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/ExtractOutpatientSummary | Version: 0.1.0 | |||
| Active as of 2026-10-06 | Computable Name: ExtractOutpatientSummary | |||
A ClinicalImpression whose summary is the provisional diagnosis and whose supportingInfo names the complaints Observation, plus a Condition with verificationStatus provisional. Provisional is the point: this is written at the end of a single out-patient visit, and a Condition that does not say so reads as settled to everything downstream that looks at it.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractOutpatientSummary' /// name = 'ExtractOutpatientSummary' /// title = 'Out-patient Summary Extraction' /// status = 'active' /// description = 'A ClinicalImpression whose summary is the provisional diagnosis and whose supportingInfo names the complaints Observation, plus a Condition with verificationStatus provisional. Provisional is the point: this is written at the end of a single out-patient visit, and a Condition that does not say so reads as settled to everything downstream that looks at it.' 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/ClinicalImpression" alias ClinicalImpression as target uses "http://hl7.org/fhir/StructureDefinition/Condition" alias Condition as target group ExtractOutpatientSummary(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr -> bundle.entry as entry, entry.resource = create('ClinicalImpression') as ci then { qr -> ci, entry then BuildClinicalImpressionBase(qr, ci, entry) "base"; qr -> ci.status = 'completed' "status"; qr.encounter as e where ((reference.exists() and (reference.startsWith('Encounter/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Encounter')))) -> ci.encounter = e; qr.authored as t -> ci.date = t "date"; qr -> ci.description = 'Out-patient visit summary' "description"; qr.item as g where (linkId = 'visit') then { g.item as it where ((linkId = 'visit/clinician') and answer.value.exists()) then { it.answer first as a then { a.value as ref where ((reference.exists() and (reference.startsWith('Practitioner/') or reference.startsWith('PractitionerRole/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Practitioner') or ('/' + type).endsWith('/PractitionerRole')))) -> ci.performer = ref "performer"; }; } "clinicianRule"; g.item as it where ((linkId = 'visit/date') and answer.value.exists()) then { it.answer first as a then { a.value as v -> ci.effective = cast(v, 'dateTime') "effective"; }; } "dateRule"; } "visitGroup"; qr.item as g where (linkId = 'provisional-diagnosis') then { g.item as it where ((linkId = 'provisional-diagnosis/text') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> ci.summary = txt "summary"; }; } "summaryRule"; } "diagnosisGroupForSummary"; // The complaints, as an Observation the impression names. qr.item as it where ((linkId = 'complaints') and answer.value.exists()) -> 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 = '10154-3' "cd"; it -> scg.display = 'Chief complaint Narrative - Reported' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> sobs.note as n, n.text = txt "text"; }; it -> ci.supportingInfo = create('Reference') as sref, sref.reference = reference(sobs) "linkSupporting"; } "complaintsObservation"; } "outpatientImpression"; qr.item as it where ((linkId = 'interventions') 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 = 'http://loinc.org' "sys"; it -> cg.code = '62387-6' "cd"; it -> cg.display = 'Interventions Narrative' "dsp"; } "coding"; it -> cc.text = 'Interventions carried out at the out-patient visit' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_62387_6"; qr.item as it where ((linkId = 'plan') 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 = 'http://loinc.org' "sys"; it -> cg.code = '18776-5' "cd"; it -> cg.display = 'Plan of care note' "dsp"; } "coding"; it -> cc.text = 'Plan and follow-up from the out-patient visit' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_18776_5"; // ── The provisional diagnosis ─────────────────────────────────────────── qr.item as g where (linkId = 'provisional-diagnosis') then { g.item as it where ((linkId = 'provisional-diagnosis/text') 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 = 'provisional' "cd"; it -> cg.display = 'Provisional' "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 = 'encounter-diagnosis' "cd"; it -> cg.display = 'Encounter Diagnosis' "dsp"; } "coding"; } "category"; it.answer first as a then { a.value as txt -> cond.code as cc, cc.text = txt "codeText"; }; qr.authored as t -> cond.recordedDate = t "recordedDate"; qr.encounter as e where ((reference.exists() and (reference.startsWith('Encounter/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Encounter')))) -> cond.encounter = e; g.item as ex where ((linkId = 'provisional-diagnosis/condition') and answer.value.exists()) then { ex.answer first as ea then { ea.value as existing where ((reference.exists() and (reference.contains('://').not() and reference.startsWith('#').not() and reference.startsWith('urn:').not())) or reference.empty()) -> cond.evidence as ev, ev.reference = existing "evidenceReference"; }; } "existingRule"; } "provisionalCondition"; } "diagnosisGroup"; } // ───────────────────────────────────────────────────────────────────────────── // 