Benyttede FHIR Ressurser i Skjemaløsningen
Innledning
I forbindelse med løsningen for digitale skjema benyttes følgende FHIR ressurser på Helsenorge. Alle ressursene er FHIR R4:
Skjemaoppgave Task. Detaljert beskrivelse: FHIR Task - Oppgave
Organization. Benyttes som contained ressurs i Task.
Skjemadefinisjon: Questionnaire
Skjemarespons: QuestionnaireResponse
For “lesbare” dokumenter eller proprietære formater: DocumentReference
Sammensetning av flere FHIR ressurser: Bundle
Questionnaire
Denne benyttes for å beskrive skjemaer, lovlige respons verdier samt logikken i skjemaet. Det kan også legges inn initielle verdier i et slikt skjema.
Helsenorge har en egen skjemautfyller som opererer på slike skjema definisjoner.
Skjemadefinisjonen kan være forhåndslagret i Helsenorge sin skjemakatalog eller sendes med som input fra aktøren som ønsker at innbygger fyller ut et skjema.
Dersom man ønsker at innbygger skal fylle ut et skjema som er forhåndslagret i Helsenorge sin skjemakatalog, må man i “skjemaoppgaven” Task referere til dette. Man kan referer til et skjema på to måter:
Angi “blankett-nummer”. Dette er identifikasjonen på et logisk skjema. Et skjema, identifisert med “blankett-nummer”, kan finnes i flere språk-versjoner. Dersom man refererer til et skjema med “Blankett-nummer” tilbys innbygger å velge skjemaet i ønsket språk, dersom skjemaet er laget på flere språk.
Angi “skjema-id”. Dette er en instans av et “Blankett-nummer” på et bestemt språk. Vanligvis vil en aktør referere til et “blankett-nummer”.
Det er laget en egen profil for denne FHIR-ressursen med en del utvidelser: SDF Questionnaire
QuestionnaireResponse
Denne benyttes for å beskrive resultatet av at innbygger har fylt ut et skjema. Ofte trenger mottager av denne også skjemadefinisjonen (Questionnaire) for å kunne “tolke” responsen.
Helsenorge sin egen skjemautfyller benytter alltid denne ressursen for å angi strukturert resultat av utfylt skjema.
Eksterne skjemautfyllere oppfordres også til å benytte denne ressursen for å beskrive resultatet av at innbygger har fylt ut et skjema. Dette er likevel ikke en forutsetning for at Helsenorge kan håndtere den eksterne skjemautfylleren.
Det er laget en egen profil for denne FHIR-ressursen med en del utvidelser: SDF QuestionnaireResponse
DocumentReference
Denne benyttes i Skjemaløsningen for å beskrive innhold som ikke er standardiserte FHIR ressurser.
Benyttes for å være bærer av menneskelig lesbar versjon av et utfylt skjema (dvs. PDF-versjon)
Kan eventuelt benyttes i framtidig funksjonalitet for å være bærer av strukturert format for utfylt skjema der dette ikke er en FHIR QuestionnaireResponse. Vil kun benyttes dersom det benyttes ekstern skjemautfyller som ikke benytter standardiserte FHIR ressurser.
DocumentReference for lesbart skjemasvar (PDF)
Helsenorge sender alltid med denne i tillegg til strukturert respons. Se under om bruk av Bundle i skjemaløsningen.
Eksterne skjemautfyllere skal alltid sende en kopi til Helsenorge av utfylt skjema i PDF-format. Dette blir innbyggers kopi av innsendt svar. Dette skal gjøres selv om ekstern skjemautfyller selv distribuerer svaret til mottagende organisasjon.
<DocumentReference>
<id value="753d3a1e-367d-4ecf-8c66-857ab441f9e9"/>
<status value="current"/>
<docStatus value="final"/>
<!-- Den innbygger utfylt skjema gjelder / omhandler -->
<subject>
<identifier>
<system value="urn:oid:2.16.578.1.12.4.1.4.1"/>
<value value="01126222358"/>
</identifier>
<display value="Adrian Moe"/>
</subject>
<!-- Tar med dato det ble fylt ut av innbygger. -->
<date value= "2020-12-21T13:45:30+01:00"/>
<!-- Innbygger som har fylt ut skjemaet. Kan være annen enn "subject" hvis representasjon tillates -->
<author>
<identifier>
<system value="urn:oid:2.16.578.1.12.4.1.4.1"/>
<value value="01126222358"/>
</identifier>
<display value="Adrian Moe"/>
</author>
<!-- Generert verdi -->
<description value="Svar på skjema {xxxx} i PDF-format "/>
<content>
<attachment>
<contentType value="application/pdf" />
<!-- Bare et vilkårlig PDF-dokument her i eksemplet, ikke det virkelige -->
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</context>
</DocumentReference>
DocumentReference ved proprietært format på Utfylt skjema
UseCase 1: Benyttes dersom ekstern skjemautfyller mellomlagrer delvis utfylt skjema på Helsenorge.
Usecase 2 (støttes pr. i dag ikke på Helsenorge): Benyttes når Helsenorge formidler skjemarespons fra eksterne skjemautfyllere som ikke benytter QuestionnaireRespons (dvs. proprietære formater).
Forutsetter at mottager som skal tolke skjemasvaret kjenner det proprietære formatet. I dette tilfelle skal det også være en “lesbar” PDF-kopi til innbygger i samme Bundle.
