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Short Description

This At-Home Result Report track is focused on testing the functionality of the draft At-Home Test FHIR Implementation Guide. The Implementation Guide focuses on transmitting At-Home Point-of-Care lab test results to local, state, territorial and federal health agencies. 

Long Description

This is the inaugural FHIR Connectathon track for this Implementation Guide. The workflow of communication of At-Home test results to state agencies was already tested using At-Home Test Apps and APIs but sending the data using V2 messages.

The goal is to test the same workflow mechanisms using the FHIR profiles designed in the guide. The Implementation Guide Framework for sending At-Home test results will be tested using At-Home Covid Test lab results within that framework.

The overall aspect of the IG and workflow that will be tested is to have 2 or more Apps negotiate relationships with a a single data hubs and then relay the test results to a federal and/or one or more state public health agencies test system.

Specifically:

  • 2 or more apps send a single message with fields sufficient for state-level reporting to the Hub. Then one of the following next steps;
    • The Hub relays one copy of the message to a state, and creates a copy of the message after removing Personal Identifiable Information (PII) that is then sent to federal systems.
    • The Hub relays one copy of the message to a state. The state then creates a copy of the message after removing PII that is then sent to federal systems.
  • An app creates two versions of a message, one that is necessary for state reporting, and another that is necessary for federal reporting. The Hub then relays the appropriate message to the appropriate destination.

Type

Test an Implementation Guide

Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group  

This track will be hosted by the At-Home Test Result Report Team in collaboration with the Orders and Observation Work Group and input from the Pubic Health work Group.

Track Lead(s)

Primary: Sarah Gaunt.

Gay Dolin, Matt Rahn

Track Lead Email(s)

sarah.gaunt@lantanagroup.com, gdolin@NamasteInformatics.com, matthew.rahn@hhs.gov

Related Tracks

None Noted (at this time)

FHIR Version

FHIR R4

Specification(s) this track uses

https://trifolia-fhir.lantanagroup.com/igs/lantana_hapi_r4/homeCovid/index.html

ToDo: Replace this with the version in the FHIR IG Template when available

Artifacts of focus

https://build.fhir.org/ig/HL7/home-lab-report/StructureDefinition-Observation-home-lab-test-result.html

https://build.fhir.org/ig/HL7/home-lab-report/StructureDefinition-DiagnosticReport-home-lab-results-covid.html

https://build.fhir.org/ig/HL7/home-lab-report/StructureDefinition-Observation-covid-related-symptoms-present.html

https://build.fhir.org/ig/HL7/home-lab-report/StructureDefinition-Observation-date-time-symptom-onset.html

Expected participants

Inferno

Representatives from:

  • Michigan State Health Department
  • Tennessee State Health Department

Zulip stream

https://chat.fhir.org/#narrow/stream/322481-At-Home-In-Vitro-Test-IG

Track Kick Off Call

Tuesday 4/26/22 - 2 - 3 pm ET

Meeting Slides: 

Meeting Recordings:

Track Details

System roles: 

At-Home Test Vendor application

Server acting as Public Health Agency system server

Generic FHIR Server with IG loaded

Scenarios

  • Patient performs At-Home Test
  • Patient either:
    • enters result of test into app
    • app is used to interpret result of test
  • Result is sent to app server
  • Result in FHIR Bundle is sent to health authority
  • Basic Level
    • Manually or use software to create a FHIR Bundle conformant to the IG
    • Validate FHIR Bundle either:
      • using Inferno validator tooling
      • manually with FHIR validator
  • Good
    • Use Postman to send FHIR Bundle to server
    • Use Postman to validate FHIR Bundle on server
    • Receive and validate Bundle in test software/server
  • Better
    • Use App Test Software to
      • create FHIR Bundle
      • validate FHIR Bundle
      • send FHIR Bundle to  FHIR test server
    • Use App Test Software to
      • create FHIR Bundle
      • validate FHIR Bundle
      • send FHIR Bundle to Inferno (test harness??) acting as Public Health system server
      • validate FHIR Bundle on Inferno acting as Public Health system server
  • Best
    • Use App Test Software to send and validate  to Public Health system server
    • Public Health system server validates

Track Agenda

  • Day 1
    • Track Logistics (Sarah, others?)
    • Introduction to Track Leads
    • Introduction
      • Introduction to project (Matt?, Gay?)
      • Previous work (V2 etc?) (Matt?, Gay?)
      • Track Purpose and Goals
    • IG walk through (Sarah)
    • Testing Scenarios (Sarah, others?)
    • Independent testing. Support will be available on Zoom. Breakouts as needed
    • 1pm– 2pm: Track Kick-Off
    • 2pm – 4pm: Testing
    • 4pm – 5pm: Issues, questions, plans for Day 2
  • Day 2
    • Independent testing. Support will be available on Zoom. Breakouts as needed
    • Discuss what accomplishments, issues & next steps we want to highlight in our report-out
    • 1pm– 1:30pm: Day 2 Check in
    • 1:30pm – 3:30pm: Testing
    • 3:30pm – 4pm: Issues, questions
    • 4pm – 5pm: Track final discussion/report-out planning/report-out

FHIR Validation

Instructions on how to use the FHIR Validator to validate XML instances against the At-Home In-Vitro Test IG.

Downloads and General Instructions

Relevant Parameters

Current version of the At-Home In-Vitro Test IG

 -ig hl7.fhir.us.home-lab-report#current

Version 4.0.1 of FHIR

-version 4.0.1

(Optional - send validation output to a file)

-output <filename.xml>

Examples

Example 1 - no validation output file:

java -jar validator_cli.jar "input\resources\bundle\bundle-at-home-in-vitro-test-results-p-noelle.xml" -version 4.0.1 -ig hl7.fhir.us.home-lab-report#current

Example 2 - with validation output sent to file

java -jar validator_cli.jar "input\resources\bundle\bundle-at-home-in-vitro-test-results-p-noelle.xml" -version 4.0.1 -ig hl7.fhir.us.home-lab-report#current -output validation.xml

Example Validation Output

validation.xml