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The eHealth Infrastructure document-query and document-transformation services provide integrations to the Danish national document-sharing infrastructure.

This page describes the eHealth infrastructure capabilities for

  1. How to query and retrieve documents from NSP

  2. How to upload CDA documents to NSP

  3. Details on transformations FHIR to CDA Document

  4. Details on transformations CDA Document to FHIR

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Transformation

Source (XML document in FHIR DocumentReference)

Target (XML document in FHIR DocumentReference)

Comment

$transform-to-PHMR

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-to-PHMR.html

Bundle of FHIR resources.

The primary source of information is a FHIR Observation.

PHMR v1.3 XML document.

Used in assembly, transformation and upload of FHIR Observation transformed to PHMR to XDS-based document sharing infrastructure as described in Sharing through Registering Documents in National Document Sharing Infrastructure.

$transform-to-QRD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-to-QRD.html

Bundle of FHIR resources.

The primary source of information is an FHIR QuestionnaireResponse.

QRD v1.3 XML document

Used in assembly, transformation and upload of FHIR QuestionnaireResponse transformed to QRD to XDS-based document sharing infrastructure as described in Sharing through Registering Documents in National Document Sharing Infrastructure.

Info

Before release 2024.3

$transform-to-QFDD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-to-QFDD.html

Bundle of FHIR resources.

The primary source of information is the FHIR Questionnaire.

QFDD v1.1 XML document

Info

With release 2024.3

$transform-to-QFDD

TODO: new link

Bundle of FHIR resources.

The primary source of information is the FHIR Questionnaire.

QFDD v1.2 XML document

$transform-to-APD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-to-APD.html

Bundle of FHIR resources.

The primary source of information is a FHIR Appointment.

APD v2.0 XML document

Used in assembly, transformation and upload of FHIR Appointment transformed to APD to XDS-based document sharing infrastructure as described in Sharing through Registering Documents in National Document Sharing Infrastructure.

$transform-from-PHMR

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-from-PHMR.html

PHMR v1.3 XML document.

Bundle of FHIR resources.

The most significant information is within an FHIR Observation.

The resultingtion(s) is not guaranteed to be a valid FHIR Observation.

$transform-from-QRD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-from-QRD.html

QRD v1.3 XML document

Bundle of FHIR resources.

The most significant information is within a FHIR QuestionnaireResponse.

The resulting QuestionnaireResponse is not guaranteed to be a valid FHIR QuestionnaireResponse.

$transform-from-QRD-based-on-questionnaire

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-from-QRD-based-on-questionnaire.html

Info

Please note that the description of the operation is valid as of v3.0.0 of the eHealth Infrastructure Implementation Guide (IG) even though the link is to the IG continuous build. Please refer to the latest released version of the IG for all other purposes.

QRD v1.3 XML document

Bundle of FHIR resources

Most significant information is within an FHIR QuestionnaireResponse with a structure matching the Questionnaire given as input. The QuestionnaireResponse will have linkIDs matching the corresponding Questionnaire.

The resulting QuestionnaireResponse is not guaranteed to be a valid FHIR QuestionnaireResponse.

Info

Before release 2024.3

$transform-from-QFDD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-from-QFDD.html

QFDD v1.1 XML document

Bundle of FHtheR resources.

The primary source of information is the FHIR Questionnaire.

Info

With release 2024.3

$transform-from-QFDD

Todo: new link

QFDD v1.2 XML document

The primary resource in the return bundle is the FHIR Questionnaire.

$transform-from-APD

https://ehealth.sundhed.dk/fhir/OperationDefinition--s-transform-from-APD.html

APD v2.0 XML document

Bundle of FHIR resources.

The primary source of information is a FHIR Appointment.

The resulting Appointment is not guaranteed to be a valid FHIR Appointment.

...

Info

With FUT-I Release 2024.3.1_RC-Medcom:

  1. At root level of the FHIR Questionnaire, the number of question groups (Questionnaire.item with item.type set to group) shall match the number of QFDD sections

...

