SHR Functional Specification discussion

Brian_Armstrong · September 16, 2016, 11:38am

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

Carl_Fourie1 · September 16, 2016, 12:38pm

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

···

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Brian_Armstrong · September 16, 2016, 12:58pm

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

···

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Carl_Leitner1 · September 16, 2016, 1:18pm

Hi all,

Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.
For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.
As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

···

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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ryan · September 21, 2016, 8:22am

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

···

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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ryan · September 21, 2016, 8:37am

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

···

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Carl_Fourie1 · September 21, 2016, 9:28am

Hi Carl L and Ryan

Great points and thank you for the input. I think the question around FHIR is exactly the question that we need ot start looking at as the community. As Carl L is pointing out there are emerging implementations and implementers that are looking at FHIR as an option. the current SHR requirements document that Brian has pulled together has been to “heard the cats” (so to say) of the years of hearsay and documents that the SHR community has to create a single point of truth that has context of what the component (SHR) is expected to do but also references and is driven from what the broader OHIE Architecture has defined as the “approved” workflows.

Shortly put: Think FHIR could be a good idea for the SHR to add as optional requirements. However we’d need to tie these back to architecture use cases and agreement that OHIE sees SHR as a standard that it supports for workflows.

Thoughts about this?

···

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,
Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

Regards
Carl Fourie
Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

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On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Brian_Armstrong · September 21, 2016, 11:26am

Hi Carl L,

Thank you for review and sharing. What we tried to do with the SHR Spec was to capture the context from the community about what the current state of thinking was around the SHR and its workflows, interactions and requirements were, including standards.

I agree that we need to start capturing how FHIR influences these, but maybe we need to think about capturing these additions/maturations in a discussion document and then merge these into a version 2 of the SHR Spec.

The problem with trying to design a full specification after the fact (e.g. after development and implementations have occurred) is that the goal posts present a moving target, making it difficult to achieve consensus on a cohesive vision. Getting to a Spec that doesn’t change will also be likewise difficult, and so perhaps we can achieve consensus through a roadmap for the SHR Spec where we will see inclusion of FHIR and other enhancements.

I would personally would like to see some of the work you and others are doing added to the Guidebook, as I think this is where we will see full realization of the SHR Spec within the implementation of OHIE.

Thoughts?

Cheers, Brian

···

On Fri, Sep 16, 2016 at 9:18 AM, Carl Leitner litlfred@gmail.com wrote:

Hi all,
Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

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Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Brian_Armstrong · September 21, 2016, 11:34am

Hi Ryan,

Perhaps what we need is to design a Roadmap for the development of the SHR Spec beyond this version 1.0, where we see inclusion of FHIR and other determine what parts of IHE IPs can be replaced. Since FHIR is still in development and not fully fleshed out, we have to ensure that we don’t leave the existing implementations of the SHR or the IL in limbo.

There are many efforts underway in many countries to utilize OHIE and its components (e.g. CR, FR, SHR, etc.) and we need to make sure that we are documenting the Spec in such a way that though it is forward looking, that it is also backwards compatible.

I think a Roadmap would be perfect for planning and tracking the progression and maturing of the Spec to document additions/changes/deprecations, including the addition of FHIR.

Thoughts?

Cheers, Brian

···

On Wed, Sep 21, 2016 at 4:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,
Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Carl_Leitner1 · September 21, 2016, 12:51pm

Hi,

Whatever we do with FHIR with regards to clinical information, I do think we should retain the current SHR workflows - it was not my intention to suggest that we replace them.

What we ran into is that making DHIS2 into an XDS repository just didn’t really make sense for variety of reasons, at least as a first step. The vision is to use FHIR as sort of an abstraction layer to access the clinical data. It will be interesting to see if IHE takes on a work item such as incorporating FHIR into ODD and/or mapping specific FHIR resources into CDA content profiles.

Cheers,

-carl

···

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,
Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards
Brian Armstrong
Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

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E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

Regards
Carl Fourie
Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards
Brian Armstrong
Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Mead_Walker · September 21, 2016, 1:29pm

Hi,

I have not been active here for a while, but I am active in HL7, and around a lot of FHIR talk. Are you interested in trying to get additional support from FHIR developers to address possible uses within the SHR?

