Stream: implementers
Topic: FHIR Migration roadmap ideas
Jose Costa Teixeira (Apr 12 2021 at 08:17):
Hi. We're starting to list good practices / antipatterns for the migration of some of our regional systems to FHIR (from an old infrastructure).
Is there anyone that can give advice on
- coexistence of previous standard & FHIR
- data migration
- architecture (we had a "document"-like architecturewhich I expect will remain at least partially)
...?
Jose Costa Teixeira (Apr 12 2021 at 08:18):
@Alexander Henket (how) are the NL planning to do it?
Jose Costa Teixeira (Apr 12 2021 at 08:19):
@Oliver Egger I think you also have some migration / coexistence?
Jose Costa Teixeira (Apr 12 2021 at 08:19):
pinging some people @Nick Hermans @Brecht Van Vooren @Robin Bosman @Hanne Vuegen
Nick Hermans (Apr 12 2021 at 08:57):
Jose Costa Teixeira said:
Hi. We're starting to list good practices / antipatterns for the migration of some of our regional systems to FHIR (from an old infrastructure).
Is there anyone that can give advice on
- coexistence of previous standard & FHIR
- data migration
- architecture (we had a "document"-like architecturewhich I expect will remain at least partially)
...?
I have a public presentation that talks about how University Hospital Leuven runs their national document sharing infrastructure with IHE profiles (in a complete proprietary national ecosystem), it's not very in depth because the audience was not _very_ technical, but i can always elaborate on the choices. I think there are some interresting things that can be learned from looking at this prior 'art'.
https://docs.google.com/presentation/d/16Ft7lU0E8EHSiw9AW2S7vL_0cGrFiNB-DMyZHT1NCSk/edit?usp=sharing
Oliver Egger (Apr 12 2021 at 09:57):
@Jose Costa Teixeira we are working on a mhealth implementation guide which should allow apps to use the mobile IHE profiles (based on FHIR) to be used with our IHE XDS/XCA/PIX V3 achitecture for our Swiss EPR, this is currently in development, see http://build.fhir.org/ig/ehealthsuisse/ch-epr-mhealth/index.html. on the content side we are trying to map the swiss emedication exchange formats based on IHE PHARM CDA's to FHIR and back: http://fhir.ch/ig/cda-fhir-maps/index.html . Our approach is to try the new specifications during our national projectathon once a year and hope we get to the maturity that we can use then these specifications for the ordonnace, but we have to live with coexistencing standards in a few areas.
Jose Costa Teixeira (Apr 12 2021 at 10:34):
Thank you. I'm especially looking at how will an individual system (a data vault) handle the data that is available in the old standard vs the new standard.
Jose Costa Teixeira (Apr 12 2021 at 10:34):
Are systems duplicating the data? Migrating it? Is there a progressive data migration, or a big bang? Or only for new patients? How is the criteria for validating any migration?
Alexander Henket (Apr 12 2021 at 11:18):
Definitely no big bang. We foresee a long time where V3 is the basis for whatever we do in FHIR. Both ways actually: FHIR to V3 and V3 to FHIR. This is a headache case that is the source of many of questions here. V3 and Resource.id do not mix. Managing OIDs and URIs is a pain in the a**. The last couple of years we have consistently 'designed' our V3 efforts in tandem with our FHIR efforts because compatibility does not come for free. We will likely have V2/V3/CDA for 15 more years or so if our millions of Edifact messages since 1989 are any sort of measure.
We are also starting a broader vision on APIs with our ministry of health and several other partners. We currently do this use case by use case, and that serves us well on a per use case basis, but we experience how hard it is to find alignment between use cases and we recognize that there are infinitely more use cases than we will ever be able to work on. So we need smarter solutions going forward and we think the maturity in thinking about this, has the right momentum.
Nick Hermans (Apr 14 2021 at 20:42):
I forgot to mention Jose, that University Hospital Leuven also has a mapping from the Belgian Kmehr standard for the eHealth hubs to the PDQ(m), PIX(m) and MHD IHE profiles based on fhir, since the current national system is mostly based on documents... Moving forward I think we need more than just documents, so coexistence becomes complicated++.
Jose Costa Teixeira (Apr 14 2021 at 21:40):
So it becomes interesting... :)
Lloyd McKenzie (Apr 16 2021 at 15:57):
There's not much here about legacy, but there is a good set of documentation about architectural options and trade-offs. The plan is to move this into the R5 core spec.: https://build.fhir.org/ig/HL7/davinci-ehrx/exchanging.html
Last updated: Apr 12 2022 at 19:14 UTC
