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1a. Project Name

FHIR Shorthand

1b. Project ID


1c. Is Your Project an Investigative Project (aka PSS-Lite)?


1d. Is your Project Artifact being Reaffirmed or proceeding to Normative directly after being either Informative or STU?


1e. Today's Date

1f. Name of standard being reaffirmed

1g. Project Artifact Information

1h. ISO/IEC Standard to Adopt

1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption?

1j. Unit of Measure

2a. Primary/Sponsor WG

FHIR Infrastructure

2d. Project Facilitator

Mark Kramer

2e. Other Interested Parties (and roles)

Chris Moesel (lead implementer), Rick Geimer (tester), Ewout Kramer (design advisor).

2f. Modeling Facilitator

2g. Publishing Facilitator

2h. Vocabulary Facilitator

2i. Domain Expert Representative

2j. Business Requirements Analyst

2k. Conformance Facilitator

2l. Other Facilitators

2m. Implementers

MITRE Corporation, Lantana

3a. Project Scope

FHIR Shorthand is a specification of a domain-specific language (DSL) to allow Implementation Guide authors to define conformance resources (e.g., StructureDefinitions, ValueSets, etc.) and general instances (e.g., examples). This project will define the syntax of FHIR Shorthand, and develop a reference implementation of an importer/exporter/compiler ("Sushi") that creates FHIR content ready for the FHIR IG Publisher or other consumers of Conformance Resources. Project will also explore importing StructureDefinitions to FSH.


3b. Project Need

To better support complex clinical modeling/profiling projects and effectively integrate across projects.

To grow, the FHIR community needs scalable, user-friendly tools for IG creation and maintenance. Currently, IG projects are difficult and slow, and the results inconsistent. As a user-facing format, StructureDefinitions (SDs) are complex and unwieldy. While available tools (Forge, Trifolia-on-FHIR, Excel spreadsheets) improve this situation, there are still shortcomings:
a. Although the current tools provide a friendlier interface, the tools are not particularly agile when it comes to refactoring.
b. Source code control system (SCCS) features such as differentials and merging changes are not well supported. Excel files cannot be effectively diff’ed, and the other tools can be managed in SCCS only as SDs.

To address these limitations, we propose a domain specific language (DSL) designed for the job of defining profiles, extensions, invariants, value sets, examples, search parameters, etc. FHIR Shorthand (FSH) will be designed to work optimally with SCCS, with meaningful differentials, support for merging and conflict resolution, and refactoring through global search/replace operations. These features will permit FSH to scale in ways that visual editors and spreadsheets cannot.

3c. Security Risk


3d. External Drivers

3e. Objectives/Deliverables and Target Dates

Version 1 for Connectathon testing by May 2020 with concurrent comment-only ballot.
First release version with STU ballot by Sept 2020 (at the earliest).

3f. Common Names / Keywords / Aliases:

FSH, SUSHI, DSL, shorthand, IG, language

3g. Lineage

Based on similar free, open source tool called CIMPL (Clinical Information Modeling and Profiling Language) developed primarily by MITRE Corp. and used to develop mCODE, ODH, and other balloted IGs.

3h. Project Dependencies


3i. HL7-Managed Project Document Repository URL:

3j. Backwards Compatibility


3k. Additional Backwards Compatibility Information (if applicable)

3l. Using Current V3 Data Types?


3l. Reason for not using current V3 data types?

FHIR datatypes are used.

3m. External Vocabularies


3n. List of Vocabularies

3o. Earliest prior release and/or version to which the compatibility applies


4a. Products

Creating/Using a tool not listed in the HL7 Tool Inventory

4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to?

R4 +

4c. FHIR Profiles Version

4d. Please define your New Product Definition

4d. Please define your New Product Family

5a. Project Intent

Create new standard

5a. White Paper Type

5a. Is the project adopting/endorsing an externally developed IG?

5a. Externally developed IG is to be (select one)

5a. Specify external organization

5a. Revising Current Standard Info

5b. Project Ballot Type

Comment (aka Comment-Only), STU to Normative

5c. Additional Ballot Info

5d. Joint Copyright


5e. I understand I must submit a Joint Copyright Letter of Agreement to the TSC in order for the PSS to receive TSC approval.


6a. External Project Collaboration

Will work with FHIR Accelerator projects (e.g., DaVinci, CODEx).

6b. Content Already Developed


6c. Content externally developed?


6d. List Developers of Externally Developed Content

6e. Is this a hosted (externally funded) project?


6f. Stakeholders

Standards Development Organizations (SDOs), Other

6f. Other Stakeholders

FHIR Community (anyone who develops IGs)

6g. Vendors


6g. Other Vendors

6h. Providers


6h. Other Providers

6i. Realm


7d. US Realm Approval Date

7a. Management Group(s) to Review PSS


7b. Sponsoring WG Approval Date

Sep 18, 2019

7c. Co-Sponsor Approval Date

7c. Co-Sponsor 2 Approval Date

7c. Co-Sponsor 3 Approval Date

7c. Co-Sponsor 4 Approval Date

7c. Co-Sponsor 5 Approval Date

7c. Co-Sponsor 6 Approval Date

7c. Co-Sponsor 7 Approval Date

7c. Co-Sponsor 8 Approval Date

7c. Co-Sponsor 9 Approval Date

7c. Co-Sponsor 10 Approval Date

7e. CDA MG Approval Date

7f. FMG Approval Date

Nov 06, 2019

7g. V2 MG Approval Date

7h. Architecture Review Board Approval Date

7i. Steering Division Approval Date

Nov 21, 2019

7j. TSC Approval Date


  1. Paul Knapp Rob McClure This is ready to go to Infrastructure SD vote.