This project will aim to port over the Simplifier IG IHE SDC on FHIR, which describes how to convert a CAP electronic Cancer Checklists (eCC) and other IHE SDC forms to FHIR Observations. The guide also describes how to transport IHE SDC forms using the DocumentReference resource, similar to a C-CDA document or PDF.  The original Simplifier IG does not use DiagnosticReport, but this resource would be added as part of this project. The current Simplifier IG also only describes transformation to Observation, and this project would expand this to include a definition based extraction which will be leveraged by PSS-1682 Cancer Electronic Pathology Reporting.  PSS-1688 - Getting issue details... STATUS

The Integrating Cancer Reporting Scenario in the Public Health Connectathon Track has tested these transformations and transport methods in several FHIR and IHE Connectathons and found them to be viable with the existing and planned future use cases for eCCs and North American Association of Central Cancer Registry (NAACCR) use cases.

The following text is background modified from: https://simplifier.net/guide/SDConFHIR/Introduction

This implementation guide will describe how to use IHE Structured Data Capture (SDC) Forms with FHIR. Specific resources used include the DocumentReference, Observation, and DiagnosticReport. The aim of this proposal is to create a specified format for IHE SDC to be transported through FHIR, using the DocumentReference, and/or transformed into FHIR resources using the Observations and DiagnosticReport. IHE SDC primarily supports pathology use cases, and would enable access to a large amount of structured data.

This project will deliver descriptions of how to attach IHE SDC forms to DocumentReferences, and mappings for data extraction to other resources including the Observation and DiagnosticReport. It will also include further development of the IHE SDC on FHIR parser to better enable these transformations. These deliverables will be usable by anyone who has or intends to implement any products that use the IHE SDC technical framework and enable better interoperability with FHIR SDC.

Note:

IHE Structured Data Capture (SDC) on FHIR uses a form driven workflow to capture and encode data by creating FHIR Observations from the captured data. The primary use case for this implementation guide is point of care reporting for clinicians using structured forms to capture high quality data for care and reporting purposes. Structured data can enable easier auto-population of future medical documents, easily queriable data, and high quality reporting for quality measurement and evaluation, and research.

The SDC initiative was established by the ONC in 2013 to develop two implementation guides:

On March 30, 2017 both initiatives transitioned into community led projects focused on data capture. The ideal scenario is that data captured in any manner can exist in FHIR for maximum interoperability. Both initiatives focus on improving data capture within healthcare. The CAP has already developed and implemented IHE SDC for their collection of electronic Cancer Checklists (eCCs), and being able to extract data from these cancer checklists to create FHIR Observations will enhance interoperability.

The project proposal can be found here: IHE SDC/eCC on FHIR

Meeting Updates:

Meetings occur on the IHE SDC Working group calls. Meeting information can be found below. Please contact: agoel@cap.org with any concerns or agenda items for the meeting.

Project Information

Project Insight NumberPSS-1700
HL7 Sponsor(s)

Orders and Observations

Project Proposal    

PSS-1683 - Getting issue details... STATUS

Accepted: 2021-02-05

PSS

IHE SDC/eCC on FHIR
Approved: 2021-02-23


FHIR IG Proposal

IHE SDC/eCC on FHIR IG Proposal

Approved by FMG: PSS-1949 - Getting issue details... STATUS

All in favor

TSC Approval: 2022-03-21 TSC Agenda/Minutes

Githubhttps://github.com/HL7/ihe-sdc-ecc-on-fhir/
May 2021 Connectathon

2021-05 Cancer Pathology Reporting to EHRs

Track Report Out

January 2022 Connectathon

2022-01 Cancer Pathology Reporting to EHRs

*tested in MedMorph track

May 2022 Connectathon2022 - 05 Connectathon 30
Cancer FHIR IG CI Build

https://build.fhir.org/ig/HL7/ihe-sdc-ecc-on-fhir/

IG ProposalIHE SDC/eCC on FHIR IG Proposal

Project Team:

