Advanced .net api (ewout)

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Advanced .NET API
Ewout Kramer, Furore Health Informatics

Who am I?
 Name: Ewout Kramer
 Company: Furore Health Informatics
 Background:
 Computer Science (operating systems)
 In Health IT since 1999
 FHIR Core team
 Lead dev on the .NET API
 e.kramer@furore.com, @ewoutkramer
 http://thefhirplace.com2

Structure of packages
3
Hl7.Fhir.Support
(Net4, Net4.5, Net1.0, Net1.3)
• Utility methods
• ElementModel
Hl7.FhirPath
(Net4, Net4.5, Net1.0)
• FhirPath compilation
• FhirPath evaluation
Hl7.Fhir.Core
(Net4.5, Net1.1, Net1.3)
• Model classes
• Serialization
• Http client
Hl7.Fhir.Specification
(Net4.5, Net1.3)
• Access to definitions
• Terminology services
• Validation

ELEMENTMODEL
4

Why?
 In Hl7.Fhir.Support
 Lowest-level access to FHIR instance data
 No POCO’s involved
 Applications:
 Access to parts of FHIR data - no need to parse whole POCO’s in
memory
 Generic clients/servers not needing pre-compiled model classes
 Tools that can parse (partially) invalid FHIR data
 Accessing DSTU2 and STU3 data
5

“Logical” structure of FHIR data
6

IElementNavigator
7
 Represents a position in
a tree of FHIR data
 Has all the aspects of a
node (from last slide)
 Location:
Patient.name[1]
.family[0]

IElementNavigator extension
methods
8
LINQ to ElementModel extension methods go beyond the
basic MoveToNext() and MoveToFirstChild() methods

Central connecting concept
9

From xml to POCO and back
10
Xml text
XmlDomFhirNavigator
FhirParser
POCO
Xml text
NavigatorXmlWriter
XmlDomFhirNavigator
POCO
Xml text
NavigatorXmlWriter
XmlDomFhirNavigator
POCO
SummaryNavigator

Parsing huge bundles
11
• Bundle scanned sequentially
• Parses only one entry at a time
• Low memory footprint, even with huge bundels
• Efficient Seek()

GETTING TO METADATA

Specification data
 All the definitions of the core resources, types, search
parameters, operations, etc. are available through the
Hl7.Specification.[STU3/DSTU2] package on NuGet
 The package contains a zip (specification.zip) with meta data
produced by the FHIR publication process
 profiles-resources.xml, profiles-types.xml, extension-definitions.xml
 search-parameters.xml
 v2-tables.xml, v3-codesystems.xml, valuesets.xml
 xsd schemas, schematrons, others....

Conformance Resources
 Provide “metadata” about
 Model Definitions (StructureDefinition)
 Operations (OperationDefinition)
 Search parameters (SearchParameter)
 List of codes (ValueSet)
 All are identified and referenced by a “canonical url” that
SHOULD resolve, e.g.
“http://hl7.org/fhir/StructureDefinition/Pati
ent”

Resolution
 Directly using a FHIR REST call to the url
 More likely:
 As packaged in specification.zip
 As part of a “snapshot”/zip of files delivered with your app
 Compiled into your app
 In a database
15

IResourceResolver
 Concrete implementations in API:
 DirectorySource, ZipSource
 WebSource
 CachedResolver (wraps another resolver)
 MultiResolver (tries a list of resolvers)16

Combine at will
17
MyDbResolver
ZipSource WebResolver
MultiResolver
CachedResolverMultiResolver

Practicalities
 Packaged in Hl7.Fhir.Specification assembly
 Namespace Hl7.Fhir.Specification.Source
 Includes useful extension methods like:
 FindStructureDefinition(this IResourceResolver resolver, string uri, bool requireSnapshot =
false)
 FindStructureDefinitionForCoreType(this IResourceResolver resolver, FHIRDefinedType
type)
 FindExtensionDefinition(this IResourceResolver resolver, string uri, bool requireSnapshot =
false)
 Data for base spec is in “specification.zip”, easy to get to using
ZipSource.CreateValidationSource()
18

TERMINOLOGY

FHIR Resources
 CodingSystem resource (STU3)
 A dictionary of concepts (possibly huge!)
 ValueSet (DSTU2, STU3)
 A (use-case specific) selection of concepts from 1..* CodingSystems
 May be directly enumerated (‘extensional’)
 May be composed using filters (‘intensional’)
 “all the LOINC codes in LOINC Part Concept Cholesterol | Bld-Ser-Plas
(LP43571-6), except for 5932-9 Cholesterol [Presence] in Blood by Test
strip”
 May be composed from other ValueSets

Main functionality
 Expand an intensional ValueSet
 Determine whether some code is member of a ValueSet
 Do a code-lookup
 Find details like alternative designation
 Could be done “in-memory” (i.e. using an expanded
ValueSet)
 By calling the FHIR terminology operations
21

