Dev days 2017 questionnaires (brian postlethwaite)
- 1. FHIR® is the registered trademark of HL7 and is used with the permission of HL7. The Flame Design mark is the registered trademark of HL7 and is used with the permission of HL7. Amsterdam, 15-17 November | @fhir_furore | #fhirdevdays17 | www.fhirdevdays.com FHIR Questionnaires Brian Postlethwaite, Telstra Health
- 2. Brian Postlethwaite Senior Solutions Architect FHIR core team member FHIR Management Group member Co-chair HL7 International Patient Administration Workgroup fhir-net-api contributor FhirPathTester author sqlonfhir server Harley Rider
- 3. What is going to be covered? • Overview • Uses • Workflows • FHIR resource definitions • Creating Questionnaires • Pre-population • Conversion/Mapping data to other resources • Advanced validation
- 4. Overview • Surveys, assessments, forms • Schema • Layout • Validation • Mappings • Data • Questionnaire • QuestionnaireResponse • ValueSet / Terminologies • Similar to StructureDefinition
- 5. Uses of FHIR Questionnaires • Assessments (GP) • Assessments (consumer) • Surveys • Gov't/Statutory forms • Referrals template? • Admission form? • General data entry? • Care Plans • Research • Oncology • Pathology • Public Health Reporting • Insurance/Payments
- 6. Workflow • Locate questionnaire to use (for given context) • Load/render questionnaire (and referenced content) • Pre-populate questionnaire with other data • E.g. patient demographics, observations etc • User enters data • Local validations may occur during data entry • QuestionnaireResponse is validated by server • Errors/Warnings/issues reported to the user • QuestionnaireResponse is saved to the target server • Data extracted into other resources
- 7. Form Definitions Questionnaire • Metadata • Items (nested) • LinkId • Text • Item Type • repeats • Data rules (validation) • Formatting hints QuestionnaireResponse • Context • Items (nested) • LinkId (must match) • Answer value LinkId joins answer to definition MUST MATCH (including the nesting depth)
- 8. Item-Type Response Type Definition group Group An item with children, may be repeating. Could be a section, table or other layout (e.g. tabs) display (none) Just a label to be displayed (no answer to be collected) Boolean valueBoolean Yes/no answer (checkbox, radio group or similar) decimal valueDecimal Real number answer (restricted textbox, slider, …) integer valueInteger Integer answer (restricted textbox, slider, …) date valueDate Date answer (restricted textbox, date picker …) dateTime valueDateTime Date and time answer (restricted textbox, date picker …) time valueTime Time only answer (hour:minute:second) answer independent of date (restricted textbox, …) string valueString Short free-text answer (single line textbox) text valueString Longer free-text answer, potentially multi-paragraph (multi-line textbox) url valueUri URL (website, FTP site, etc.) answer (restricted textbox) choice valueCoding Coding drawn from a list of options (specified in either the option property, or via the ValueSet referenced in the options property) as an answer (radio buttons, checkboxes, combobox, autocomplete …) open-choice valueCoding or valueString Coding drawn from a list of options (as with the choice type) or a free-text entry in a string (similar controls to choice, except with ability to include textbox) attachment valueAttachment Binary content such as a image, PDF, etc. as an answer (file selector …) reference valueReference A reference to another resource, e.g. practitioner, organization, etc. (resource finder?) quantity valueQuantity Question with a combination of a numeric value and unit. ()
- 9. Difference between DSTU2 and STU3 DSTU2 • Group/Question • Group 0..1 at root • enableWhen, readonly, maxLength, intialValue (extension) • Concept • Label (extension) • Group/question child collection ordering ambiguous STU3 • Item (with type=group) • Item 0..* at root • Moved to core • Code (and definition) • Use Item (type=display) • More metadata at root http://hl7.org/fhir/questionnaire.html (check the R2 Diff tab – not a complete mapping)
- 10. Structured Data Capture (SDC) Implementation Guide • Data Element Registries • Form Manager http://hl7.org/fhir/us/sdc/index.html http://hl7.org/fhir/us/sdc/sdc-questionnaire.html
- 11. Creating Questionnaires • Converting existing non FHIR definitions • SmartQ editor (DSTU2 only) http://smartqedit.azurewebsites.net • Grahame’s editor • Using text editor • Others? (or combination of the above)
- 13. Pre-population • $populate operation • XML content, with paths for extract • Questionnaire.item.definition http://hl7.org/fhir/questionnaire.html#2.38.5.4 • ConceptMap • Currently no standard defining the data selection • SDC extends this • Telstra Health $populate • Extension for FHIR query to execute • Uses Smart on FHIR context in query syntax • Extension for fhirpath statement to extract content from results of above extension • Works with repeating groups
- 14. Conversion/Mapping to other resources • Questionnaire.item.definition http://hl7.org/fhir/questionnaire.html#2.38.5.4 • Directly link to an element in a structure definition • Can link each item • Supports repeating items! • Perfect for extraction • Map to a specific StructureDefinition • Caveat: can’t do complex split/join/calculations • Custom Operations • $convert-to-resources • $save-atomic-data
- 15. Validation • FHIR json/xml valid (serialization) • Core FHIR profile validation (maybe local profiles too) • QuestionnaireResponse validation • Item Types • Extensions • Custom validation? • OperationOutcome • Content/messages appropriate to display to users?