College of American Pathologists (IG developers)

  • Alex Goel, Consultant (agoel@cap.org)
  • Fred Marsh
  • Rich Moldwin
  • Jeffery Karp
  • Eric Daley

Centers for Disease Control and Prevention

IHE SDC Working Group

Scheduled: Oct 13, 2021 at 14:00 to 16:00, EDT

Join Zoom Meeting

https://zoom.us/j/98946517900?pwd=R2plZVBwZWxrUU1jcTFIbm4xWFZmdz09

 

Meeting ID: 989 4651 7900

Passcode: 306176

One tap mobile

+13126266799,,98946517900#,,,,*306176# US (Chicago)

+13017158592,,98946517900#,,,,*306176# US (Washington DC)

 

Dial by your location

        +1 312 626 6799 US (Chicago)

        +1 301 715 8592 US (Washington DC)

        +1 929 205 6099 US (New York)

        +1 669 900 6833 US (San Jose)

        +1 253 215 8782 US (Tacoma)

        +1 346 248 7799 US (Houston)

Meeting ID: 989 4651 7900

Passcode: 306176

Find your local number: https://zoom.us/u/akZARn1ET


Minutes:

DateAttendeesNotesActions
Feb 8, 2023Alex Goel, Maria Fodor, Jay Goldthorpe, Sandy Jones, Caitlin Kennedy, Rich Moldwin, Jeffery Karp, Fred Marsh
  • Have passed ballot, now trying to get published https://jira.hl7.org/browse/FHIR-38066
  • Alex has submitted the IG for OO WG’s QA
    • Once everything is in order, then we will submit a publication request

Review QA report

Submit publication request once everything is in order

Feb 1, 2023Alex Goel, Maria Fodor, Jay Goldthorpe, Sandy Jones, Rich Moldwin, Jeffery Karp, Fred Marsh, Jennifer Mayo, Jean Baumflek
  • Have passed ballot, now trying to get published https://jira.hl7.org/browse/FHIR-38066
  • Waiting for OO Vote - need to figure out what publishing requirements are necessary
    • Alex to follow up with what to do next
Identify publishing requirements
Dec 17, 2022Alex Goel, Maria Fodor, Jay Goldthorpe, Sandy Jones, Rich Moldwin, Eric Daley, Jeffery Karp, Fred MarshOO Vote
Dec 7, 2022Alex Goel, Maria Fodor, Jay Goldthorpe, Sandy Jones, Rich Moldwin, Eric Daley, Jeffery Karp, Fred MarshOO Vote
Nov 16, 2022

Alex Goel, Maria Fodor, Jay Goldthorpe, Sandy Jones, Rich Moldwin, Eric Daley, Jeffery Karp, Fred Marsh

OO Vote
Nov 9, 2022

Alex Goel, Sandy Jones, Rich Moldwin, Eric Daley, Jeffery Karp, Jay Goldthorpe, Fred Marsh

  • Completed Comment review
  • Continuing wait for OO block vote
OO Vote
Oct 5, 2022Alex Goel, Sandy Jones, Caitlin Kennedy, Jean Baumfelk, Maria Fodor, Ross Simpson
  • Reviewed ballot comments
    • Have completed Comment review waiting for OO block vote
OO Vote
Sep 28, 2022Alex Goel, Rich Moldwin, Fred Marsh, Jeffery Karp, Maria Fodor, Sandy Jones, Caitlin Kennedy, Jean Baumfelk
  • Ballot reconciliation
Ballot reconciliation
Aug 28, 2022Alex Goel, Rich Moldwin, Fred Marsh, Jeffery Karp, Sandy Jones, Caitlin Kennedy
  • Connectathon prep
Connectathon!
Aug 10, 2022Alex Goel, Rich Moldwin, Fred Marsh, Jeffery Karp, Maria Fodor, Sandy Jones, Caitlin Kennedy
  • IG submitted for Ballot