In-memory
 Expand using the ValueSetExpander class in
Hl7.Fhir.Specification.Terminology
 Set limits on expansion size
 Uses IResourceResolver to locate ValueSets
 Current limitations:
 No filters
 No imports of whole CodeSystems
22

Working with the expansion
 Useful extension methods on ValueSet
 HasExpansion()
 ExpansionSize()
 FindInExpansion(String code, string system)
 bool CodeInExpansion(String code, string system)
 Note: no automatic expansion, use ValueSetExpander
23

Terminology operations
 https://www.hl7.org/FHIR/valueset-operations.html
 $expand, $lookup, $validate-code
 class FhirClient
 ExpandValueSet()
 ConceptLookup()
 ValidateCode()
24

ITerminologyService
25

ITerminologyService (2)
 Current implementations:
 LocalTerminologyService
Does an in-memory expand & lookup
 ExternalTerminologyService
Uses the FhirClient calls to validate a code (possibly even
sending your valueset across!)
 FallbackTerminologyService
First tries LocalTerminologyService, if that fails (too
complex!), invoke an external service
 Note: returns OperationOutcome
26

FHIRPATH SUPPORT
27

FhirPath in .NET
 Available as a .NET Core library Hl7.FhirPath on NuGet
 Is built on top of IElementNavigator – so it could work on
*any* object model
 Advantage: Compile once, run many (fast)
 class FhirPathCompiler
 public CompiledExpression Compile(string expression)
 CompiledExpression is a native Lambda that will run the statement
against an IElementNavigator
 You can also compile to an Expression tree (for debug/display
purposes)

Using CompiledExpression
 First, compile the statement
 var ce = compiler.Compile(“Patient.name”);
 Then:
 var result = ce(…)
 result is a set of IElementNavigators
 Or:
 object s = ce.Scalar(…);
 bool p = ce.Predicate(…);
 bool b = ce.IsBoolean(true, …);
29

Convenience methods
 Comparable methods exist on IElementNavigator so you
can directly query a source of data
 Example:
IElementNavigator nav =
new PocoNavigator(myPatient);
object cnt =
nav.Scalar(“Patient.name.count()”);
 Compiles & caches last 500 expressions for you
30

On POCO’s directly…
 The Hl7.Fhir.Core assembly has extension methods in
Hl7.Fhir.FluentPath for working directly on FHIR POCO’s
Patient p = …;
object cnt = p.Scalar(“Patient.name.count()”);
31

HIDDEN GEMS

ResourceIdentity
 class ResoureIdentity : Uri
 Builds FHIR RESTful Uri’s
 Factory methods Build():
 .Build(“Patient”, “4E75”, vid: “4”)
 “/Patient/4E75/_history/4”
 StructureDefinition URLs for core types
 .Core(FHIRDefinedType.HumanName)
 “http://hl7.org/fhir/StructureDefinition/HumanName”

ResourceIdentity (2)
 Even more useful: parsing RESTful Urls
 var ep = “http://server.org/fhir/Patient/4”
var u = new ResourceIdentity(ep);
 u.ResourceType
 “Patient”
 u.Id
 “4”
34

Extension Manipulations
 IEnumerable<Extension> AllExtensions()
 returns extensions + modifier extensions
 Extension GetExtension(string url)
 searches both extensions + modifier extensions
 bool GetBoolExtension(string url), string
GetStringExtension(...), integer GetIntegerExtension(...)
 Also setters, adders, removers, ....
35

Annotations
 POCO’s and IElementNavigator also implement IAnnotated
and IAnnotatable
 You can set transient annotations on such instances. Useful
to keep in-memory state on FHIR Poco objects
 e.g. url where you got the POCO from, resolved references, etc.
 these are not serialized nor parsed!
 Create a class for each type of annotation
 Set or retrieve them using SetAnnotation<A>(A yourAnnotation)
 Get them using A GetAnnotation<A>()
36

Annotations (2)
37

TransactionBuilder
38

QUESTIONS?
39

HANDS-ON TRACK
Suggestions for a pleasurable afternoon

IResourceResolver
 Try to use the ZipSource with the specification.zip to get
some core resource definitions
 Now create an implementation of IResourceResolver that
contains a List<ValueSet>, so it will resolve a list of in-
memory ValueSets.

ITerminologyService
 Use the new IResourceResolver you wrote in the previous
exercise to resolve a ValueSet. Then use the
ValuesetExpander to expand it.
 Use ValueSet’s FindInExpansion() to verify whether you
succeeded.
 Look at the C# implementation of LocalTerminologyService.
Could you make an implementation of ITerminologyService
that calls the FhirClient.ValidateCode() instead, so it will use
an external terminology service?
42

Advanced .net api (ewout)

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