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Child digital health record web application for Health Check Assessment as SMART on FHIR application.

HCA - Heath Check Assessment: growth and development assessment form for a child; administered as age specific health check assessments.

CDH - Child Digital Health; referring to the project 

CDHR - Child Digital Healr Record; referring to the project health records in general

CDR Hub - Child Digital Health Hub: FHIR service available to participating authorised parties and systems to consume and provide child health records


Community and Connectahon Chat: https://chat.fhir.org/#narrow/stream/179284-australia-child-health  sign up on  https://chat.fhir.org/  and use this channel for queries and passing info.... 

Contact: Brett Esler managing the form content and operation. 

Launch Option A: SMART on FHIR Launch

Option A: SMART launch sequence as per http://www.hl7.org/fhir/smart-app-launch/ 

For those with a SMART enabled EMR SMART on FHIR launch is supported by the HCA application.  Registration details as follows; let me know if you need anything special.


Health Check Assessment SMART registration

Client Id : 44337d84-cbec-40f5-b5ff-746279f8f4df

Launch URL: https://oridashi.com.au/site/ncdhc/launch.html

Redirect URL: https://oridashi.com.au/site/ncdhc/index.html


Authorisation scopes requestd byt the HCA form on launch are broad for the connectathon (see me if you need anything special)

Connectathon Scopes

fhirUser - get user context

launch - context

openid - context

user/*.* - read/write


This is a more realistic set of scope expected for the project (not in place currently)

Official Scopes

fhirUser - get user context

launch - get patient context

patient/Patient.read - read patient details from EMR

patient/Observation.* - read Height, Weight, Head Circum, BMI read/write to EMR

patient/DocumentReference.read - read from CDHR

patient/Encounter.write - write summary note to EMR

patient/Consent.read - read current CDHR status

patient/Bundle.write - write CDHR HCA content submission

user/Practitioner.read - read from EMR

user/Organization.read - read from EMR


Launch Option B: Direct Launch with arguments

Supply arguments to launch directly into supplied context (not secure)

https://oridashi.com.au/site/ncdhc/index.html?patientid=[patientId]&practitionerId=[practitionerId]&iss=


FHIR API Interactions

[patientId] - from SMART on FHIR launch socpe request response e.g. patient : 123 http://www.hl7.org/fhir/smart-app-launch/scopes-and-launch-context/index.html#quick-start

[organizationId] - from retrieved patient Patient.managingOrganization 

[practitionerId] - from SMART on FHIR launch; 

Interactions

GET /Patient/[patientId]

Current context patient details as per CDH requirement + population of the patient.managingOrganization element

[patientId] via patient claim on SMART launch or via parameter patientId for direct launch (no SMART)

Profile: http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-patient-baby.html

GET /Observation?subject=[patientId]&code=[obstype]&_since=[date-time]

[obstype] is LOINC 8302-2 height; 29463-7 weight, 8287-5 head circumference or BMI

[patientId] via patient claim on SMART launch or via parameter patientId for direct launch (no SMART)

Current patient select observations entered today (since midnight); search one-by-one.

Profiles:

Weight http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bodyweight.html

Height/Length http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bodyheight.html

Head Circumference http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-headcircum.html

BMI http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bmi.html

GET /Practitioner/[practitionerId]

Current context practitioner details; obtained from fhirUser (profile) claim on smart launch or via parameter practitionerId for direct launch (no SMART)

Profile:

Australian Practitioner http://hl7.org.au/fhir/base/aubase1.1/StructureDefinition-au-practitioner.html

GET /Organization/[organizationId]

Current context organisation details - organizationId as per current patient in context Patient.managingOrganization

Profile:

Australian Organsation http://hl7.org.au/fhir/base/aubase1.1/StructureDefinition-au-organisation.html

GET /Consent?category=[category-code]&status=[status]&patient=[patientId]

Current CDHR consent status establised by the EMR or by live verification with CDR Hub; we search for active consent as a child participant in the CDHR

[patientId] via patient claim on SMART launch or via parameter patientId for direct launch (no SMART)

Well known codes defined for this system

Request GET /Consent?patient=123&category=http://hl7.org.au/fhir/ch/v1/CodeSystem/ncdhc-consent-category|CROPT&status=active

Response:

  • includes consent staus
  • include CDHR patient reference
{
  "resourceType": "Bundle",
  "id": "a6d20432-10e6-4867-b1bd-ffba96732769",
  "meta": {
    "versionId": "20200201233153",
    "lastUpdated": "2020-02-01T12:31:53.625+00:00"
  },
  "type": "searchset",
  "total": 1,
  "entry": [
    {
      "fullUrl": "https://localhost.oridashi.com.au:8102/Consent/ccff09aa-efba-43aa-8ca9-28b23d599af3",
      "resource": {
        "resourceType": "Consent",
        "id": "ccff09aa-efba-43aa-8ca9-28b23d599af3",
        "meta": {
          "versionId": "20200201123153",
          "lastUpdated": "2020-02-01T12:31:53.624+00:00"
        },
        "text": { "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Active Child Digital Health Record Operation Consent for Patient [123]</p></div>" },
        "status": "active",
        "category": [
          {
            "coding": [
              {
                "system": "http://hl7.org.au/fhir/ch/v1/CodeSystem/ncdhc-consent-category",
                "code": "CROPT",
                "display": "Child Digital Health Record Operation Consent"
              }
            ]
          }
        ],
        "patient": { "reference": "Patient/123" },
        "consentingParty": [ { "reference": "123" } ],
        "actor": [
          {
            "role": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/extra-security-role-type",
                  "code": "datasubject"
                }
              ]
            },
            "reference": { "reference": "https://prov.sit.ncdhc.test.health.nsw.gov.au/fhir/v1.0.0/Patient/a2d44dc9-6597-4a3a-9c32-00ee301b427f" }
          }
        ]
      }
    }
  ]
}


POST /Observation

Submit an observation for EMR storage (entered in form); only Height, Weight, Head Circumference and BMI

Profiles:

Weight http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bodyweight.html

Height/Length http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bodyheight.html

Head Circumference http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-headcircum.html

BMI http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-observation-vitalsign-bmi.html


POST /Encounter

Submit an event noting the HCA text summary of content from.

Profle: none defined

  • Must Support Encounter.text
  • Must Support Encounter.period
  • Must Support Encounter.subject

Example submission

{
  "resourceType": "Encounter",
  "id": "b5225f56-431f-4a43-b842-2e99cc11409b",
  "meta": { "lastUpdated": "2020-02-01T23:38:54.459+11:00" },
  "text": { "div": "<p>Child Digital Health Record - 18 Month assessment (01/02/2020)<br/>Vital Signs and Measurements<br/>\tWeight : 23 kg<br/>
     \tHeight : 123 cm<br/>\tHead circumference : 43 cm<br/>Health conditions section<br/>
     \tSkin : Yes - Outcome: Review<br/>\tGait : Yes - Outcome: Review<br/><p>" },
  "status": "finished",
  "subject": { "reference": "Patient/123" }
}

POST /

Submit a document bundle according to CDH specification for processing for the EMR, this can include submission to the CDR Hub and/or storage of the atomic/FHIR content of the submission

Profile:

Health Check Assessment http://build.fhir.org/ig/hl7au/au-fhir-childhealth/StructureDefinition-ncdhc-composition-health-check-assessment.html

Example Submissions : hca-samples.zip

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