Mead Walker

···

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Carl Leitner
Sent: Wednesday, September 21, 2016 8:52 AM
To: Carl Fourie carl@jembi.org
Cc: Ryan Crichton ryan@jembi.org; Brian Armstrong brian.armstrong@jembi.org; Shared Health Record (OpenHIE) openhie-shr@googlegroups.com
Subject: Re: SHR Functional Specification discussion

Hi,

Whatever we do with FHIR with regards to clinical information, I do think we should retain the current SHR workflows - it was not my intention to suggest that we replace them.

What we ran into is that making DHIS2 into an XDS repository just didn’t really make sense for variety of reasons, at least as a first step. The vision is to use FHIR as sort of an abstraction layer to access the clinical data. It will be interesting to see if IHE takes on a work item such as incorporating FHIR into ODD and/or mapping specific FHIR resources into CDA content profiles.

Cheers,

-carl

On Sep 21, 2016, at 5:28 AM, Carl Fourie carl@jembi.org wrote:

Hi Carl L and Ryan

Great points and thank you for the input. I think the question around FHIR is exactly the question that we need ot start looking at as the community. As Carl L is pointing out there are emerging implementations and implementers that are looking at FHIR as an option. the current SHR requirements document that Brian has pulled together has been to “heard the cats” (so to say) of the years of hearsay and documents that the SHR community has to create a single point of truth that has context of what the component (SHR) is expected to do but also references and is driven from what the broader OHIE Architecture has defined as the “approved” workflows.

Shortly put: Think FHIR could be a good idea for the SHR to add as optional requirements. However we’d need to tie these back to architecture use cases and agreement that OHIE sees SHR as a standard that it supports for workflows.

Thoughts about this?

Regards
Carl Fourie

Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,

Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards

Brian Armstrong

Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards

Brian Armstrong*

Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

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dritz · September 21, 2016, 2:07pm

Hi Mead – what a great idea. I think that would be a real benefit to us as we explore FHIR and how we’ll include it in our plans. Thanks for the offer.

Warmest regards,

Derek.

Derek Ritz, P.Eng., CPHIMS-CA

ecGroup Inc.

+1 (905) 515-0045

This communication is intended only for the party to whom it is addressed, and may contain information which is privileged or confidential. Any other delivery, distribution, copying or disclosure is strictly prohibited and is not a waiver of privilege or confidentiality.

···

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Mead Walker
Sent: Wednesday, September 21, 2016 9:29 PM
To: ‘Carl Leitner’; ‘Carl Fourie’
Cc: ‘Ryan Crichton’; ‘Brian Armstrong’; ‘Shared Health Record (OpenHIE)’
Subject: RE: SHR Functional Specification discussion

Hi,

I have not been active here for a while, but I am active in HL7, and around a lot of FHIR talk. Are you interested in trying to get additional support from FHIR developers to address possible uses within the SHR?

Mead Walker

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Carl Leitner
Sent: Wednesday, September 21, 2016 8:52 AM
To: Carl Fourie carl@jembi.org
Cc: Ryan Crichton ryan@jembi.org; Brian Armstrong brian.armstrong@jembi.org; Shared Health Record (OpenHIE) openhie-shr@googlegroups.com
Subject: Re: SHR Functional Specification discussion

Hi,

Whatever we do with FHIR with regards to clinical information, I do think we should retain the current SHR workflows - it was not my intention to suggest that we replace them.

What we ran into is that making DHIS2 into an XDS repository just didn’t really make sense for variety of reasons, at least as a first step. The vision is to use FHIR as sort of an abstraction layer to access the clinical data. It will be interesting to see if IHE takes on a work item such as incorporating FHIR into ODD and/or mapping specific FHIR resources into CDA content profiles.

