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Short Description

This track will test the creation, exchange and visualization of patient summary data across jurisdictions and usage contexts using the FHIR International Patient Summary (IPS)
Implementation Guide specification.

Long Description

This track will test the creation, exchange and visualization of patient summary data across jurisdictions and usage contexts using the FHIR International Patient Summary (IPS) Implementation Guide specification.  The track will focus on the primary theme of cross-border IPS document bundle data exchange. This will support initiatives by the Joint Initiative Council (JIC) on IPS (See http://jointinitiativecouncil.org/projects/ips.asp) and also nations participating through the Global Digital Health Partnership (See https://gdhp.health/). Any organization within any country in invited to participate.  

Several themes will be advanced as part of the track including: 

• Pilot implementations of multiple jurisdictions (e.g., GDHP) for cross-border IPS document bundle data exchange
• Test implementation of proposed Patient resource $summary operation (See https://build.fhir.org/ig/HL7/fhir-ips/OperationDefinition-summary.html)
  • Can generate an IPS instance for a patient based on existing data and a set of rules
  • Rules can be server-defined (default) or specified by parameter
  • Need to answer the “relevant” question for what data to include
  • Need to refine what text is included in IPS
• Enhanced IPS instance testing leveraging available testing suites
  • The Inferno testing tool (ONC/MITRE)
  • The Gazelle testing tool suite (used in common with the IHE North American and European Connectathons) (optionally, as available)
  • One or more FHIR server(s) for demonstrating and testing IPS data exchange
• Examine the relationship between IPA (International Patient Access) and IPS
• Optional: Transform IPS data to a WHO DDCC:VS vaccination certificate document including the EU DCC, Smart Health Cards, and DIVOC QR code specifications.

General track goals include:

• Promote the sharing of experiences
• Identify tools and resources for IPS examples and validation
• Identify gaps and pitfalls in the IPS adoption

An open approach will be followed, expecting attendees to actively participate in the selection and definition of the tests to be performed and topics to be discussed,
beyond those suggested by the track leaders.

Type

Test an Implementation Guide

Track Prerequisites

• Get acquainted with the why for a patient summary: https://international-patient-summary.net/
• How to read a FHIR IG and have reviewed the current build of the International Patient Summary: https://build.fhir.org/ig/HL7/fhir-ips/
• Try out a sample International Patient Summary. For example, you can look at a sample in 1-minute at this site: https://www.ipsviewer.com (click the green try a sample button) 
• Attend of listen to the recording of the track kick-off call. 

Track Lead(s)

John D'Amore, More Informatics, 
Rob Hausam, Hausam Consulting,

Track Lead Email(s)

 johnd@moreinformatics.com; rob@hausamconsulting.com

Specification Information

https://build.fhir.org/ig/HL7/fhir-ips/

Call for participants

Organizations and vendors anticipating implementation of the IPS

Zulip stream

https://chat.fhir.org/#narrow/stream/207835-IPS

Track Kickoff will be offered on September 9 at 2pm ET. Call will be recorded for those who cannot attend. 
https://us06web.zoom.us/j/84429001459?pwd=U1h0Sk5yUXRoUFMxMm5ObjRnS01WQT09&from=addon

Recording: https://us06web.zoom.us/rec/share/6H6PKDVFVFbtP56XCG6jhEElfdZWEYHkb4SPFXJLqcFSFiC20VDIakxxGApWbGfv.O76xtAtjnSNNKBNJ (Passcode: x5cj5V#m)

International Patient Access 

Vulcan/Gravitate

Pre-connectathon Track kickoff call: Friday Sept 9 at 2pm ET (Zoom above)

Track kickoff: Saturday Sept 17 9-10am (in person) 

Review of the new IPS Publication & Available Reference Servers: Sept 17 10-11am  (in person)

Joint Session with IPA Sept 17 11am - 12pm (In person and online)

Online Zoom for Joint session: https://us06web.zoom.us/j/83377761937?pwd=UnkzcmFwa1ByR3RsTFV6MTBtSU5KQT09&from=addon

Working Sessions: Saturday 12pm - 5pm & Sunday 9am - 4pm (in person) 

IPS Reference Implementation Server Report-out: 23:30pm 00pm (in person, Federal Hill Breakout)  

Joint presentation with IPA to International Council: Sunday at 4:30pm (in person)  

Testing Scenario:

System roles:

Generator of IPS documents (such as personal health records, health information exchanges or electronic health records)
Receiver of IPS documents

No advance preparation is specifically required, although reviewing the implementation guide and examples of IPS samples will be helpful (https://github.com/jddamore/IPSviewer/tree/main/samples)

Roles & Scenarios

IPS Document Creator

Creates or updates 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. 

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.

IPS Document Processor

Uses a FHIR IPS document and/or individual component resource instances for the purpose of creating/updating other kinds of IPS based documents as for example
vaccination certificate.

Action:

• Create an IPS bundle from a FHIR server using the $summary operation (http://build.fhir.org/ig/HL7/fhir-ips/OperationDefinition-summary.html)
• View an IPS bundle using tools provided 
• Demonstrate IPS terminology utilization (and translations)
• Discuss the role of narrative content within IPS. For reference see: 
  • https://chat.fhir.org/#narrow/stream/207835-IPS/topic/generation.20of.20narrative
  • https://build.fhir.org/documents.html

Precondition: Success Criteria: 

• Usage of tools to validate IPS conformance
• Usage of tools to visualize IPS content 

Success Criteria:  

• Conformant IPS documents that validate without errors
• Successful visualization of IPS documents
• Advancement and feedback on the implementation guidance

Bonus point:

• BONUS: Demonstrate IPS transformations to/from other standards (e.g. WHO DDCC and IPS) 
• BONUS: Demonstrate IPS language translation 
• BONUS: Use of $docref operation (see http://build.fhir.org/ig/HL7/fhir-ipa/OperationDefinition-docref.html)

TestScript(s):

No test scripts at this time. 

Security and Privacy Considerations:

No plans to test security at this time. Privacy and confidentiality are within scope for discussion. 

• IPS Reference Server (in development) from GDHP/ONC
  • https://ips.health/fhir/ 
  • This server will use a UUID id strategy, so will update with some sample calls when ready

• Terminz
  

  https://terminz.azurewebsites.net/fhir
  
  Will now accept (and save) POSTs of IPS Bundles that satisfy the following criteria...

  • Bundle.Type == Bundle.BundleType.Document
  • Bundle.Identifier.System == "urn:oid:2.16.724.4.8.10.200.10"
  • Contains one Composition and one Patient Resource
  • Contains at least one of each of these resources - AllergyIntolerance, Condition and MedicationStatement.
  • Includes at least one Patient.Identifier with populated system and value elements (these are used for persistence and $summary request purposes)

  The $summary operation is also provisionally defined at https://terminz.azurewebsites.net/fhir/OperationDefinition/Patient-summary
  
  

• Rob Hausam's test server
  https://fhir.hausamconsulting.com
  Based on HAPI 5.4.0.  No $summary operation (yet).
  
  
• IPS Viewer:  https://www.ipsviewer.com/
  
  
• Inferno Validator: https://inferno.healthit.gov/suites/ (select IPS) 
  
  
• ClinFHIR (not IPS specific but helpful for bundle visualization):  http://clinfhir.com/bundleVisualizer.html