i.item as it where ((linkId = 'hour/intake/iv-infusion-name') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-iv-infusion-given' "cd"; it -> cg.display = 'IV infusion given' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_iv_infusion_given"; i.item as it where ((linkId = 'hour/intake/iv-amount') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-iv-fluid-volume' "cd"; it -> cg.display = 'IV fluid volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_iv_fluid_volume"; i.item as it where ((linkId = 'hour/intake/ng-feeding') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-nasogastric-feed-volume' "cd"; it -> cg.display = 'Nasogastric feed volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_nasogastric_feed_volume"; row -> obs then SetIoRowTime(row, obs) "rowTime"; } "hourlyIntake"; row.item as o where ((linkId = 'hour/output') and item.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"; o -> obs.code as cc then { o -> cc.coding as cg then { o -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; o -> cg.code = 'fluid-balance-hourly-fluid-output' "cd"; o -> cg.display = 'Hourly fluid output' "dsp"; } "coding"; } "code"; o.item as it where ((linkId = 'hour/output/urine') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-urine-volume' "cd"; it -> cg.display = 'Urine volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_urine_volume"; o.item as it where ((linkId = 'hour/output/stools') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-stool-volume' "cd"; it -> cg.display = 'Stool volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_stool_volume"; o.item as it where ((linkId = 'hour/output/vomit') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-vomit-volume' "cd"; it -> cg.display = 'Vomit volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_vomit_volume"; o.item as it where ((linkId = 'hour/output/ng-suction') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-nasogastric-suction-volume' "cd"; it -> cg.display = 'Nasogastric suction volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_nasogastric_suction_volume"; o.item as it where ((linkId = 'hour/output/drainage') and answer.value.exists()) -> obs.component as comp then { it -> comp.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 = 'fluid-balance-drainage-volume' "cd"; it -> cg.display = 'Drainage volume' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_drainage_volume"; row -> obs then SetIoRowTime(row, obs) "rowTime"; } "hourlyOutput"; } "hourlyRows"; } // A clock time, not a dateTime -- the sheet is one day per block with the date // in its header -- so it rides as a note rather than being forced into // Observation.effective as a bare time, which that element does not accept. group SetIoRowTime(source row, target obs : Observation) { row.item as it where ((linkId = 'hour/time') and answer.value.exists()) then { it.answer first as a then { a.value as t -> obs.note as n, n.text = 'Recorded against the clock hour on the intake and output record' "timeNote"; }; } "rowTimeRule"; } // ───────────────────────────────────────────────────────────────────────────── // 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"; } // ── 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 = 'intake-output-record' "provenanceCode"; qr -> t.display = 'Intake and output 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"; }