Cheers,

-carl

On Sep 21, 2016, at 5:28 AM, Carl Fourie carl@jembi.org wrote:

Hi Carl L and Ryan

Great points and thank you for the input. I think the question around FHIR is exactly the question that we need ot start looking at as the community. As Carl L is pointing out there are emerging implementations and implementers that are looking at FHIR as an option. the current SHR requirements document that Brian has pulled together has been to “heard the cats” (so to say) of the years of hearsay and documents that the SHR community has to create a single point of truth that has context of what the component (SHR) is expected to do but also references and is driven from what the broader OHIE Architecture has defined as the “approved” workflows.

Shortly put: Think FHIR could be a good idea for the SHR to add as optional requirements. However we’d need to tie these back to architecture use cases and agreement that OHIE sees SHR as a standard that it supports for workflows.

Thoughts about this?

Regards
Carl Fourie

Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,

Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards

Brian Armstrong*

Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards

Brian Armstrong*

Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

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Carl_Fourie1 · September 21, 2016, 2:31pm

Hi Mead and Derek

Yeah that would be great! We are also looking to host an SHR call in the next few weeks to discuss topics such as the current document that was released and I think FHIR would be a good point too. Would you be able to join (and possibly have some of the other developers join too? @Mead?)

BTW good to have your voice on the list Mead!

···

On Wed, Sep 21, 2016 at 4:07 PM, Derek Ritz (ecGroup) derek.ritz@ecgroupinc.com wrote:

Hi Mead – what a great idea. I think that would be a real benefit to us as we explore FHIR and how we’ll include it in our plans. Thanks for the offer.

Warmest regards,

Derek.

Derek Ritz, P.Eng., CPHIMS-CA

ecGroup Inc.

+1 (905) 515-0045

This communication is intended only for the party to whom it is addressed, and may contain information which is privileged or confidential. Any other delivery, distribution, copying or disclosure is strictly prohibited and is not a waiver of privilege or confidentiality.

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Mead Walker
Sent: Wednesday, September 21, 2016 9:29 PM
To: ‘Carl Leitner’; ‘Carl Fourie’
Cc: ‘Ryan Crichton’; ‘Brian Armstrong’; ‘Shared Health Record (OpenHIE)’
Subject: RE: SHR Functional Specification discussion

Hi,

I have not been active here for a while, but I am active in HL7, and around a lot of FHIR talk. Are you interested in trying to get additional support from FHIR developers to address possible uses within the SHR?

Mead Walker

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Carl Leitner
Sent: Wednesday, September 21, 2016 8:52 AM
To: Carl Fourie carl@jembi.org
Cc: Ryan Crichton ryan@jembi.org; Brian Armstrong brian.armstrong@jembi.org; Shared Health Record (OpenHIE) openhie-shr@googlegroups.com
Subject: Re: SHR Functional Specification discussion

Hi,

Whatever we do with FHIR with regards to clinical information, I do think we should retain the current SHR workflows - it was not my intention to suggest that we replace them.

What we ran into is that making DHIS2 into an XDS repository just didn’t really make sense for variety of reasons, at least as a first step. The vision is to use FHIR as sort of an abstraction layer to access the clinical data. It will be interesting to see if IHE takes on a work item such as incorporating FHIR into ODD and/or mapping specific FHIR resources into CDA content profiles.

Cheers,

-carl

On Sep 21, 2016, at 5:28 AM, Carl Fourie carl@jembi.org wrote:

Hi Carl L and Ryan

Great points and thank you for the input. I think the question around FHIR is exactly the question that we need ot start looking at as the community. As Carl L is pointing out there are emerging implementations and implementers that are looking at FHIR as an option. the current SHR requirements document that Brian has pulled together has been to “heard the cats” (so to say) of the years of hearsay and documents that the SHR community has to create a single point of truth that has context of what the component (SHR) is expected to do but also references and is driven from what the broader OHIE Architecture has defined as the “approved” workflows.

Shortly put: Think FHIR could be a good idea for the SHR to add as optional requirements. However we’d need to tie these back to architecture use cases and agreement that OHIE sees SHR as a standard that it supports for workflows.

Thoughts about this?

