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/ExtractSurgicalIrrigationRecord | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractSurgicalIrrigationRecord | |||
The 24-hour urine output under LOINC 9192-6 – out less in, which on a bladder irrigation is the urine the patient actually made and the only number anyone reads off this chart – plus each hourly row as its own panel. A return carrying clots is flagged abnormal: clots obstruct the catheter and call a surgeon, and that is the observation the chart exists to catch.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractSurgicalIrrigationRecord' /// name = 'ExtractSurgicalIrrigationRecord' /// title = 'Surgical Irrigation Record Extraction' /// status = 'active' /// description = 'The 24-hour urine output under LOINC 9192-6 -- out less in, which on a bladder irrigation is the urine the patient actually made and the only number anyone reads off this chart -- plus each hourly row as its own panel. A return carrying clots is flagged abnormal: clots obstruct the catheter and call a surgeon, and that is the observation the chart exists to catch.' 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 ExtractSurgicalIrrigationRecord(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; // ── The balance, as the 24-hour urine output ──────────────────────────── qr.item as g where (linkId = 'totals') then { 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 = 'http://loinc.org' "sys"; it -> cg.code = '9192-6' "cd"; it -> cg.display = 'Urine output 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 = 'Irrigation out less irrigation in. On a continuous bladder irrigation this is the urine the patient actually made.' "note"; } "measureq_9192_6"; g.item as it where ((linkId = 'totals/in') 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-irrigation-volume-instilled-over-24-hours' "cd"; it -> cg.display = 'Irrigation volume instilled 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_balance"; g.item as it where ((linkId = 'totals/out') 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-irrigation-volume-returned-over-24-hours' "cd"; it -> cg.display = 'Irrigation volume returned 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"; } "totalsGroup"; qr.item as g where (linkId = 'context') then { g.item as it where ((linkId = 'context/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 = 'http://loinc.org' "sys"; it -> cg.code = '11450-4' "cd"; it -> cg.display = 'Problem list - Reported' "dsp"; } "coding"; it -> cc.text = 'Diagnosis on the surgical irrigation record' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_11450_4"; } "contextGroup"; // ── One hourly row ────────────────────────────────────────────────────── qr.item as row where ((linkId = 'hour') 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"; 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 = 'fluid-balance-continuous-irrigation-entry' "cd"; row -> cg.display = 'Continuous irrigation entry' "dsp"; } "coding"; } "code"; row.item as it where ((linkId = 'hour/solution') 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-irrigation-solution' "cd"; it -> cg.display = 'Irrigation solution' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_irrigation_solution"; row.item as it where ((linkId = 'hour/amount-in') 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-irrigation-volume-instilled' "cd"; it -> cg.display = 'Irrigation volume instilled' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_irrigation_volume_instilled"; row.item as it where ((linkId = 'hour/amount-out') 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-irrigation-volume-returned' "cd"; it -> cg.display = 'Irrigation volume returned' "dsp"; } "coding"; } "code"; it -> comp then SetComponentValue(it, comp) "value"; } "comp_fluid_balance_irrigation_volume_returned"; row.item as it where ((linkId = 'hour/return-colour') 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-colour-of-the-irrigation-return' "cd"; it -> cg.display = 'Colour of the irrigation return' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_fluid_balance_colour_of_the_irrigation_return"; // Clots, flagged. The one finding on this sheet that stops an irrigation. row.item as it where (linkId = 'hour/return-colour') then { it.answer first as a then { a.value as cv where (code = 'urine-clots') -> obs.interpretation as interp then { cv -> interp.coding as icg then { cv -> icg.system = 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation' "sys"; cv -> icg.code = 'A' "cd"; cv -> icg.display = 'Abnormal' "dsp"; } "coding"; } "clotsInterp"; }; } "clotsRule"; 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 time on the irrigation record' "timeNote"; }; } "timeRule"; row.item as it where ((linkId = 'hour/recorded-by') and answer.value.exists()) then { it.answer first as a then { a.value as ref -> obs.performer = ref "performer"; }; } "byRule"; } "irrigationRow"; } // ───────────────────────────────────────────────────────────────────────────── // 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 = 'surgical-irrigation-record' "provenanceCode"; qr -> t.display = 'Surgical continuous irrigation 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"; }