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Submitting WG/Project/Implementer Group

  • Patient Care, IPS project

Justification and Objectives

This track will test the creation and exchange of FHIR International Patient Summary (IPS) documents (using a document Bundle resource containing a Composition and other supporting resources) and individual IPS component profiles. We will extend and adjust the work done on data exchange in prior Connectathons to be more toward the use (including searching and exchange) of individual IPS profile components (e.g. immunization, medications), as well as patient summary documents.  An area of ongoing interest is evaluation and consideration of issues and aspects of alignment of IPS with the Argonaut specifications.  The Connectathon testing is expected to be primarily on the (soon to be) published FHIR IPS IG specification (STU, based on FHIR R4).

This track will use the versions of FHIR:

  • R4
  • potentially may also use STU3 (particularly from the European CEN specifications)

Clinical input requested (if any)

No specific needs have been identified.  The project does have leadership with clinical background and experience.

Related tracks

None specific noted at present.

Proposed Track Lead

Rob Hausam, rrhausam@gmail.com

Expected participants

We expect to have multiple local and potentially some remote participants.  HL7 Germany intends to test their national profiles which heavily rely on the IPS.

Track Orientation

We invite interested participants to join the weekly IPS calls on Wednesdays from noon to 1:00 PM Eastern (https://global.gotomeeting.com/join/399580637).

System Roles

PS Document Creator

Creates a FHIR IPS document (Bundle containing a Composition and supporting resources) from source data. The source data likely will be existing data on a FHIR server, but this can be done using whatever means are appropriate, including manual creation, assembling documents from other resources, transforming from a CDA IPS document, etc. Submits that document to a FHIR server. Optionally a document creator may digitally sign the document (but this is not expected at this time).

IPS Document Consumer

Retrieves a FHIR IPS document and/or individual component resource instances created by the Document Creator from the FHIR server and does one or more of the following: a) validates the document and/or component resource instances against the IPS Clinical Document profile, b) displays the document and/or discrete data components in a browser (or by other means), c) translates the coded and/or narrative data to a different language for display, or d) translates the coded data to different code system(s) used in a jurisdiction that is different from the source.

Scenarios

For all scenarios below, participants are expected to provide their own content for the documents (obviously nothing with PHI should be used at a public Connectathon). If participants don't have readily available content, they are encouraged to create documents that mimic the content in IPS or other patient summary sample files.

1. Create an IPS document

Action: User creates a FHIR IPS document consisting of a Composition resource with narrative sections, bundled with Patient (Composition.subject) and Practitioner (Composition.author) and the additional supporting component resources containing the summary clinical data. User then POSTs the document to a FHIR server.Precondition: none, but existing resources may be used.Success Criteria: Bundle is successfully submitted to a FHIR server. Consumer in Scenario 4 can display the document and render all attested content.

Basic script:

  • Step 1: Create a Composition resource
  • Step 2: Ensure the subject, author, and custodian references point to valid Patient, Practitioner, and additional clinical resources .
  • Step 3: POST the Composition to a FHIR server
  • Step 4: Check the operation outcome to ensure it was successful
  • Step 5: Call $document on the Composition (if supported by the server) to get a full document Bundle back, or create the Bundle through other means (custom code, etc.)

2. Display an IPS document and/or individual component resources

Action: User retrieves an IPS document and/or discrete component resources from the FHIR server and displays the data in a web browser (or by other means).Precondition: An IPS document exists on the target FHIR server.Success Criteria: Document is successfully displayed.

3. Translate the narrative and coded data into different language(s) for display or to other code systems appropriate for different jurisdictions (as in IPS Document Consumer c, d above).

TestScript(s)

No test scripts have been defined for this at present.

Security and Privacy Considerations

No specific security expectations have been identified or defined.

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