Sam's FHIR journey

This exercise will help you practice your FHIR skills by having you create resources that follow our Sam Fhirman's small journey through the healthcare system.

Step 1: Exercise description

Step 2: Create a ValueSet

Step 3: Perform an $expand on your ValueSet

Step 4: Create a ConceptMap mapping

Step 5: Perform a $translate on your ConceptMap

Step 1: Exercise description

Sam, our Patient with a known allergy (AllergyIntolerance) has an Appointment at a hospital (Organization) which results in a hospital Encounter. The doctor (Practitioner), who previously recorded Sams allergy, examines Sam and notices an allergy to fish, so he orders a test to be done (ProcedureRequest) at the pathology lab (Organization). The hospitals system tracks this request using a Task, so the doctor can check the task at any time to see if there's been any progress made. When the pathology lab performs its analysis, it records 'Hemoglobin' result as an Observation in its 'Complete blood count' DiagnosticReport which is send to the FHIR server of the hospital. The pathology lab system updates the Task with the DiagnosticReport and notifies the doctor that results are available.

Ok, so maybe this doctor and pathology lab have no idea about healthcare, a 'Complete blood count' with only a single 'Hemoglobin' result for a Fish allergy. Sounds very fishy to me!

We need you to model this scenario as FHIR resources. You will need to create a Patient, AllergyIntolerance, Appointment, Encounter, Practitioner, ProcedureRequest, Task, DiagnosticReport, Observation, and two Organization resources and have them reference each other appropriately. Try working as a group to split the load, or just work through the resources one by one together!

See diagram below for how the resources could be setup:

Exercise answer

The answer with all resources included is available here (right-click and use 'Save as'). As this example is a FHIR transaction bundle, you can also just POST it to a FHIR servers endpoint and have all of the resources created for you on the server. But that would be cheating!

Answer is also available for viewing below:

