FHIR protocols: FIPPA, PHIPA, HPPA, HIC, - GregLinthicum/From-Logistic-Regression-to-Long-short-term-memory-RNN GitHub Wiki

Disclaimer: The author of notes has experience limited to three years of data flow testing according to CMS protocols and content specifications in the USA.

Affordable Care Act

FHIR

FHIR (Fast Healthcare Interoperability Resources) was created by the standards development organization Health Level 7 (HL7) and was introduced in May 2012. FHIR started as a draft standard with 49 resources, but it has now expanded to 145 resources. FHIR is a set of rules and specifications for exchanging electronic health care data. supports multiple data representation formats:

  • JSON: A lightweight, human-readable format.
  • XML: A widely used format for structured data.
  • RDF (Resource Description Framework): A format for representing information about resources in a graph form.

Documentation Links

FHIR implementation challenges in the USA

FHIR Implementations in Canada

Ontario eReferral HL7® FHIR® Implementation Guide and message definitions

eConsult

FHIR Artifacts (sample only)

  • MessageDefinition: ServiceRequest Bundle
  • MessageDefinition: Task Bundle
  • MessageDefinition: Appointment Bundle
  • MessageDefinition: Communication Bundle
  • StructureDefinition: Bundle Profile
  • StructureDefinition: MessageHeader Profile
  • StructureDefinition: OperationOutcome Profile
  • StructureDefinition: ServiceRequest Profile
  • StructureDefinition: Task Profile
  • StructureDefinition: Appointment Profile
  • StructureDefinition: Communication Profile
  • StructureDefinition: Patient Profile
  • StructureDefinition: PractitionerRole Profile
  • StructureDefinition: Practitioner Profile
  • StructureDefinition: Organization Profile
  • StructureDefinition: Location Profile
  • StructureDefinition: AllergyIntolerance Profile
  • StructureDefinition: Condition Profile
  • StructureDefinition: Consent Profile
  • StructureDefinition: DocumentReference Profile
  • StructureDefinition: QuestionnaireResponse Profile

Ontario Patient Summary – HL7® FHIR® Implementation Guide (Release 1)

SMART on FHIR:

Substitutable Medical Applications and Reusable Technologies (SMART on FHIR) takes FHIR to the next level.

  • It adds a security layer based on open standards, including OAuth2 and OpenID Connect.
  • With SMART on FHIR, applications can access clinical information through a data store, such as an Electronic Health Record (EHR) system.
  • Developers can create apps that work across different healthcare organizations, regardless of the specific EHR in use.
  • It’s all about making healthcare apps seamless, secure, and interoperable.

Health Information Custodian (HIC) requirements

PHIPA

FIPPA

HPPA

MFIPPA

PIA Privacy Impact Assessment

SERIS

EHR/DHDR

Patient Summary Submission Bundle

News

Libraries, Implementations, integrators

Marketplaces

  • Microsoft Azure API for FHIR (71 offerings); SaaS (56/756 offerings)
  • Google Cloud Healthcare API (87) FHIR (5 offerings); SaaS (2/79 offerings)
  • AWS HealthLake FHIR (79 offerings); SaaS (7/28 offerings)
  • Oracle Marketplace FHIR( 3 offerings) Healthcare (101 offerings)

Echoes

FHIR Adoption Accelerates in European Healthcare Systems: In a groundbreaking move, several European countries have ramped up their adoption of FHIR standards. Countries like Germany, France, and Sweden are actively integrating FHIR into their healthcare infrastructure. This shift aims to enhance data exchange, streamline patient care, and improve interoperability across borders. Experts predict that this momentum will continue to grow as more nations recognize the benefits of FHIR.

Ontario’s FHIR Sandbox Revolutionizes Health App Development: The Ontario Ministry of Health has launched an innovative FHIR sandbox environment for developers. This platform allows app creators to test and refine their health-related applications using real-world data while adhering to FHIR standards. By fostering collaboration between developers, healthcare providers, and patients, Ontario aims to spur the development of cutting-edge health apps that enhance patient engagement and data sharing.

