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/ExtractNursingCarePlan | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractNursingCarePlan | |||
One CarePlan with an activity per problem, plus a Condition per nursing diagnosis and an Observation carrying the assessment, rationale, implementation and evaluation for that row. Every column is kept, including the scientific rationale – this sheet is the one place the reasoning behind a nursing action is written down, and without it the intervention reads as arbitrary.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractNursingCarePlan' /// name = 'ExtractNursingCarePlan' /// title = 'Nursing Care Plan Extraction' /// status = 'active' /// description = 'One CarePlan with an activity per problem, plus a Condition per nursing diagnosis and an Observation carrying the assessment, rationale, implementation and evaluation for that row. Every column is kept, including the scientific rationale -- this sheet is the one place the reasoning behind a nursing action is written down, and without it the intervention reads as arbitrary.' 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/CarePlan" alias CarePlan as target uses "http://hl7.org/fhir/StructureDefinition/Condition" alias Condition as target group ExtractNursingCarePlan(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr where (item.where(linkId = 'problem').item.where(linkId = 'problem/nursing-diagnosis').answer.value.exists()) -> bundle.entry as entry, entry.resource = create('CarePlan') as plan then { qr -> plan, entry then BuildCarePlanBase(qr, plan, entry) "base"; qr -> plan.status = 'active' "status"; qr -> plan.intent = 'plan' "intent"; qr -> plan.title = 'Nursing care plan' "title"; qr.authored as t -> plan.created = t "created"; qr.encounter as e -> plan.encounter = e; qr.source as src -> plan.custodian = src "custodian"; qr -> plan.category as cat then { qr -> cat.coding as cg then { qr -> cg.system = 'http://loinc.org' "sys"; qr -> cg.code = '18776-5' "cd"; qr -> cg.display = 'Plan of care note' "dsp"; } "coding"; } "category"; // One activity per problem row, displaying the intervention. The expected // outcome rides as a note beside it, because a CarePlan activity has // nowhere to hold a goal without creating a Goal resource the sheet does // not give enough to build honestly -- no target date, no measure. qr.item as row where (linkId = 'problem') then { row.item as it where ((linkId = 'problem/intervention') and answer.value.exists()) -> plan.activity as act then { it.answer first as a then { a.value as txt -> act.plannedActivityReference = create('Reference') as ref, ref.display = txt "interventionDisplay"; }; } "interventionRow"; row.item as it where ((linkId = 'problem/expected-outcome') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> plan.note as n, n.text = txt "outcomeNote"; }; } "outcomeRow"; } "problemRows"; } "nursingCarePlan"; // ── The nursing diagnosis, as a Condition ─────────────────────────────── // Category 'problem-list-item' and verificationStatus 'unconfirmed': a // nursing diagnosis is a real problem statement but it is not a medical // diagnosis, and conflating the two would put "risk of falls" alongside // "pneumonia" as though a doctor had confirmed it. qr.item as row where (linkId = 'problem') then { row.item as it where ((linkId = 'problem/nursing-diagnosis') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Condition') as cond then { qr -> cond, entry then BuildConditionBase(qr, cond, entry) "base"; it -> cond.clinicalStatus as cs then { it -> cs.coding as cg then { it -> cg.system = 'http://terminology.hl7.org/CodeSystem/condition-clinical' "sys"; it -> cg.code = 'active' "cd"; it -> cg.display = 'Active' "dsp"; } "coding"; } "clinicalStatus"; it -> cond.verificationStatus as vs then { it -> vs.coding as cg then { it -> cg.system = 'http://terminology.hl7.org/CodeSystem/condition-ver-status' "sys"; it -> cg.code = 'unconfirmed' "cd"; it -> cg.display = 'Unconfirmed' "dsp"; } "coding"; } "verificationStatus"; it -> cond.category as cat then { it -> cat.coding as cg then { it -> cg.system = 'http://terminology.hl7.org/CodeSystem/condition-category' "sys"; it -> cg.code = 'problem-list-item' "cd"; it -> cg.display = 'Problem List Item' "dsp"; } "coding"; it -> cat.text = 'Nursing diagnosis' "catText"; } "category"; it.answer first as a then { a.value as txt -> cond.code as cc, cc.text = txt "codeText"; }; qr.encounter as e -> cond.encounter = e; row.item as d where ((linkId = 'problem/date') and answer.value.exists()) then { d.answer first as a then { a.value as v -> cond.recordedDate = v "recordedDate"; }; } "dateRule"; } "nursingDiagnosis"; // ── The rest of the nursing process for that row ────────────────────── row where (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 SetSurveyCategory(qr, obs) "category"; row -> obs.code as cc then { row -> cc.coding as cg then { row -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; row -> cg.code = 'nursing-process-record' "cd"; row -> cg.display = 'Nursing process record' "dsp"; } "coding"; } "code"; row.item as it where ((linkId = 'problem/assessment') 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 = 'nursing-process-nursing-assessment' "cd"; it -> cg.display = 'Nursing assessment' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_nursing_assessment"; row.item as it where ((linkId = 'problem/expected-outcome') 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 = 'nursing-process-expected-outcome-or-goal' "cd"; it -> cg.display = 'Expected outcome or goal' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_expected_outcome_or_goal"; row.item as it where ((linkId = 'problem/intervention') 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 = 'nursing-process-nursing-intervention' "cd"; it -> cg.display = 'Nursing intervention' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_nursing_intervention"; row.item as it where ((linkId = 'problem/rationale') 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 = 'nursing-process-scientific-rationale-for-the-intervention' "cd"; it -> cg.display = 'Scientific rationale for the intervention' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_scientific_rationale_for_the_intervention"; row.item as it where ((linkId = 'problem/implementation') 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 = 'nursing-process-implementation-of-the-nursing-plan' "cd"; it -> cg.display = 'Implementation of the nursing plan' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_implementation_of_the_nursing_plan"; row.item as it where ((linkId = 'problem/evaluation') 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 = 'nursing-process-evaluation-of-the-nursing-plan' "cd"; it -> cg.display = 'Evaluation of the nursing plan' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_nursing_process_evaluation_of_the_nursing_plan"; row -> obs then SetNursingRowTime(row, obs) "rowTime"; } "nursingProcess"; } "problemRowsAgain"; } // The row's own timestamp on everything extracted from that row. group SetNursingRowTime(source row, target obs : Observation) { row.item as it where ((linkId = 'problem/date') and answer.value.exists()) then { it.answer first as a then { a.value as v -> obs.effective = cast(v, 'dateTime') "effective"; }; } "rowTimeRule"; row.item as it where ((linkId = 'problem/nurse') and answer.value.exists()) then { it.answer first as a then { a.value as ref -> obs.performer = ref "by"; }; } "rowByRule"; } // ───────────────────────────────────────────────────────────────────────────── // 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 BuildCarePlanBase(source qr : QR, target r : CarePlan, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetCarePlanFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'CarePlan' "requestUrl"; } "entryRequest"; qr.subject as s -> r.subject = s; } group SetCarePlanFullUrl(source r : CarePlan, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/CarePlan/', id) "assignFullUrl"; } group BuildConditionBase(source qr : QR, target r : Condition, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetConditionFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'Condition' "requestUrl"; } "entryRequest"; qr.subject as s -> r.subject = s; } group SetConditionFullUrl(source r : Condition, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Condition/', 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 = 'nursing-care-plan' "provenanceCode"; qr -> t.display = 'Nursing care plan' "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"; }