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View Code? Open in Web Editor NEWFHIR® Implementation Guide for the Electronic Laboratory Report of the Swiss Federal Office of Public Health
FHIR® Implementation Guide for the Electronic Laboratory Report of the Swiss Federal Office of Public Health
Change status of IG from Draft to Release for version 1.2.0
ch.fhir.ig.ch-elm#1.0.0 /StructureDefinition-ch-elm-document.html
Change minimal cardinality for Practitioner from 1..1 to 0..1
Franz Auf der Maur, BAG
will be managed by FOPH to check speciment code if it sent but not requried
Invalid GLN or social security should not give an error and should pass validation.
This error comes from CH Core, will be fixed with in hl7ch/ch-core#257
Bundle.entry[3].resource: Constraint failed: ch-elm-patient-name-representation-initial-snomedct: 'If Observation.code is a mapped to initials in http://fhir.ch/ig/ch-elm/ConceptMap/ch-elm-results-to-foph-patient-name-representation then patient.name.first and given can must have one character' (defined in http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory-strict)
example has a full name and should not fail
ch.fhir.ig.ch-elm#1.0.0 /
Some general feedback from Epic:
-The specification is clearly written. The definition of MustSupport is excellent - refreshingly simple to understand compared to many other implementation guides. We're also interested to see the use of imposeProfile, as this is a relatively new concept and few other implementation guides use it yet.
-The main concern we have is with complexity, and therefore difficulty of implementation.
For example:
-Varying name format by organism type.
-This is rare in a FHIR specification, and will require work from vendors and/or
laboratory organizations to develop.
-In some cases in other countries, we've seen the use of a centralized middleware
layer to do some translation instead of having every implementer maintain this logic,
allowing implementers to use standard FHIR profiles.
-Varying codeset by diagnosis.
-This is complex and potentially requires workflow updates to ensure laboratory
users document the required information.
-Could this information be sent as a standard DiagnosticReport (like the example of a
microbiology report at https://hl7.org/fhir/STU3/diagnosticreport-micro1.json.html,
or using the microbiology format with methods outlined in Epic's documentation at
https://fhir.epic.com/Specifications?api=998?)
-FHIR is seeing global success due to its implementation of REST with standard and reuseable healthcare resources and OAuth. This spec is trialing FHIR documents with bespoke FHIR resources using mTLS instead of OAuth. What's the reason for doing that, rather than using what has been successful elsewhere?
Katie Reynolds, Epic
there are two different validation approaches for ch-elm.
the regular validation checks that the message is correct but it allows that in case of a new infectious diseases a new message could be added and still pass through validation. in addition some business rules are not enforced.
the strict validation checks that all the message conforms to the published implementation guide, e.g a new infectious diseases code will throw an error in validation.
recommendation: check during implementation that your implementation is conforming to the strict version, test in production regular validation.
canonical url's for validation:
ch.fhir.ig.ch-elm#1.0.0-trialuse /profiles.html
Weekly vom 2.10: It would be nice to have the cardinalities (0..1), (0..*) etc defined in the overview for the link Fig. 6: Resource Overview, ahdis will add this to next version of the ig
Oliver Egger, ahdis
ch.fhir.ig.ch-elm#1.0.0-trialuse /StructureDefinition-ch-elm-patient.html
FHIR element patient.gender should be 1..1 (required)
Franz Auf der Maur, BAG
ch.chmed.emediplan#3.0.0-ci-build /
test
Michaela Ziegler, ahdis ag
ch.fhir.ig.ch-elm#1.0.0-trialuse /api.html
Aber ich fände es auch schön, im Sequenzdiagramm klar zu zeigen, dass die Einlieferung und das Pollen zwei unterschiedliche Requests sind. Das sieht man im Ersten nicht bildlich heraus, sondern muss den Text lesen.
Feedback BAG
Oliver Egger, ahdis ag
FullUrl wird in Bundles gesetzt, um die einzelnen Ressourcen miteinander zu verlinken, es gibt zwei Arten wie fullUrl's angebeben werden können:
Je nachdem wie man die fullUrl setzt müssen dann die Referenzen entsprechend angegeben werden, siehe exakte Beschreibung hier:
https://build.fhir.org/bundle.html#references
in Kurzform: "subject" : { "reference" : "Patient/1Pat-DM" } in der Composition wird dann aufgelöst im Bundle mit fullUrl http://test.fhir.ch/r4/Patient/1Pat-DM
bei einer uuid wäre es dann "subject" : { "reference" : "urn:uuid:9616e879-c4d0-411e-88c3-e001cb7a8fcd"} in der Composition wird dann aufgelöst im Bundle mit fullUrl "urn:uuid:9616e879-c4d0-411e-88c3-e001cb7a8fcd"
Für Specimen.type wird das BAG ein ValueSet zu Verfügung stellen
Modulo 11 verfahren
If we test the ConceptMap CH ELM Expecting Specimen Specification To Results Completion Vs and intentionally send a specimen code that is not allowed per valueset ("geni_spec"), then the document is correctly rejected, but the error message is misleading ('Must have a resolvable URL conforming to the CH-ELM Bundle.') and says nothing about the actual problem why it is not conform.