March 9, 2022

Alex Goel, Rich Moldwin, Fred Marsh, Jeffery Karp, Maria Fodor, Sandy Jones, Caitlin Kennedy

  • Updated IG based on QA reports
  • Followed up about creating an official http://cap.org/ecc terminology link
Await WG approval and make any necessary edits

March 2, 2022

Alex Goel, Rich Moldwin, Eric Daley, Fred Marsh, Jeffery Karp, Maria Fodor, Peter Mello, Sandy Jones

  • Test @instanceGUID in the SDC Form used for transformation to FHIR Observation
  • Finish profile updates
  • QA IG errors before ballot 
  • Important dates: 
    • Mar 15 WG Review of IG - resolve QA issues by then
    • March 24 WG Final approval
    • Mar 25 apply changes by WG review
    • Mar 27 submit to Lynn
    • Mar 29 ballot readiness deadline
    • April 1 ballot opens
Fix QA report
Feb 23, 2022 Alex Goel, Rich Moldwin, Eric Daley, Fred Marsh, Jeffery Karp, Sandy Jones
  • IHE SDC on FHIR has passed appeal to ballot in May 2022
    • There are concerns about name, will follow up with IHE to create formal agree to use derivative of work
    • Need to create URI for CAP specific terminology as an external code system- will follow up with CAP about getting url e.g. http://cap.org/ecc 
Validating and Requesting Identifiers for External Code Systems and Identifier Systems 		Follow up with IHE Reps about Naming
Feb 16, 2022

Alex Goel, Rich Moldwin, Fred Marsh, Jeffery Karp, Peter Mello 

  • Have missed FMG approval and content review for May 2022 cycle all other milestones hit
    • Are appealing on FMG
  • IG Build has been updated to reflect most data types in IHE SDC 
    • Some new examples in the build
Appeal to FMG, update IG
Jan 5, 2022

Alex Goel, Fred Marsh, Rich Moldwin, Jeffery Karp, Eric Daley, Peter Mello, Maria Fodor, Caitlin Kennedy, Dave deRoode 

  • Added new examples
  • Need to push those examples to GitHub

Dec. 15, 2021

Alex Goel, Fred Marsh, Rich Moldwin, Jeffery Karp, Eric Daley, Jovanka Harrison 

  • Updated IG
  • Will need to start fixing qa errors
Fix QA errors
Dec 8, 2021Alex Goel, Maria Fodor, Fred Marsh, Rich Moldwin, Jeffery Karp
  • Added Section Observations 
  • Worked on how to structure identifiers for Observations
  • How to represent heavily nested questions
Update CI Build with changes to
Dec 1, 2021Alex Goel, Sandy Jones, Rich Moldwin, Maria Fodor
  • Testing as part of a MedMorph track
  • Alex and team to deploy an eCRNow App instance and use MedMorph Test data
  • Goal is to submit IHE SDC data in combination with MedMorph Cancer Data 
  • Can we generate an amount of fake data with synthea? 
    • Host that data on a test server
    • Then create fully fleshed out data bundles for cancer pathology data
    • Dynamically assemble data from the test patients into a bundle 
    • Test FHIR Path Queries

Nov 10, 2021

Alex Goel, Rich Moldwin, Maria Fodor, Alex Mays, Jennifer Mayo, Fred Marsh, Jeffery Karp, Eric Daley, Ross Simpson

  • Trying to work on capturing challenging questions such as tumor extent
  • There are some questions in SDC by not having <title> 
    • How do we represent this question if it were rendered as a single Observation?
    • What if it were rendered in a group?
    • IHE SDC forms may need to be adapted to include an <alttext> element on these blank <title> questions
    • Will need to QA the forms to check if there are any issues 
  • Observation.identifer should be mapped to SDC Answer instanceGUID

New Observation Maps:

Update reference implementation with new requirements
Nov 3, 2021

Alex Goel, Rich Moldwin, Maria Fodor, Alex Mays, Jennifer Mayo, Fred Marsh, Sandy Jones, Jeffery Karp

  • Have decided to update the multiselect question to be represent the Q/A pairs 
  • It is easier for implementers, and search
  • Problem with finding Observation’s grouped together
    • Must search for the diagnostic report
Request feedback from FHIR-I and O&O on management of complex Observation parent-child relationships
October 27, 2021

Alex Goel, Rich Moldwin, Maria Fodor, Alex Mays, Sandy Jones, May Terry, Greg Shemancik, Erin Berg, Sharon Sebastian, Rob Dingwell

  • Received co-sponsorship from FHIR-I 
  • Awaiting feedback from O&O 
  • Delayed until the May 2022 ballot. Will file NIB in February 2022
Participating in ballot reconciliation for Cancer Pathology Data Sharing
October 20, 2021Alex Goel, Fred Marsh, Rich Moldwin, Jeffery Karp, Maria Fodor
  • IHE SDC/eCC on FHIR going for NIB - delayed until May 2022
  • Added a table to SDC on FHIR
Participating in ballot reconciliation for Cancer Pathology Data Sharing
September 1, 2021

Alex Goel, Fred Marsh, Rich Moldwin, Peter Mello 

Special Guests: Greg Shamncik, Sharon Sebastian, Erin Berg

SDC Community Updates

  • FHIR Connectathon Sept 13-15

Cancer Pathology Data Sharing  

  • Reviewed Cancer Reporting IG ballot comment review
  • Have notes separately for review: Pasted below: 
  • Alex has submitted most comments on DiagnosticReport, Encounter, ServiceRequest, Procedure
  • Outstanding questions on DiagnosticReport, US Core Patient
  • Outstanding change requests on Specimen

Aug 25, 2021

Alex Goel, Maria Fodor, Sandy Jones, Fred Marsh, Rich Moldwin, Anil Mathur 

Special Guests: Jovanka Harrison

Reviewed Cancer Reporting IG ballot comment review


August 18, 2021

Alex Goel, Maria Fodor, Jeffery Karp, Richard Moldwin, Fred Marsh, Pete O’Toole, Eric Daley

Special Guests: Jovanka Harrison

Reviewed Cancer Reporting IG ballot comment review


August 4, 2021Alex Goel, Maria Fodor, Jeffery Karp, Richard Moldwin, Peter Mello, Fred Marsh, Sandy Jones

Reviewed SDC on FHIR IG, Cancer Reporting IG

  • Alex to add Observation profiles for each type of SDC data type

Notes on Cancer Pathology Data Sharing IG

  • Should ServiceRequest be included to cover the ORC segment?
    • The ordering facility name is required, but does not seem to be captured in the DiagnosticReport or other profile, such as MSH
    • Linking 2 related DiagnosticReports may require matching those DRs on basedOn, subject, encounter, and/or specimen elements 
    • ServiceRequest should be in the DiagnosticReport.basedOn
  • Specimen Reference in DiagnosticReport should be required
    • It was a mistake by not having it required in NAACCR Vol V
  • Should the category and code in DiagnosticReport be restricted to a smaller grouping of acceptable LOINC Codes (see Chap. 1 pg. 9 of NAACCR Vol V https://www.naaccr.org/wp-content/uploads/2020/07/NAACCR-Vol-V_Revised_20200720.pdf)
  • MessageHeader will need required contact information - check Vol V for what contact information is required from the Vol V MSH segment

July 28, 2021

Alex Goel, Maria Fodor, Jeffery Karp, Richard Moldwin

Special guests: Greg Shemancik, Michelle Casagni, Erin Berg, Robert Dingwell, Sharon Sebastian

SDC on FHIR and Cancer Data Pathology Sharing is being used in HIMSS in August

HIMSS Prep

  • Connectathon Review: 
    • Check whether we need the Specimen and other sections