Regards
Carl Fourie

Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,

Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards

Brian Armstrong*

Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards

Brian Armstrong*

Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Ryan Crichton

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Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

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Regards
Carl Fourie
Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

Mead_Walker · September 21, 2016, 3:17pm

Note,

I am not that expert, but I know some of the actual experts, and I am sure they would be interested in contributing. Just let me know.

Mead

···

From: Derek Ritz (ecGroup) [mailto:derek.ritz@ecgroupinc.com]
Sent: Wednesday, September 21, 2016 10:07 AM
To: ‘Mead Walker’ dmead@comcast.net; ‘Carl Leitner’ litlfred@gmail.com; ‘Carl Fourie’ carl@jembi.org
Cc: ‘Ryan Crichton’ ryan@jembi.org; ‘Brian Armstrong’ brian.armstrong@jembi.org; ‘Shared Health Record (OpenHIE)’ openhie-shr@googlegroups.com
Subject: RE: SHR Functional Specification discussion

Hi Mead – what a great idea. I think that would be a real benefit to us as we explore FHIR and how we’ll include it in our plans. Thanks for the offer.

Warmest regards,

Derek.

Derek Ritz, P.Eng., CPHIMS-CA

ecGroup Inc.

+1 (905) 515-0045

This communication is intended only for the party to whom it is addressed, and may contain information which is privileged or confidential. Any other delivery, distribution, copying or disclosure is strictly prohibited and is not a waiver of privilege or confidentiality.

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Mead Walker
Sent: Wednesday, September 21, 2016 9:29 PM
To: ‘Carl Leitner’; ‘Carl Fourie’
Cc: ‘Ryan Crichton’; ‘Brian Armstrong’; ‘Shared Health Record (OpenHIE)’
Subject: RE: SHR Functional Specification discussion

Hi,

I have not been active here for a while, but I am active in HL7, and around a lot of FHIR talk. Are you interested in trying to get additional support from FHIR developers to address possible uses within the SHR?

Mead Walker

From: openhie-shr@googlegroups.com [mailto:openhie-shr@googlegroups.com] On Behalf Of Carl Leitner
Sent: Wednesday, September 21, 2016 8:52 AM
To: Carl Fourie carl@jembi.org
Cc: Ryan Crichton ryan@jembi.org; Brian Armstrong brian.armstrong@jembi.org; Shared Health Record (OpenHIE) openhie-shr@googlegroups.com
Subject: Re: SHR Functional Specification discussion

Hi,

Whatever we do with FHIR with regards to clinical information, I do think we should retain the current SHR workflows - it was not my intention to suggest that we replace them.

What we ran into is that making DHIS2 into an XDS repository just didn’t really make sense for variety of reasons, at least as a first step. The vision is to use FHIR as sort of an abstraction layer to access the clinical data. It will be interesting to see if IHE takes on a work item such as incorporating FHIR into ODD and/or mapping specific FHIR resources into CDA content profiles.

Cheers,

-carl

On Sep 21, 2016, at 5:28 AM, Carl Fourie carl@jembi.org wrote:

Hi Carl L and Ryan

Great points and thank you for the input. I think the question around FHIR is exactly the question that we need ot start looking at as the community. As Carl L is pointing out there are emerging implementations and implementers that are looking at FHIR as an option. the current SHR requirements document that Brian has pulled together has been to “heard the cats” (so to say) of the years of hearsay and documents that the SHR community has to create a single point of truth that has context of what the component (SHR) is expected to do but also references and is driven from what the broader OHIE Architecture has defined as the “approved” workflows.

Shortly put: Think FHIR could be a good idea for the SHR to add as optional requirements. However we’d need to tie these back to architecture use cases and agreement that OHIE sees SHR as a standard that it supports for workflows.

Thoughts about this?

