2019-11-20 NOV

HL7 FHIR

• FHIR Tutorial from Cerner
• EPICs FHIR resources
• Cerner Smart authorization presentation
• Cerner FHIR presentation
• Smart on FHIR tutorial
• http://www.hl7.org/fhir/overview.html :
• Format: http://www.hl7.org/fhir/json.html
• API: http://www.hl7.org/fhir/http.html
• Resources: http://www.hl7.org/fhir/resourcelist.html

Cerner's Open Sandbox API (retrieve FHIR data w/o SMART authorization):

Open vs Secure Sandbox: https://fhir.cerner.com/millennium/dstu2/#service-root-url

Cerner FHIR Documentation from w/ Examples for three common resources:

Patient - demographics and identifiers: https://fhir.cerner.com/millennium/dstu2/individuals/patient/

Conditions - problems and diagnoses: https://fhir.cerner.com/millennium/dstu2/general-clinical/condition/

Observation - vital signs and labs: https://fhir.cerner.com/millennium/dstu2/diagnostic/observation/

GET URL (example): https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation

Different parts of the URL:

• "DSTU2" = draft version of the FHIR standard - latest one is R4, released earlier this year. https://www.hl7.org/fhir/history.html
• "0b8...1ca" = the Tenant ID - specific to site or domain. For instance, our Cerner DEV and PROD domains have different tenant IDs
• "Observation" = FHIR resource. 20+ available, permissions to read or write configured for your app in the Code Console and also requested by your app during OAuth2.

Let's use Postman to retrieve some FHIR data:

• Header: Application/JSON
• Method: GET
• URL examples for the resources above:
  • Patient - Find patient demographics and system ID using his/her MRN (identifier with the address URN:OID:1.1.1.1.1.1)
    • https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Patient?identifier=urn:oid:1.1.1.1.1.1|10002701
    • URN - uniform resource name
    • OID - object identifier
  • Observation - Find labs corresponding to loinc codes 2514-8 (Ketone Urine Dipstick) and 5811-5 (Specific Gravity Urine Dipstick), done between 8/16/2018 and 8/15/2020 for patient whose system ID is 4342008 (to find system ID, see query to Patient endpoint above).
    • https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation?patient=4342008&date=gt2018-08-16&date=lt2020-08-15&code=http://loinc.org|2514-8,http://loinc.org|5811-5
  • Condition - Find all *active* *diagnoses* for a patient whose system ID is 4342008 (to find system ID, see query to Patient endpoint above).
    • https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Condition?patient=4342008&category=diagnosis&clinicalstatus=active