Hamilton Health Sciences (HHS) Adopts FHIR for Instant Lab Results: HHS, a prominent hospital system in Ontario, has become the first in the province to utilize cutting-edge FHIR technology for instant lab results. With the implementation of FHIR, lab results from the Ontario Laboratories Information System (OLIS) are now available instantly to HHS physicians. This achievement is made possible through HHS’ new hospital information system, Epic. The integration allows seamless access to lab test orders and results across the province, eliminating delays and improving patient care.

OLIS FHIR Integration in the Innovation Lab: As of June 29th, registered users of the Innovation Lab can explore integration with OLIS using the draft FHIR specification. FHIR, as a next-generation standards framework, facilitates the exchange of health care information electronically. This initiative aims to enhance data sharing and interoperability within the Ontario health system. OLIS automation and security

Digital Health Immunization Repository Consumer Access Specification – FHIR: Ontario is committed to creating a provincial immunization system where individuals, health care providers, and public health have real-time access to comprehensive, accurate, and timely immunization records. The Digital Health Immunization Repository (DHIR) serves as a centralized repository for standardized electronic immunization data. Through the DHIR Consumer Access FHIR, authorized health care providers can retrieve and contribute immunization data, supporting clinical practice and empowering individuals to manage their health actively

Is PIA needed https://www.priv.gc.ca/en/privacy-topics/privacy-impact-assessments/gd_exp_202003/ ( Justice Laws Website)

Glossary:

  • Loi sur l'accès à l'information et la protection de la vie privée (LAIPVP)==Freedom of Information and Protection of Privacy Act (FIPPA)
  • Ressources d'interopérabilité rapide des soins de santé (FHIR) == Fast Healthcare Interoperability Resources (FHIR)

  • Open source

  • HAPI FHIR (Java): Developed by James Agnew and the University Health Network, HAPI FHIR provides a comprehensive Java library for creating FHIR servers and clients. It’s designed to quickly add FHIR capabilities to existing applications, supporting all resource types, most operations, and both XML and JSON encodings. You can find it on GitHub .

  • Firely .NET SDK (C#): Firely’s .NET SDK offers object models, parsers/serializers, utilities, and a client for FHIR. It supports all resource types, searches, validation, FhirPath, and basic terminology server implementation. You can explore it on GitHub here.

  • Spark (C#): Spark is a reference server built in parallel with Grahame’s to test the FHIR specification. It supports all resource types, searches, and many operations. Built in .NET with the .NET reference implementation, it uses WebApi 2.0 library and MongoDB for storage and search. Check it out on GitHub here .

  • SMART on FHIR (Java): SMART on FHIR is an open-source reference implementation of the SMART on FHIR stack in Java and MySQL. It incorporates synthetic and de-identified data sets for DSTU2 and STU3, along with data management tools like the SMART Patient Browser and FRED FHIR Resource Editor. You can find more information at the SMART on FHIR documentation and explore the code on GitHub here.

  • Snow Owl (Java): Snow Owl is a terminology server that supports FHIR. It’s production-ready, scalable, and includes a CQL evaluation engine. You can find it on GitHub here

EUROPE

USA

Elicitation and Requirement Modeling

advanced-level-elicitation-handbook 2024-03

advanced-level-requirements-modeling 2022-08

Change Request and traceability to code

Note: in 2022: The IREB Advanced Level (AL) certification was replaced by the IREB Expert Level certification.

Elicitation Techniques: IREB vs BABOK

ElicitationTechniques_IREB_vs_BABOK

Here are some popular graphical visualization tools that fit these criteria and are commonly used by IREB or BABOK practitioners:

  • Miro: A collaborative whiteboard tool that excels at mind mapping with its real-time co-editing features and visually engaging interface.
  • XMind: An open-source mind mapping tool offering various layouts, themes, and brainstorming modes for efficient requirements capture.
  • MindMeister: A user-friendly mind mapping tool with a focus on clarity and ease of use, making it suitable for various stakeholders.
  • Microsoft Visio: While primarily a diagramming tool, Visio can also be used for mind mapping. Its strength lies in its ability to integrate with other Microsoft products.

Mind mapping

Mind Mapping Technique specifically recommends to avoid using sterile, alike looking lines between entities and rather using color-coded, width-coded, meaning and purpose hinting interconnections.

Tools

back to BA

  • Digital Identity standards:
    • NIST,
    • FIDO,
    • Open ID Connect,
    • SAML