Regards
Carl Fourie

Senior Program Manager | Digital Health Division

Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Wed, Sep 21, 2016 at 10:37 AM, Ryan Crichton ryan@jembi.org wrote:

@Brian, as far the functional docs go, these look pretty good to me and encapsulate much of what we have been talking about through the years. What I’m wondering at the moment is how we cast these Functional Requirement in light that shows how they will be taken into the future. I think FHIR will have a big future in eHealth and that the SHR functional docs should be setup to show how some IHE parts can replaced by FHIR equivalents. I know we mentions MHD in the docs, but I wonder if it’s worth bringing the FHIR discussions to the surface. Although, maybe this is best done in another ‘innovation’ type document.

Just some thoughts.

Cheers,

Ryan

On Wed, Sep 21, 2016 at 10:22 AM Ryan Crichton ryan@jembi.org wrote:

Hi Carl L,

Thanks for the FHIR comments. I just want to add a note that I think FHIR will be very useful to use in the future of OpenHIE and it may be a good idea to come to a combined understanding of the OpenHIE communities feeling about FHIR and how to work towards support it.

Cheers,

Ryan

On Fri, Sep 16, 2016 at 3:18 PM Carl Leitner litlfred@gmail.com wrote:

Hi all,

Just a few quick comments:

We have been working on setting up DHIS2 as an Immunization Registry in Zambia. The IR acts as a subset of a full SHR, but specializing in one part of the clinical content. For a variety of reasons, we have decided to proceed with FHIR as main API for data exchange (immunization, patient, value set resources). I suspect that we will see more and more FHIR based sources of clinical information come up, and I think it would be worthwhile to think about the connection with an SHR/XDS Repository in this context. For example, we could have a synchronization or facade service to turn, in this case, the FHIR Immunization Resource data into the appropriate CDA via the Immunization Content profile from IHE.

For I.001 “Request Aggregate Data For The Time Period” we were able to use the Bundle.total for a search against the FHIR Immunization resource for this quite successfully - the actual content wasn’t set (perhaps page size was set to zero, I don’t recall the details). This was as a proof-of-concept, this time in Tanzania but worked well enough.

As an FYI, we do have draft FHIR adaptors available for the ILR that may be worth considering, in addition to CSD.

Of course, this opens a larger questions about where we are going with FHIR w/ OpenHIE.

Cheers,

-carl

On Sep 16, 2016, at 8:58 AM, Brian Armstrong brian.armstrong@jembi.org wrote:

Thanks Carl.

Another thought is whether or not it is still envisioned that the SHR can be separated from fundamental elements such as the OpenHIE IL, as it has been stated (and included in the Spec) that the SHR can be implemented without the other components of the framework. Technically things are possible to decouple, but is it still feasible given the requirements of security and privacy to secure access to PHI.

Regards

Brian Armstrong

Digital Health Systems Architect

Jembi Health Systems | SOUTH AFRICA
Mobile: +1-778-984-4009 | Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

On Sep 16, 2016, at 08:38, Carl Fourie carl@jembi.org wrote:

Thanks Brian for sharing this. As one context: we looked at trying to help people answer the question of what is an shr in light of OpenHIE. It had been a few years since we’ve reviewed the requirements and brought them all together. We’d love to have the combined knowledge of the community reviews these and either go: yip that’s exactly as I know it, or hmm… Really is that what we said? Or I’m not sure that’s valid anymore or Oh you missed xyz

Carl Fourie | Senior Program Manager | Jembi Health Systems NPC | +27715404477 | Skype: carl.fourie17

sent from mobile

On 16 Sep 2016 13:38, brian.armstrong@jembi.org wrote:

Hi everyone,

I would like to share some work that we have been doing at Jembi to design a Shared Health Record Functional Specification v1.0 (Draft) which we would like the Community to review and comment upon.

It is a work in progress so please ‘kick the tires’ and own it - it’s meant for the Community to develop, but we have designed a starting place to work from.

Thanks,

Brian

Regards

Brian Armstrong*

Digital Health Systems Architect | HIS Specialist

Jembi Health Systems | SOUTH AFRICA
Office: +27 21 701 0939 | Skype: briankarmstrong

E-mail: brian.armstrong@jembi.org

Web: www.jembi.org

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Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

–

Ryan Crichton

Lead Developer, Jembi Health Systems | SOUTH AFRICA

Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org

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