the invariant itself is not sufficient to get the failing validation information and we should make it more explicit with introducing slice constraint:
https://fhir.ch/ig/ch-elm/StructureDefinition-PublishDocumentReference.html
add slice for min 1 contained resource Bundle with profile http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document
https://fhir.ch/ig/ch-elm/StructureDefinition-PublishDocumentReferenceStrict.html
constrain slice above for min 1 contained resource Bundle with profile http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document-strict
we could simplify then also the constraint that is only checks that url resolves and remove the conformsTo
as soon as the igs where we are depending on are published, change the version to a fix one (not current):
Meeting 01.11.2023:
Maximumkardinalitäten einschränken bei definierten, verwendeten Elementen; bspw. AHV-Nummer Pat. (so dass nicht mehrere Angaben gemacht werden können und nicht differenziert werden kann, welcher Eintrag genommen werden soll)
ch.fhir.ig.ch-elm#1.0.0-trialuse /
Turtle als Austauschformat für Beispiele / Profile entfernen
Diskussion Telco 3.10.2013
Oliver Egger, ahdis ag
ch.fhir.ig.ch-elm#1.0.1 /
integration of a new concept map defining a valueset of valid interpretation-codes for each observation.code (leading code)
Franz Auf der Maur BAG
attachment.url points to the containted bundle, however it is not checked if the contained bundle is conforming to ch-elm-document requirements
ch.fhir.ig.ch-elm#0.1.0 /
Test2
oliver
update description to be conform to those of the FOPH:
CodeSystem-ch-elm-foph-patient-name-representation.json
This CH ELM resource defines the codes which identify possible patient name schemas to be used.
ValueSet-ch-elm-foph-patient-name-representation.json
This CH ELM resource defines the codes which identify possible patient name schemas to be used.
Meeting 14.11.2023:
Wir sehen 4 Datentypen vor:
String-100
String-50
String-25
String-10
FHIR-Element | String-MAX |
---|---|
patient.name.family | 100 |
patient.name.given | 100 |
patient.phone | 25 |
patient.address.streetName | 100 |
patient.address.houseNumber | 10 |
patient.address.city | 50 |
patient.address.state | ? korrekte Angabe durch Bindung an ISO-Code gewährleitet ? falls ja: keine String-Begrenzung nötig |
patient.address.postalCode | 10 |
patient.address.country | ? korrekte Angabe durch Bindung an ISO-Code gewährleitet ? falls ja: keine String-Begrenzung nötig |
Lab.OrganizationName | 100 |
ServiceRequest.Identifier.Value | 100 |
Orderer.OrganizationName | 100 |
Orderer.OrganizationDepartment | 100 |
Orderer.Practitioner.Name.Family | 100 |
Orderer.Practitioner.Name.Given | 100 |
Orderer.practitioner.phone | 25 |
Orderer.practitioner.email | 50 |
Bei String-Elementen, wo ein Coding/System dahintersteht wie z.B. bei GLN, AHV-Nummer oder ISO-Country Code sehe ich eine String-Begrenzung als nicht erforderlich, weil die korrekte Angabe durch das dahinterliegende System/Regel geprüft wird.
ch.fhir.ig.ch-elm#1.0.0 /api.html
Release 4 of the HL7® FHIR® standard.
Link the correct Release: https://hl7.org/fhir/r4/index.html
Michaela Ziegler, ahdis ag
We do not except (and actually discourage) that source systems send the meta.profile in the instances.
However the example bundles show for each resource according to which profile they are valid.
We should remove them, it should. be confiugrable in sushi, see https://chat.fhir.org/#narrow/stream/179252-IG-creation/topic/Examples.20shouldn't.20have.20meta.2Eprofile.2C.20text
Chlamydia trachomatis: https://fhir.ch/ig/ch-elm/guidance.html#collection-material
Eine Änderung am bestehenden Leitfaden hat sich im Zusammenhang mit der Patient-Identifikator für Fürstentum Liechtenstein ergeben (patient.identifier:oasi-li). Wir hatten bis anhing die FL-Version der AHV Nummer als System hinterlegt. Dieses fällt weg und wird ersetzt durch die ID-N Nummer des Fürstentums Liechtenstein. Die OID der ID-N Nummer ist 2.16.438.10.20.10.10.1.2.1.