June 16, 2021Alex Goel, Christa Wan, Peter Mello, Fred Marsh, Dave Jones, Jeffery Karp, Maria Fodor, Richard Moldwin

Connectathon Review: Check whether we need the Specimen and other sections


June 9, 2021Alex Goel, Christa Wan, Peter Mello, Ross Simpson, Richard Moldwin

Connectathon Review: Check whether we need the Specimen and other sections


May 26, 2021

Alex Goel, Fred Marsh, Rich Moldwin, Maria Fodor, David E. Jones, Sandy Jones, Wendy Blumenthal, Peter Mello, Jeffery Karp, Jenn Mayo 

Special Guests: Michelle Casagni, Greg Shemancik

Connectathon Review: Check whether we need the Specimen and other sections


May 12, 2021Alex Goel, Christa Wan, Fred Marsh, Rich Moldwin, Maria Fodor, David E. Jones, Jeffery Karp, Sandy Jones

https://drive.google.com/file/d/13AJa6H6B2MZG-kYWWBIiSX2PAlsk6H04/view?usp=sharing 

  • Connectathon Prep: 
    • Have to fix the parser’s reference and identifier structure
    • Updated IHE SDC on FHIR Parser to do DiagnosticReport
    • Have updated sample of Bundle 
    • Kick off call 12-1:30pm May 13th for Connectathon Track 

May 5, 2021Alex Goel, Christa Wan, Eric Daley, Fred Marsh, Rich Moldwin, Maria Fodor, David E. Jones, Dave deRoode, Sandy Jones, Jeffery Karp
April 28, 2021Alex Goel, Christa Wan, Peter Mello, Eric Daley, Fred Marsh, Jeffery Karp, Rich Moldwin, Dave Kwan, Maria Fodor, Dave DeRoode, Sandy Jones, Jenn Mayo

https://drive.google.com/file/d/13AJa6H6B2MZG-kYWWBIiSX2PAlsk6H04/view?usp=sharing 

  • Have started making a Message Bundle for NAACCR on FHIR
  • Terminology
    • FHIR Validation tool must be created to extract and validate correctly (check if report text is correctly rendered)
    • Custom validator to ensure sent report text is properly formatted and correct rather than the clinician display text
    • Rich is not in support of using any kind of FHIR ValueSet 
    • ValueSets offer the opportunity to check the content of the code - it is also better for balloting through HL7 
    • CAP will provide SDC mapping tables 
  • Connectathon Prep: 
    • Shared drive links with Dave deRoode to create Cancer Electronic pathology reporting scenario
    • MedMorph wants us to help notifications and subscriptions with triggers
      • Need to determine if this is worthwhile to spend time on 
      • Could support the Push workflow since that works with the kind of data we’re creating in SDC 
      • Trigger based on when the report is completed? - Plan Definition for this
    • NAACCR on FHIR
      • Continue mapping and do some testing with the parser 
      • Use parser to produce a bundle capable of testing the NAACCR on FHIR IG
      • Validation of Observations based on SDC format 
  • DiagnosticReport
    • Attach SDC form as piece of DiagnosticReport 
    • For validation and use

Review FHIR Bundle Structure 

  • Contain Section headers in the Observations 
    • Use hasMember and derivedFrom for all Obs 
    • Rebuilding the form based on the Observations 
    • Make a diagram 
    • Our stance is that US Core/USCDI does not clearly support Composition
      • Can’t represent that
      • Dangerous to break the SDC/eCC tree - clinically dangerous to skip what section the should be 
      • Need to give sections a type and code 
  • Use the text field and div for report text - human readable HTML summary
  • How do you validate everything inside of the Bundle? 
    • Profile? 
    • Custom validator? 
  • Encounter that we care about in the Pathology transmission is the one that generated the Pathology tissue sample
    • The Procedure: surgery, FNA, etc. 
  • ServiceRequest 
    • We only want the request for the pathology Procedure

  • No labels