Stream: implementers
Topic: Examples of FHIR Document profiles
Kumar Satyam (Aug 06 2020 at 14:25):
I am looking for some sample profiles to create FHIR documents. I am trying to create a prescription document , which will be a Bundle of type "document" with Composition, MedicationRequest, DocumentReference and some other resources. I could find profiles on Composition resource when I search for documents. however I am specifically looking for a profile on Bundle for documents. Please share any pointers to samples .
David Pyke (Aug 06 2020 at 14:29):
A Bundle with a Composition resource is a Bundle for documents. What is your workflow you're trying to design for?
David Pyke (Aug 06 2020 at 14:29):
A MedicationRequest is a prescription, what are you attaching to it?
Kumar Satyam (Aug 06 2020 at 14:37):
David Pyke said:
A MedicationRequest is a prescription, what are you attaching to it?
We have a usecase where we want to exchange a prescription document. The document may contain structured content if available and/or a image/pdf of physical prescription. We may have multiple MedicationRequest resources in a document. We want to create a document which will contain all the medicantionRequests together in the document along with a pdf of the prescription or just the pdf .
David Pyke (Aug 06 2020 at 14:41):
Then you need a Composition bundle if you want the Bundle to be a static group. If not, then a simple transaction bundle should be fine. See http://hl7.org/fhir/documents.html
Kumar Satyam (Aug 06 2020 at 14:47):
David Pyke said:
Then you need a Composition bundle if you want the Bundle to be a static group. If not, then a simple transaction bundle should be fine. See http://hl7.org/fhir/documents.html
Yes, A Composition Bundle is what I am looking at. Wanted to see if some sample profiles are already available for such. Not able to find any . Did search on simplifier & some IGs but no luck.
Vassil Peytchev (Aug 06 2020 at 15:07):
Keep in mind that representing a prescription as a document may not always be the best approach. Direct replication of paper-based artifacts to electronic communications is usually fraught with problems.
John Moehrke (Aug 06 2020 at 15:28):
There are IHE Profiles that produce FHIR-Document (as well as CDA). see https://wiki.ihe.net/index.php/Category:FHIR-Doc
John Moehrke (Aug 06 2020 at 15:29):
The better example would be the IPS http://hl7.org/fhir/uv/ips/
John Moehrke (Aug 06 2020 at 15:31):
John Moehrke said:
The better example would be the IPS http://hl7.org/fhir/uv/ips/
and the IHE Profile showing how to use IPS in IHE Document Sharing https://wiki.ihe.net/index.php/International_Patient_Summary
Kumar Satyam (Aug 06 2020 at 15:42):
John Moehrke said:
John Moehrke said:
The better example would be the IPS http://hl7.org/fhir/uv/ips/
and the IHE Profile showing how to use IPS in IHE Document Sharing https://wiki.ihe.net/index.php/International_Patient_Summary
Hi John, Thanks for sharing the example. I looked at IPS and I found a Composition resource profile. However did not see a profile on Bundle. Should there be no profile on Bundle ?
John Moehrke (Aug 06 2020 at 15:44):
yes, I would have expected that... but sometimes our expectations are short. They likely spoke to the bundling of the profile Composition in text and not using a structureDefinition... good comment for them, they have a jira bucket
Lloyd McKenzie (Aug 06 2020 at 15:55):
There's some guidance on how to decide whether to use documents here: https://build.fhir.org/ig/HL7/davinci-ehrx/exchanging.html
In general, you don't need documents just because you want to transmit a package of stuff - documents are about a need to tell a story - and a package of orders doesn't generally involve much story-telling. That doesn't mean that you can't use documents, but you might find that the overhead of the document approach interferes with some of what you're trying to do.
Oliver Egger (Aug 06 2020 at 16:23):
IHE Pharmacy has defined CDA documents for different usecases, e.g. prescription, see https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_PRE.pdf. For our national e-medication project we defined specific CDA and corresponding FHIR documents for that, you find some a profile and example here: http://fhir.ch/ig/ch-emed/StructureDefinition-ch-emed-document-medicationprescription.html
Mareike Przysucha (Aug 06 2020 at 19:28):
For our eNursingSummary (https://simplifier.net/epflegebericht/), which will be balloted soon, we have profiled a Bundle (see https://simplifier.net/epflegebericht/genssummarybundle).
We also discussed how strict a Bundle should be profiled in this context. We chose not to add many constraints, as there are already some constraints in the basic Bundle for documents (e.g. presence of date, identifier, composition as first resource). We added the invariant Bundle.entry.descendants().reference.distinct().subsetOf(%resource.entry.fullUrl) to the Composition to ensure that the entries inside the Bundle are referenced in the Composition (thanks to @Simone Heckmann for this invariant). That way there was no need to add more slices to the Bundle.
Kumar Satyam (Aug 07 2020 at 05:59):
Oliver Egger said:
IHE Pharmacy has defined CDA documents for different usecases, e.g. prescription, see https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_PRE.pdf. For our national e-medication project we defined specific CDA and corresponding FHIR documents for that, you find some a profile and example here: http://fhir.ch/ig/ch-emed/StructureDefinition-ch-emed-document-medicationprescription.html
Thank you
Kumar Satyam (Aug 07 2020 at 06:01):
Mareike Przysucha said:
For our eNursingSummary (https://simplifier.net/epflegebericht/), which will be balloted soon, we have profiled a Bundle (see https://simplifier.net/epflegebericht/genssummarybundle).
We also discussed how strict a Bundle should be profiled in this context. We chose not to add many constraints, as there are already some constraints in the basic Bundle for documents (e.g. presence of date, identifier, composition as first resource). We added the invariant
Bundle.entry.descendants().reference.distinct().subsetOf(%resource.entry.fullUrl)to the Composition to ensure that the entries inside the Bundle are referenced in the Composition (thanks to Simone Heckmann for this invariant). That way there was no need to add more slices to the Bundle.
Thank you . I wanted to verify if I was on the right track. Examples in your response & from @Oliver Egger helped.
Mareike Przysucha (Aug 07 2020 at 20:43):
Glad to help. Good luck
Last updated: Apr 12 2022 at 19:14 UTC