<DocumentReference>
<id value="fb02b1bb-0942-494a-afce-8671937877f4"/>
<status value="current"/>
<docStatus value="final"/>
<!-- Hvilken innbygger skjemaet gjelder/omhandler -->
<subject>
<identifier>
<system value="urn:oid:2.16.578.1.12.4.1.4.1"/>
<value value="01126222358"/>
</identifier>
<display value="Adrian Moe"/>
</subject>
<!-- Dato skjemaet ble fylt ut av innbygger. -->
<date value= "2020-12-21T13:45:30+01:00"/>
<!-- Innbygger som har fylt ut skjemaet (kan være annen enn "subject" hvis representasjon tillates -->
<author>
<identifier>
<system value="urn:oid:2.16.578.1.12.4.1.4.1"/>
<value value="01126222358"/>
</identifier>
<display value="Adrian Moe"/>
</author>
<!-- Generert verdi -->
<description value="Svar på skjema {xxxx}"/>
<content>
<attachment>
<contentType value="application/octet-stream" />
<!-- Binært innhold som representere proprietært format -->
<data 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Bruk av Bundle i skjemaløsningen
Formidling av utfylt skjema fra Helsenorge til mottager
Standardisert skjemarespons FHIR QuestionnaireResponse
Bundle inneholder:
QuestionnaireResponse
Questionnaire
DocumentReference (for PDF versjon av respons)
ServiceRequest. Dersom skjema har oppsummerende informasjon, typisk som del av triagering.
Fra versjon 1.1 av melding er bruken av ServiceRequest mulig og bruken av link utvidet til å kunne knytte et skjema til andre element enn oppgave.
<?xml version="1.0" encoding="UTF-8"?>
<Bundle
xmlns="http://hl7.org/fhir"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="http://hl7.org/fhir fhir-single.xsd">
<!-- En unik ressurs GUID for denne Bundle -->
<id value="fb02b1bb-0942-494a-afce-8671937877f4"/>
<!-- Bruker "collection" når sendt med AMQP og "transaction" ved bruk av REST API (HTTP PUT) -->
<type value="collection"/>
<!-- Tidspunkt når Bundle ble generert -->
<timestamp value="2020-12-21T13:45:30+01:00"/>
<link>
<!-- Denne er med dersom dette er en respons på en oppgave dvs. FHIR Task -->
<relation value="replies"/>
<!-- Dette er GUID i Task.identifier for den oppgave dette er respons på -->
<url value="urn:uuid:aa54d29e-4009-49cb-9ec4-847a6469459d"/>
</link>
<entry>
<fullUrl value="urn:uuid:51f5f36f-13ad-48b4-a7a7-2c4285f8c96b" />
<resource>
<!-- QuestionnaireResponse med eller uten Narrative <txt>- del -->
<QuestionnaireResponse>
<id value="51f5f36f-13ad-48b4-a7a7-2c4285f8c96b"/>
.
.
</QuestionnarieResponse>
</resource>
</entry>
<entry>
<!-- Kopi av Questionnaire -->
<fullUrl value="urn:uuid:f3da38c2-594c-4d0a-b969-4ab9dfc0cc3f" />
<resource>
<Questionnaire>
<!-- Benytter skjemaets ressurs id -->
<id value="f3da38c2-594c-4d0a-b969-4ab9dfc0cc3" />
.
.
</questionnarie>
</resource>
</entry>
<entry>
<!-- Bruker DocumentReference for PDF-dokument! -->
<fullUrl value="urn:uuid:753d3a1e-367d-4ecf-8c66-857ab441f9e9" />
<resource>
<DocumentReference>
<id value="753d3a1e-367d-4ecf-8c66-857ab441f9e9"/>
.
.
<!-- Context gir knytning mellom PDF dokumnentet og "strukturert skjemarespons".
Det kan også være med knytning til "skjemaoppgave" (Task) dersom responsen er resultat av en skjemaoppgave. -->
<context>
<!-- Knytning til "strukturert skjemarespons". Her QuestionnaireResponse.id (i denne bundle) -->
<related>
<type value="QuestionnaireResponse"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:51f5f36f-13ad-48b4-a7a7-2c4285f8c96b"/>
</identifier>
</related>
<!-- Knytning til skjemaoppgave, dersom responsen er resultat av skjemaoppgave. Referere til Task.identifier -->
<related>
<type value="Task"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:aa54d29e-4009-49cb-9ec4-847a6469459d"/>
</identifier>
</related>
</context>
</DocumentReference>
</resource>
</entry>
</Bundle>
Bruk av Bundle.Link for referanse til annet element
En skjemaoppgave kan være sendt inn selvstendig, knyttet til en oppgave som innbygger har mottatt (task) eller knyttet til en timebestilling, melding eller annet.
For å få med denne referansen benyttes link
Referanse til Oppgave:
Referanse til timeavtale:
Referanse til melding:
Flere referanser kan blir støttet på sikt.
Proprietær strukturert skjemarespons (kan benyttes ved ekstern utfyller). Denne UseCase støttes pr i dag ikke på Helsenorge.
Bundle inneholder:
DocumentReference (for binær representasjon av proprietært format for strukturert respons)
DocumentReference (for PDF versjon av respons)
Innsending av Oppgave til Innbygger (Helsenorge) der skjemadefinisjonen er med
Det kan også benyttes Bundle for skjemaoppgaver.
Dette skal kun gjøres dersom det ikke refereres til et skjema som er lagret i Skjemakatalogen på Helsenorge.
I slik tilfelle skal en skjemaoppgave sendes inn med en FHIR bundle bestående av:
Et FHIR Task (FHIR Task - Oppgave)
FHIR Questionnaire
Se her for fullstendige XML-eksempler: