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/ExtractPsychologicalReview | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractPsychologicalReview | |||
A SOAP note extracts as a ClinicalImpression whose summary is the assessment – that is what ClinicalImpression.summary is for – with the subjective and objective sections as Observations under LOINC 61150-9 and 61149-1 that the impression names in supportingInfo, and the plan as a CarePlan. Four resources rather than one narrative, because the point of SOAP is that a reader can find the assessment without reading the subjective account first, and because a plan a counsellor set at session four is a thing the next session has to review. LOINC has Subjective and Objective Narrative but no plain Assessment or Plan term, so those two carry local concept codes.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractPsychologicalReview' /// name = 'ExtractPsychologicalReview' /// title = ' Review Extraction' /// status = 'active' /// description = 'A SOAP note extracts as a ClinicalImpression whose summary is the assessment -- that is what ClinicalImpression.summary is for -- with the subjective and objective sections as Observations under LOINC 61150-9 and 61149-1 that the impression names in supportingInfo, and the plan as a CarePlan. Four resources rather than one narrative, because the point of SOAP is that a reader can find the assessment without reading the subjective account first, and because a plan a counsellor set at session four is a thing the next session has to review. LOINC has Subjective and Objective Narrative but no plain Assessment or Plan term, so those two carry local concept codes.' 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/CarePlan" alias CarePlan as target group ExtractPsychologicalReview(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; qr.item as g where (linkId = 'session') then { 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 -> ci.encounter = e; qr.authored as t -> ci.date = t "date"; qr -> ci.description = 'Psychological review, counselling session' "description"; // The counsellor is the performer, from the form's own signature line // rather than from qr.source: the person who keys a session note in is // not necessarily the person who held the session. g.item as it where ((linkId = 'session/counsellor') and answer.value.exists()) then { it.answer first as a then { a.value as ref -> ci.performer = ref "performer"; }; } "counsellorRule"; // Effective time is the session date. A note written up a week later is // still a note about that session. g.item as it where ((linkId = 'session/date') and answer.value.exists()) then { it.answer first as a then { a.value as v -> ci.effective = cast(v, 'dateTime') "effective"; }; } "sessionDateRule"; g.item as it where ((linkId = 'session/designation') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> ci.note as n, n.text = txt "designationNote"; }; } "designationRule"; g.item as it where ((linkId = 'session/ward-or-clinic') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> ci.note as n, n.text = txt "wardNote"; }; } "wardRule"; // The assessment as the impression's summary. This is the one section // with a native home on the resource, and putting it anywhere else would // leave ClinicalImpression.summary empty on an impression. qr.item as it where ((linkId = 'assessment') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> ci.summary = txt "summary"; }; } "assessmentRule"; // The subjective and objective sections, created here so the impression // can name them. A reference to a resource created in a sibling rule is // not reachable -- the target variable does not exist there -- so they // have to be built inside this rule. qr.item as it where ((linkId = 'subjective') 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 = '61150-9' "cd"; it -> scg.display = 'Subjective Narrative' "dsp"; } "coding"; it -> scc.text = 'What the client reported at this session' "codeText"; } "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"; } "soap_subjective"; qr.item as it where ((linkId = 'objective') 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 = '61149-1' "cd"; it -> scg.display = 'Objective Narrative' "dsp"; } "coding"; it -> scc.text = 'What the counsellor observed at this session' "codeText"; } "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"; } "soap_objective"; } "psychologicalImpression"; } "sessionGroup"; // ── The session number ────────────────────────────────────────────────── // Its own Observation. A counselling episode is a series and "which session // was this" is the question every review of that series starts from; there // is nowhere on ClinicalImpression that a query would find it. qr.item as g where (linkId = 'session') then { g.item as it where ((linkId = 'session/number') 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 = 'soap-counselling-session-number' "cd"; it -> cg.display = 'Counselling session number' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as v -> obs.value = v "set"; }; } "measure_soap_component"; } "sessionNumberGroup"; // ── The plan ──────────────────────────────────────────────────────────── // A CarePlan, because what a counsellor agrees at the end of a session is // what the next session opens by reviewing. As a note on the impression it // would be findable only by reading the last note. qr.item as it where ((linkId = 'plan') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('CarePlan') as plan then { qr -> plan, entry then BuildCarePlanBase(qr, plan, entry) "base"; it -> plan.status = 'active' "status"; it -> plan.intent = 'plan' "intent"; it -> plan.title = 'Plan agreed at psychological review' "title"; qr.authored as t -> plan.created = t "created"; qr.encounter as e -> plan.encounter = e; it -> plan.category as cat then { it -> cat.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"; } "category"; it.answer first as a then { a.value as txt -> plan.description = txt "description"; }; qr.item as g where (linkId = 'session') then { g.item as c where ((linkId = 'session/counsellor') and answer.value.exists()) then { c.answer first as a then { a.value as ref -> plan.contributor = ref "contributor"; }; } "counsellorRule"; } "sessionGroupForPlan"; } "psychologicalPlan"; } // ───────────────────────────────────────────────────────────────────────────── // 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 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 -> 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 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"; } // ── 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 = 'psychological-review' "provenanceCode"; qr -> t.display = 'Psychological review notes' "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"; }