<Bundle xmlns='http://hl7.org/fhir'>
  <type value='transaction'/>
  <entry>
    <fullUrl value='Patient/patient'/>
    <resource>
      <Patient xmlns='http://hl7.org/fhir'>
        <id value='patient'/>
        <text>
          <status value='generated'/>
          <div xmlns='http://www.w3.org/1999/xhtml'>
            <p>Patient: Fhirman, Sam</p>
          </div>
        </text>
        <identifier>
          <type>
            <coding>
              <system value='http://hl7.org/fhir/v2/0203'/>
              <code value='NI'/>
              <display value='National unique individual identifier'/>
            </coding>
            <text value='IHI'/>
          </type>
          <system value='http://ns.electronichealth.net.au/id/hi/ihi/1.0'/>
          <value value='8003608166690503'/>
        </identifier>
        <identifier>
          <use value='usual'/>
          <type>
            <coding>
              <system value='http://hl7.org/fhir/v2/0203'/>
              <code value='MR'/>
            </coding>
          </type>
          <system value='urn:oid:1.2.36.146.595.217.0.1'/>
          <value value='6666'/>
          <period>
            <start value='2001-05-06'/>
          </period>
          <assigner>
            <display value='Acme Healthcare'/>
          </assigner>
        </identifier>
        <name>
          <use value='official'/>
          <text value='Sam Fhirman'/>
          <family value='Fhirman'/>
          <given value='Sam'/>
          <prefix value='Mr'/>
        </name>
        <telecom>
          <system value='phone'/>
          <value value='+61481059995'/>
          <use value='mobile'/>
        </telecom>
        <gender value='male'/>
        <birthDate value='1973-09-30'/>
        <address>
          <use value='work'/>
          <line value='400 George Street'/>
          <city value='Brisbane'/>
          <state value='QLD'/>
          <postalCode value='4000'/>
          <country value='AUS'/>
        </address>
        <maritalStatus>
          <coding>
            <system value='http://hl7.org/fhir/v3/MaritalStatus'/>
            <code value='M'/>
            <display value='Married'/>
          </coding>
        </maritalStatus>
      </Patient>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Patient/patient'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='AllergyIntolerance/allergyintolerance'/>
    <resource>
      <AllergyIntolerance xmlns='http://hl7.org/fhir'>
        <id value='allergyintolerance'/>
        <status value='active'/>
        <type value='allergy'/>
        <criticality value='high'/>
        <code>
          <coding>
            <system value='http://snomed.info/sct'/>
            <code value='227037002'/>
            <display value='Fish - dietary (substance)'/>
          </coding>
        </code>
        <patient>
          <reference value='Patient/patient'/>
        </patient>
        <recorder>
          <reference value='Practitioner/practitioner'/>
        </recorder>
      </AllergyIntolerance>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='AllergyIntolerance/allergyintolerance'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Appointment/appointment'/>
    <resource>
      <Appointment xmlns='http://hl7.org/fhir'>
        <id value='appointment'/>
        <status value='fulfilled'/>
        <reason>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/encounter-reason'/>
            <code value='274640006'/>
            <display value='Fever with chills (finding)'/>
          </coding>
        </reason>
        <description value='Mr Fhirman has been experiencing an very high temperature for two days and his wife insisted that he make an appointment.'/>
        <start value='2016-10-31T08:00:00+10:00'/>
        <end value='2016-10-31T08:30:00+10:00'/>
        <participant>
          <actor>
            <reference value='Patient/patient'/>
          </actor>
          <status value='accepted'/>
        </participant>
      </Appointment>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Appointment/appointment'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Encounter/encounter'/>
    <resource>
      <Encounter xmlns='http://hl7.org/fhir'>
        <id value='encounter'/>
        <status value='finished'/>
        <class>
          <system value='http://hl7.org/fhir/ValueSet/v3-ActEncounterCode'/>
          <code value='NONAC'/>
          <display value='inpatient non-acute'/>
        </class>
        <priority>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/v3-ActPriority'/>
            <code value='R'/>
            <display value='routine'/>
          </coding>
        </priority>
        <subject>
          <reference value='Patient/patient'/>
        </subject>
        <participant>
          <type>
            <coding>
              <system value='http://hl7.org/fhir/ValueSet/encounter-participant-type'/>
              <code value='PPRF'/>
              <display value='primary performer'/>
            </coding>
          </type>
          <individual>
            <reference value='Practitioner/practitioner'/>
          </individual>
        </participant>
        <appointment>
          <reference value='Appointment/appointment'/>
        </appointment>
        <period>
          <start value='2016-10-31T08:07:00+10:00'/>
          <end value='2016-10-31T08:28:00+10:00'/>
        </period>
        <reason>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/encounter-reason'/>
            <code value='274640006'/>
            <display value='Fever with chills (finding)'/>
          </coding>
        </reason>
        <serviceProvider>
          <reference value='Organization/hospital-organization'/>
        </serviceProvider>
      </Encounter>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Encounter/encounter'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Practitioner/practitioner'/>
    <resource>
      <Practitioner xmlns='http://hl7.org/fhir'>
        <id value='practitioner'/>
        <name>
          <family value='Junior'/>
          <given value='Peter'/>
          <prefix value='Dr.'/>
        </name>
        <gender value='male'/>
        <role>
          <organization>
            <reference value='Organization/hospital-organization'/>
          </organization>
        </role>
      </Practitioner>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Practitioner/practitioner'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='ProcedureRequest/procedurecrequest'/>
    <resource>