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 where ((reference.exists() and (reference.startsWith('Patient/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient')))) -> obs.subject = s; qr.encounter as e where ((reference.exists() and (reference.startsWith('Encounter/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Encounter')))) -> obs.encounter = e; // 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"; qr -> obs then ConformObservation(qr, obs) "profileConformance"; } 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 BuildClinicalImpressionBase(source qr : QR, target r : ClinicalImpression, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetClinicalImpressionFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'ClinicalImpression' "requestUrl"; } "entryRequest"; qr.subject as s where ((reference.exists() and (reference.startsWith('Patient/') or reference.startsWith('Group/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient') or ('/' + type).endsWith('/Group')))) -> r.subject = s; } group SetClinicalImpressionFullUrl(source r : ClinicalImpression, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/ClinicalImpression/', 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 where ((reference.exists() and (reference.startsWith('Patient/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient')))) -> r.subject = s; qr -> r then ConformCondition(qr, r) "profileConformance"; } 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 response's // identifier is copied the same way. // 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 = 'outpatient-summary' "provenanceCode"; qr -> t.display = 'Out-patient summary form' "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"; // The response's identifiers, as they are. Every profile wants one, and it is // the response's to give: nothing here mints one, so a response without an // identifier extracts resources without one. One whose assigner is not of a // type the profiles allow there is left behind whole, not altered. qr.identifier as qid where (assigner.empty() or assigner.where(((reference.exists() and (reference.startsWith('Organization/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Organization'))))).exists()) -> r.identifier = qid; } // ── Conformance to the IG profiles ─────────────────────────────────────────── // What the IG's profiles require that the response itself can supply. Called at // the end of each base group. The encounter and every who-element are the // response's own; see mapmeta.py for what is and is not here. // ── Conformance to the IG profiles ─────────────────────────────────────────── // A participant in the author role. The actor is the response's author, or its // source when it has no author. group AuthorParticipant(source who, target p) { who as w -> p.actor = w "actor"; who -> p.function as fn then { who -> fn.coding as cg then { who -> cg.system = 'http://terminology.hl7.org/CodeSystem/provenance-participant-type' "sys"; who -> cg.code = 'author' "cd"; who -> cg.display = 'Author' "dsp"; } "coding"; } "function"; } group ConformObservation(source qr : QR, target r) { qr.authored as t where ($this.toString().length() >= 20) -> r.issued = cast(t, 'instant') "issued"; qr.authored as t where ($this.toString().length() >= 20) -> r.effective = cast(t, 'instant') "effective"; qr.author as au where ((reference.exists() and (reference.startsWith('Organization/') or reference.startsWith('Patient/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Organization') or ('/' + type).endsWith('/Patient')))) -> r.performer = au "performerFromAuthor"; qr where (author.where(((reference.exists() and (reference.startsWith('Organization/') or reference.startsWith('Patient/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Organization') or ('/' + type).endsWith('/Patient'))))).exists().not()) then { qr.source as src where ((reference.exists() and (reference.startsWith('Organization/') or reference.startsWith('Patient/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Organization') or ('/' + type).endsWith('/Patient')))) -> r.performer = src "performerFromSource"; } "performerFallback"; } group ConformCondition(source qr : QR, target r) { qr.encounter as e where ((reference.exists() and (reference.startsWith('Encounter/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Encounter')))) -> r.encounter = e; qr.authored as t -> r.recordedDate = t "recordedDate"; qr.author as au where ((reference.exists() and (reference.startsWith('Patient/') or reference.startsWith('Organization/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient') or ('/' + type).endsWith('/Organization')))) -> r.participant as p then AuthorParticipant(au, p) "participantFromAuthor"; qr where (author.where(((reference.exists() and (reference.startsWith('Patient/') or reference.startsWith('Organization/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient') or ('/' + type).endsWith('/Organization'))))).exists().not()) then { qr.source as src where ((reference.exists() and (reference.startsWith('Patient/') or reference.startsWith('Organization/'))) or (reference.empty() and (type.empty() or ('/' + type).endsWith('/Patient') or ('/' + type).endsWith('/Organization')))) -> r.participant as p then AuthorParticipant(src, p) "participantFromSource"; } "participantFallback"; }