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Welcome to the OO-on-FHIR-Micro-Profile wiki!

Introduction

This focus of this document is to outline the approach for Lab reporting of culture and sensitivity results using FHIR. It is specific to US Realm lab reporting. however the patterns described are universal and can be applied to the core ( international ) FHIR specification.

This overall structure of observations is represented in this FHIR Logical model with mappings to V2 and LRI and mappings to FHIR. The Logical model is turned into a set of FHIR profiles based upon the US-Core DiagnosticReport and US-Core Observation profiles. The "entry point" for a C&S report is the Micro Report Profile. The profiles are published along with some example instances. The next steps are detailed below.

See these are the examples that follow this structure:

• LRI Example in FHIR
• rest todo

##Assumptions

1. Profile on USLab which is a profile on US-core Observation and US-Core DiagnosticReport
2. Use LRI to inform
3. Use existing examples to inform:

• FHIR example
• LRI
• NIST examples (todo)
• (todo solicit other real life examples - would be useful)

1. Other input from:#

• Australian RCPA standardisation work
  • C & S mind map

1. HAI?

Overview:

DiagnosticReport is the 'entry point' for reporting and receiving micro and susceptibility results a whole bunch of distinct Observation instances structured in a particular way to both to report all the organisms isolated, susceptibility results and other obsersvations for bacterial culture and susceptibilty.

The DiagnosticReport references Observation panel(s) for each organism isolated. Each Observation panel references related Observations which

• identify the organism
• (optionally) record other measurements such as a gram stain
• records the antibacterial susceptibility measurements with another (nested) Observation panel which references related Observations that records the susceptibility measurements.

Steps

1. Create Logical Model of the structure - done
2. Create a StructureMap and transforms to the appropriate FHIR Structures ( Observation and DiagnosticReport Profiles) - done - abandon this approach - better to use the mapping language concrete syntax - still todo
3. Create the profile definitions -done
   • see table below
4. Create the mapping languagae syntas transform V2 to profiles
5. Instantiate examples and transforms

Create the specific Profiles in which we specify:

1. Conformance requirement including terminology for Specific elements based upon:

• US-Core (DAF)
• USLab (LRI)

This will involve creating C&S valuesets.

Profile list: The following profile on Observation and DiagnosticReport would be used for reporting micro and susceptibility reports.

Profile	Derived from	Core Resource
MicroReport	US-Core DiagnosticReport,USLAB DiagnosticReport	DiagnosticReport
Organism Observation	US-Core Observation,USLAB Observation Panel	Observation
Gram Stain Observations	US-Core Observation,USLAB Coded Observation	Observation
Organism Growth Observations	US-Core Observation,USLAB Numeric Observation	Observation
Organism Colony Count Observations	US-Core Observation,USLAB Observation Panel	Observation
Other Micro Observations	US-Core Observation,USLAB Numeric Observation,USLAB Coded Observation	Observation
AOE Micro Observations	US-Core Observation,USLAB Numeric Observation,USLAB Coded Observation	Observation
Micro ABX Susceptibility Coded Observations	US-Core Observation,USLAB Coded Observation	Observation
Micro ABX Susceptibility Numeric Observations	US-Core Observation,USLAB Numeric Observation	Observation

Other stuff to consider

1. Server and Client requirements:

• require _includes here

1. Access control tags
2. Other stuff