      <ProcedureRequest xmlns='http://hl7.org/fhir'>
        <id value='procedurerequest'/>
        <status value='completed'/>
        <code>
          <coding>
            <system value='http://snomed.info/sct'/>
            <code value='26604007'/>
            <display value='Complete blood count'/>
          </coding>
        </code>
        <subject>
          <reference value='Patient/patient'/>
        </subject>
        <context>
          <reference value='Encounter/encounter'/>
        </context>
        <authoredOn value='2016-10-31T08:25:00+10:00'/>
        <requester>
            <agent>
                <reference value='Practitioner/practitioner'/>
            </agent>
        </requester>
        <performer>
          <reference value='Organization/pathlab'/>
        </performer>
      </ProcedureRequest>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='ProcedureRequest/procedurerequest'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Task/task'/>
    <resource>
      <Task xmlns='http://hl7.org/fhir'>
        <id value='task'/>
        <identifier>
          <use value='official'/>
          <system value='urn:ietf:rfc:3986'/>
          <value value='http://example.com/fhir/Task/163412'/>
        </identifier>
        <status value='completed'/>
        <stage>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/task-stage'/>
            <code value='actionable'/>
            <display value='actionable'/>
          </coding>
        </stage>
        <priority value='normal'/>
        <created value='2016-10-31T08:25:05+10:00'/>
        <lastModified value='2016-10-31T09:45:05+10:00'/>
        <requester>
          <reference value='Practitioner/practitioner'/>
        </requester>
        <input>
          <type>
            <coding>
              <system value='http://example.com/fhir/Task/progress-status-tracker'/>
              <code value='input'/>
              <display value='Input'/>
            </coding>
          </type>
          <valueReference>
            <reference value='ProcedureRequest/procedurerequest'/>
          </valueReference>
        </input>
        <output>
          <type>
            <coding>
              <system value='http://example.com/fhir/Task/progress-status-tracker'/>
              <code value='output'/>
              <display value='Output'/>
            </coding>
          </type>
          <valueReference>
            <reference value='DiagnosticReport/diagnosticreport'/>
          </valueReference>
        </output>
      </Task>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Task/task'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='DiagnosticReport/diagnosticreport'/>
    <resource>
      <DiagnosticReport xmlns='http://hl7.org/fhir'>
        <id value='diagnosticreport'/>
        <status value='final'/>
        <code>
          <coding>
            <system value='http://snomed.info/sct'/>
            <code value='26604007'/>
            <display value='Complete blood count'/>
          </coding>
        </code>
        <subject>
          <reference value='Patient/patient'/>
        </subject>
        <effectiveDateTime value='2016-10-31T09:35:00+10:00'/>
        <issued value='2016-10-31T09:45:00+10:00'/>
        <performer>
          <reference value='Organization/pathlab'/>
        </performer>
        <request>
          <reference value='ProcedureRequest/procedurerequest'/>
        </request>
        <result>
          <reference value='Observation/path-lab-observation'/>
        </result>
      </DiagnosticReport>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='DiagnosticReport/diagnosticreport'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Observation/path-lab-observation'/>
    <resource>
      <Observation xmlns='http://hl7.org/fhir'>
        <id value='path-lab-observation'/>
        <status value='final'/>
        <category>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/observation-category'/>
            <code value='laboratory'/>
            <display value='Laboratory'/>
          </coding>
        </category>
        <code>
          <coding>
            <system value='http://snomed.info/sct'/>
            <code value='26604007'/>
            <display value='Complete blood count'/>
          </coding>
        </code>
        <subject>
          <reference value='Patient/patient'/>
        </subject>
        <effectiveDateTime value='2016-10-31T09:35:00+10:00'/>
      </Observation>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Observation/path-lab-observation'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Organization/hospital-organization'/>
    <resource>
      <Organization xmlns='http://hl7.org/fhir'>
        <id value='hospital-organization'/>
        <type>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/organization-type'/>
            <code value='dept'/>
            <display value='Hospital Department'/>
          </coding>
        </type>
        <name value='Sample Hospital'/>
        <telecom>
          <system value='email'/>
          <value value='os@hospital.com.au'/>
        </telecom>
        <address>
          <line value='67 Hospital Drive'/>
          <city value='Agencyville'/>
          <state value='QLD'/>
          <postalCode value='5555'/>
          <country value='Australia'/>
        </address>
      </Organization>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Organization/hospital-organization'/>
    </request>
  </entry>
  <entry>
    <fullUrl value='Organization/pathlab'/>
    <resource>
      <Organization xmlns='http://hl7.org/fhir'>
        <id value='pathlab'/>
        <type>
          <coding>
            <system value='http://hl7.org/fhir/ValueSet/organization-type'/>
            <code value='prov'/>
            <display value='Healthcare Provider'/>
          </coding>
        </type>
        <name value='Pathology Laboratory'/>
        <telecom>
          <system value='email'/>
          <value value='pathstuff@example.com'/>
        </telecom>
        <address>
          <line value='67 Hospital Drive'/>
          <city value='Agencyville'/>
          <state value='QLD'/>
          <postalCode value='5555'/>
          <country value='Agencyville'/>
        </address>
      </Organization>
    </resource>
    <request>
      <method value='PUT'/>
      <url value='Organization/pathlab'/>
    </request>
  </entry>
</Bundle>

That's it for this exercise!

Sam's FHIR journey

Contents

Step 1: Exercise description

Exercise answer