- 16. Validation code walkthrough and demo
- 17. Advanced Validation (non standard) • Core resources can be profiled with invariants • Extension to add this to Questionnaires https://simplifier.net/sqlonfhir-stu3/Questionnaire-validation-expression
- 18. Scoring (non standard) • http://sqlonfhir-dstu2.azurewebsites.net/fhir/Questionnaire/demo-scoring2 • Concepts in options have a weighting
- 19. Summary • Create a form definition • with validation rules • with resource mappings • Create form data • Perform Validation • Map to a new resource from form data • Terminology interactions • Advanced Validations • Where will you use Questionnaires?
- 20. Questions?
- 21. Thank you Keep FHIR-ing on all cylinders
Editor's Notes
- #8: Metadata includes the URL which may be used in the same way as the Structure Definition Canonical URLs
- #9: The relationship between the answer types, user interface control hints, validation properties, and the data that you should expect coming back Note that some server’s might accept string values coming back, and chose to convert these. There is an extension 'http://hl7.org/fhir/StructureDefinition/questionnaire-unit' that can be used to define what unit would be captured (or the a unit that has a UCUM conversion from the provided unit)
- #11: Although this was defined by a US group, it isn’t a US specific spec, and is possibly coming back to HL7 international
- #13: Demo both the TCM export trick, SmartQedit and SmartQ stuff http://smartqedit.azurewebsites.net/Questionnaire/Editor?QuestionnaireId=https://sqlonfhir-ci2.azurewebsites.net/fhir/Questionnaire/vitals&fhirServiceUrl=http://sqlonfhir-ci2.azurewebsites.net/fhir smartq.azurewebsites.net/Home/Survey?questionnaireId=https://sqlonfhir-ci2.azurewebsites.net/fhir/Questionnaire/581a63a90ca74e76a69df452f77270dc/_history/3&fhirServiceUrl=https://sqlonfhir-ci2.azurewebsites.net/fhir/ http://sqlonfhir-ci2.azurewebsites.net/fhir/QuestionnaireResponse
- #14: Need to take care with DataElements as this is changing in R4
- #15: https://sqlonfhir-ci2.azurewebsites.net/fhir/Questionnaire/edit-org/_history/9?_format=html
- #16: Show the demo admission form (using the SmartQ editor) Then save the content to the server Then show the $convert-to-resources operation in action! (on the QuestionnaireResponse)
- #18: Show the sqlonfhir server validation code, demonstrate the fhirpath validator Unit tests? Contrast with Questionnaire Validation
- #19: Of course these invariants would be great if you could validate these when you’re saving these too into the questionnaire
- #20: http://smartq.azurewebsites.net/Home/Survey?questionnaireId=https%3A%2F%2Fsqlonfhir-dstu2.azurewebsites.net%2Ffhir%2FQuestionnaire%2Fdemo-scoring2&fhirServiceUrl=https%3A%2F%2Fsqlonfhir-dstu2.azurewebsites.net%2Ffhir%2F