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/ExtractMortalityCommitteeFindings | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractMortalityCommitteeFindings | |||
The death review as a Composition under LOINC 34133-9, one section per numbered question, each section naming an Observation that carries its text. A governance document rather than a clinical note, so it is kept whole: the committee's opinion means nothing separated from the initial management it is an opinion about.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractMortalityCommitteeFindings' /// name = 'ExtractMortalityCommitteeFindings' /// title = 'Mortality Committee Findings Extraction' /// status = 'active' /// description = 'The death review as a Composition under LOINC 34133-9, one section per numbered question, each section naming an Observation that carries its text. A governance document rather than a clinical note, so it is kept whole: the committee\'s opinion means nothing separated from the initial management it is an opinion about.' 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 ExtractMortalityCommitteeFindings(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 BuildCompositionBase(qr, comp, entry) "base"; qr -> comp.status = 'final' "status"; qr -> comp.title = 'Mortality committee findings and recommendations' "title"; qr.authored as t -> comp.date = t "date"; qr.source as src -> comp.author = src "author"; 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 = 'mortality-committee-findings' "cd"; qr -> cg.display = 'Mortality committee findings and recommendations' "dsp"; } "coding"; } "category"; // Restricted by default. This is a death review, and whether it belongs in // the patient's clinical record at all is a policy question -- so it is // labelled as the more sensitive of the two possibilities rather than the // less, which is the safe direction to be wrong in. // R5 removed Composition.confidentiality; the label lives in // Resource.meta.security. Restricted rather than normal, deliberately: for // a death review and for the mortuary set, whether the record belongs in // the patient's clinical file at all is an open policy question, and the // safe direction to be wrong in is the more protective one. qr -> comp.meta as m, m.security as sec then { qr -> sec.system = 'http://terminology.hl7.org/CodeSystem/v3-Confidentiality' "sys"; qr -> sec.code = 'R' "cd"; qr -> sec.display = 'restricted' "dsp"; } "confidentiality"; qr.item as g where (linkId = 'review') then { g.item as it where ((linkId = 'review/attendance-or-admission') 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"; }; } "attendanceRule"; g.item as it where ((linkId = 'review/chairman') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> comp.attester as att then { txt -> att.mode as am, am.text = 'Chairman of the mortality committee' "mode"; txt -> att.party = create('Reference') as pref, pref.display = txt "party"; } "attester"; }; } "chairmanRule"; g.item as it where ((linkId = 'review/secretary') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> comp.note as n, n.text = txt "secretaryNote"; }; } "secretaryRule"; } "reviewGroup"; qr.item as it where ((linkId = 'presenting-complaints') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Initial presenting complaints' "title"; it -> sec.code as sc then { it -> sc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '10164-2' "cd"; it -> cg.display = 'History of Present illness Narrative' "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 = '10164-2' "cd"; it -> scg.display = 'History of Present illness Narrative' "dsp"; } "coding"; it -> scc.text = 'Initial presenting complaints on the Mortality committee review' "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_presenting_complaints"; qr.item as it where ((linkId = 'previous-history') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Previous available medical history' "title"; it -> sec.code as sc then { it -> sc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '11348-0' "cd"; it -> cg.display = 'History of Past illness 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 = '11348-0' "cd"; it -> scg.display = 'History of Past illness note' "dsp"; } "coding"; it -> scc.text = 'Previous available medical history on the Mortality committee review' "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_previous_history"; qr.item as it where ((linkId = 'initial-management') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Initial management' "title"; it -> sec.code as sc then { it -> sc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '18776-5' "cd"; it -> cg.display = 'Plan of care 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 = '18776-5' "cd"; it -> scg.display = 'Plan of care note' "dsp"; } "coding"; it -> scc.text = 'Initial management on the Mortality committee review' "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_initial_management"; qr.item as it where ((linkId = 'complications') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Observed complications' "title"; it -> sec.code as sc then { it -> sc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '55109-3' "cd"; it -> cg.display = 'Complications Document' "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 = '55109-3' "cd"; it -> scg.display = 'Complications Document' "dsp"; } "coding"; it -> scc.text = 'Observed complications on the Mortality committee review' "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_complications"; qr.item as it where ((linkId = 'committee-opinion') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Opinion of the committee' "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 = 'Opinion of the committee on the Mortality committee review' "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_committee_opinion"; qr.item as it where ((linkId = 'recommendation') and answer.value.exists()) -> comp.section as sec then { it -> sec.title = 'Recommendation' "title"; it -> sec.code as sc then { it -> sc.coding as cg then { it -> cg.system = 'http://loinc.org' "sys"; it -> cg.code = '62387-6' "cd"; it -> cg.display = 'Interventions Narrative' "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 = '62387-6' "cd"; it -> scg.display = 'Interventions Narrative' "dsp"; } "coding"; it -> scc.text = 'Recommendation on the Mortality committee review' "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_recommendation"; } "mortalityReviewComposition"; // Who saw the patient first, and what they thought it was. Its own // Observation because the whole point of a mortality review is whether the // right grade of clinician saw the patient early enough, and that question is // asked across deaths, not within one. qr.item as g where (linkId = 'first-clinician') then { g.item as it where ((linkId = 'first-clinician/rank') 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 = 'mortality-review-rank-of-the-first-clinician-who-attended' "cd"; it -> cg.display = 'Rank of the first clinician who attended' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_mortality_review_rank_of_the_first_clinician_who_attended"; g.item as it where ((linkId = 'first-clinician/provisional-diagnosis') 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 = 'mortality-review-provisional-diagnosis-made-by-the-first-clinician' "cd"; it -> cg.display = 'Provisional diagnosis made by the first clinician' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_mortality_review_provisional_diagnosis_made_by_the_first_clinician"; } "firstClinicianGroup"; qr.item as it where ((linkId = 'senior-review') 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 = 'mortality-review-time-of-first-senior-clinician-review' "cd"; it -> cg.display = 'Time of first senior clinician review' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v; }; } "seniorReviewObservation"; } // ───────────────────────────────────────────────────────────────────────────── // 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 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 = 'mortality-committee-findings' "provenanceCode"; qr -> t.display = 'Mortality committee findings and recommendations' "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"; }