Die ID-N Nummer (ID für natürliche Personen) ist eine 13-stellige Zahl OHNE Prüfziffer. Sie wird im Gesundheitsbereich des FL breit eingesetzt.
Separates Tab mit CS/VS (error code and description as text)
Meeting 01.11.2023:
Address.line explizit spezifizieren (Profil):
Beispiele entsprechend anpassen.
Add simplified graphics to guidance to support the description about the ConceptMap mechanism
Meeting 21.03. mit BAG
ConceptMap die Zusatzmaterial verlangt -> BAG-seitige Änderung wird noch erfolgen
TODO: Alle Terminologie-Instanzen updaten bevor der Publikation
We always need a postcode (address.postalCode) and the city (address.city) from the client, regardless of whether the postcode and city come from the practitioner or the organisation. Can a rule be defined that ensures that we always receive a postcode and a city, regardless of whether it comes from the practitioner or the organisation?
Important: If city and postalCode are included in one of the two resources, they may be missing in the other resource.
If only the Practitioner is listed, address.city and address.postalCode must be filled in
If only the organisation is listed, address.city and address.postalCode must be filled in
If both resources are listed, address.city and address.postalCode must be completed in one of them (regardless of which one)
If city and postalCode are filled in both, this is ok.
ch.fhir.ig.ch-elm#1.0.1 /Bundle-1bDoc-NeisseriaGonorrhoeae.json.html
Example has reference to Specimen/1Spec-Specimen which is not included in the bundle. Should those point to Specimen/1bSpec-Specimen?
Oliver Egger, ahdis ag
ch.fhir.ig.ch-elm#1.0.0-trialuse /ValueSet-ch-elm-lab-specimen-types-chlamydia-trachomatis.html
Der Name/URL und allenfalls der Inhalt (?) muss angepasst werden, da das VS Werte von der Gruppe "geni-spec" enthält und nicht Erregerspezifisch ist.
Michaela Ziegler, ahdis ag
ch.fhir.ig.ch-elm#1.0.0 /StructureDefinition-ch-elm-organization-orderer.html
die auftraggebende Organisation muss künftig via BUR und/oder UID identifiziert werden. BUR und UID sollen Kardinalität 0..1 erhalten. GLN auf 0..1 belassen. Die ZSR brauchen wir nicht.
Franz BAG
ch.fhir.ig.ch-elm#1.0.1 /
test
test
ch.fhir.ig.ch-elm#1.0.0-ci-build /StructureDefinition-ch-elm-patient.html
country MS 0..1
country.extension:countrycode 1..1
Michaela Ziegler, ahdis ag
As decided in the EU LAB meeting from 13.10.23 the DiagnosticReport.identifier will be required if the Composition.identifier is required, and it should be the same. Because we are in the document context for CH ELM the Composition.identifier is required, so we have to require the DiagnosticReport.identifier aswell.
See also hl7ch/ch-lab-report#52
16.02.2024: checked with the current builds of EU LAB and CH LAB-Report (and CH Core) -> no conflicts with EU LAB
Meeting 21.03. mit BAG
Neue Regel für gewisse LOINC codes bezüglich Patientenname -> Infos folgen BAG-seitig
https://build.fhir.org/ig/ahdis/ch-elm/guidance.html#personal-data-patient-name
ch.fhir.ig.ch-elm#1.0.0 /Patient-Pat-AntoineDupont.json.html
The examples should have the adress.line also specified (in this example: Rue de la république 18"), even the IG requires in addtiiton the extension streetLine and streetNumber.
Oliver Egger, ahdis ag
https://fhir.ch/ig/ch-elm/guidance.html#collection-material
In all other cases, the Specimen.type has to be defined as fixed text: “Material declared by LOINC system axis”.
ch.fhir.ig.ch-elm#1.0.0-ci-build /ValueSet-ch-elm-lab-specimen-types.html
Je nach ValueSet Mechanismus braucht es dieses VS nicht mehr.
Michaela Ziegler, ahdis ag
Wenn der Antrag auf die Reduktion der Minimumkardinalität von Specimen.type im Ballot von EU LAB angenommen wird, könnte das in CH ELM analog angepasst werden und der "fixedValue" für Specimen.type.text wäre nicht mehr notwendig.
Meeting 01.11.2023:
Allfällige Möglichkeit zur Dokumentation der Meldezeiten im IG:
we would like to search the ig by site.
this is not supported directly with the IG Publisher. we could adapt however the Swiss IG Template that a search box can be added to an external search engine with the url "fhir.ch" and searching that the ig name is within the site parameter.
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