QFDD Element

FHIR Questionnaire

Comment

Information Only Section

A Questionnaire.item at root level with Questionnaire.item.type ="group"

A single child item Questionnaire.item.item with .type = "display"

Question Section (with one or more Question Organizer)

A Questionnaire.item at root level with Questionnaire.item.type ="group"

Root-level group

For each QFDD Question Organizer:

A single child item Questionnaire.item.item with .type = "group"

Subgroup of root-level group

For each question in the group/QFDD Question Organizer:

A single child item Questionnaire.item.item.item with .type = subtype of "question" for instance "decimal"

Question type item in subgroup of root-level group.

For subtypes of "question" see http://hl7.org/fhir/R4/valueset-item-type.html

Info

With Release 2024.3.1_RC-Medcom

Copyright Section

A Questionnaire.item at root level with:

  • Questionnaire.item.type ="group"

  • Questionnaire.item.isCopyright = true (see isCopyright)

One or more child items Questionnaire.item.item with:

  • Questionnaire.item.item.type = "display"

  • Questionnaire.item.item.isCopyright = true

Not transformed as algorithms and expressions are not supported in QFDD.

A Questionnaire.item at any level with an .extension http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression and .readOnly = "true"

A Calculated expression within the FHIR Questionnaire, see https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/1716060177/Managing+Questionnaires#Defining-a-Calculation-Expression

...

Logical Part

QFDD Document

Details

Copyright Section

/ClinicalDocument/component/structuredBody/component/section

Copyright section uses Questionnaire.copyright

...

Info

With Release 2024.3

.1

_RC-Medcom

Logical Part

QFDD Document

Details

Copyright Section

/ClinicalDocument/component/structuredBody/component/section

(with (./templateId root = "2.16.840.1.113883.10.20.32.2.2")

A root-level item with:

  • Questionnaire.item.type = "group"

  • Questionnaire.item.isCopyright = true

Title

…/component/section/title

  • Questionnaire.item.text containing the group title

Narrative

…/component/section/text

The narrative is automatically generated by the transformation and contains the plain text from each copyright text(entry) separated by three <br/>.

Note: When transforming from QFDD to FHIR Questionnaire the narrative is not transformed.

Entry

../entry/observation/value

One or more child items in the group with:

  • Questionnaire.item.item.type = "display"

  • Questionnaire.item.item.text.xhtml = formatted text

  • (Questionnaire.item.item.text contains the unformatted equivalent)

  • Questionnaire.item.item.isCopyright = true

Note: When transforming from QFDD the display items will contain the plain text.

  • Language

/ClinicalDocument/languageCode

Questionnaire.language

...

QFDD Element

FHIR Questionnaire

Comment

Information Only Section

A Questionnaire.item at root level with Questionnaire.item.type ="group"

A single child item Questionnaire.item.item with .type = "display"

Question Section (with one or more Question Organizer)

A Questionnaire.item at root level with Questionnaire.item.type ="group"

For each QFDD Question Organizer:

A single child item Questionnaire.item.item with .type = "group"

For each question in the group/QFDD Question Organizer:

A single child item Questionnaire.item.item.item with .type = subtype of "question" eg. ‘decimal’

Info

With Release 2024.3.1_RC-Medcom

Copyright Section

A Questionnaire.item at root level with:

  • Questionnaire.item.type ="group"

  • Questionnaire.item.isCopyright = true (See isCopyright)

One or more child items Questionnaire.item.item with:

  • Questionnaire.item.item.type = "display"

  • Questionnaire.item.item.isCopyright = true

Not transformed as algorithms and expressions are not supported in QFDD.

A Questionnaire.item at any level with an .extension http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression and .readOnly = "true"

A Calculated expression within the questionnaire, see https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/1716060177/Managing+Questionnaires#Defining-a-Calculation-Expression

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