FHIR
Getting started with FHIR
Question: How do I get started with FHIR?
Answer: See Getting started with HL7 FHIR
FHIR modelling questions
Question: Plans. Which parts of a plan can be adapted to the individual citizen. Both when the plan is activated and subsequently.
Answer: It is the definitions that are being rolled out. Technically, the things that have been transferred to CarePlan and ServiceRequest can be changed.
Question: Plans. Are titles and descriptions of plan definitions copied into the care plan when this is created?
Answer: No these are currently not copied.
Question: Plan. When a plan reaches an end date, will it then change CarePlan.status to “completed”. Is there automated support for this in the infrastructure?
Answer: No, this is not automated in the infrastructure. It is the employee solution's choice what to do when the plan reaches the end date. It is possible to schedule a status change that matches the end date via the ehealth-careplan status schedule field. A similar ehealth-episodeofcare status schedule is available on EpisodeOfCare.
Question: Starting rules. How should they be handled in the citizen solution and whether all options should be supported?
Answer: Not all options are supported in KAM. KAM uses a subset of the legal values in: https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-plandefinition-definitions.html#PlanDefinition.action.relatedAction.relationship
The following values are currently used:concurrent,after-start,after,after-end
Question: Seamless activities
Answer: The platform sees the activities of the seamless group as separate activities and therefore separate tasks to be acknowledged.
Question: Response from e.g. the create-episode-of-care operation does not contain the created resources as shown in the example in the implementation guide, but only the individual transaction responses.
Answer: Remember to set header ”
Prefer: return=representation"
Question: Measurement. NPU codes are locked to specific units of measurement. If, for example, a bathroom scale is set to pounds, then must it be converted to kg? And is it possible to record the original raw measurement value anywhere?
Answer: No. This is not possible. See https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/1717436538/Preparing+and+Submitting+Measurements#Ensuring-Use-of-Proper-Units
Question: Measurement. How do an e.g. employee solution supports the employee attaching a comment to received measurements / answers?
Answer: Consider using ehealth-communication. If clinical relevance then consider ehealth-clinicalimpression (DK.EHEALTH.SUNDHED.FHIR.IG.CORE\ehealth-clinicalimpression - FHIR v4.0.1)
Question: Triaging. Is it possible to see exactly which limit value that led to the triaging result?
Answer: No this is currently not possible. However, the limit values are available on the observation.
Question: Triaging. Is the triaging creation of tasks synchronous or asynchronous?
Answer: Asynchronous - Measurement service receives synchronously, which however sends events to task service that takes the task asynchronously.
Question: Observation.code should be a certain small selection of codes. Most measuring devices provide observations for a lot of extra quality parameters. Should these be coded into Observation.ehealth-quality? And are there any guidelines for how to fill in Quality.qualityCode? For example, when to use which values of "Device Measuring Quality" (https://docs.ehealth.sundhed.dk/latest-released/ig/ValueSet-ehealth-device-measuring-quality.html)?
Answer: No. It is currently not possibility of additional quality parameters, and it is a fixed set of codes
Question: ClinicalImpression. How should the codes in the value-set ClinicalImpressionFindingCodes be interpreted in relation to the triage colors red, yellow, and green when it comes to measurements?
Answer: The Color is on ClinicalImpression which is the result of the triaging. This then generates a Task with given priority. There is no one-to-one mapping for priority. It is the rule in the library that sets priority. The rules in the Infrastructure use and consistent priority as follows: STAT and ASAP as red, URGENT as yellow, and ROUTINE as green
Question: Consent. How are consents stored / edited in the infrastructure? How is this expected to be filled in? How are the processes around withdrawal and possibly regret this?
Answer: Consent is described here: https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-consent.html. The infrastructure does not relate to withdrawal of Consent. See https://docs.ehealth.sundhed.dk/latest-released/ig/StructureDefinition-ehealth-consent.html#enforcement-of-consent, . The Content status must be "active" for consent to be part of the controls. So possible to set status to "rejected" or "inactive" upon withdrawal.
Question: Episode of care. Is there are place to indicate the name of a episode-of-care?
Answer: No there is no name or description in FHIR episode-of-care. Maybe diagnosis be used for the name.
Question: ServiceRequest. How long must a ServiceRequest be exceeded before a Task is created?
Answer: The task will be created by a job the following night (according to the timing specified). See also Adhering to Care Plans and Measurement Regimes and https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/538935313/Behind+the+.
Question: ServiceRequest.code has cardinality 0..1 and ActivityDefinition.code has cardinality 1..1. Both have required binding on Activity Definition Code ValueSet. When a ServiceRequest references an ActivityDefinition, their codes will then be the same in all cases, and if so, why is there a difference in cardinality?
Answer: There should be no difference. ActivityDefinition.code is always set and copied to ServiceRequest.code and therefore in practice always set. So short answers: Yes ServiceRequest.code is always set.
Question: get-patient-procedures fail with "Invalid date compared to configured value" for some date ranges. What are the rules for valid start and end times for the operation?
Answer: There is a limit on the number of days back in time you can request in the request. This is currently not documented. It is currently set to a maximum of 30 days (MeasurentMaxAgeDays). This means that the start and end date of the request must be a maximum of previous 30 days. There are no limitations in days in the future.
Design and Architecture
Question: How are components from KAM reused in Telemedicine solutions? Are they published as NPM packages?
Answer: No. KAM is a micro frontend architecture, and are loaded and integrated runtime in the browser. See Clinical administrative module (KAM) architecture (DRAFT)
Question: Cleaning up test data. Are there any good tips for how to clean up a little, and avoid having to live with all the data errors you get built up during development?
Answer: The platform “never forget”. Update relevant resources and set status to error states ("Entered-in-error" or "Retired" or similar). Use these states to not be included in searches.
Development and deployment lifecycle
Questions in regards to development and deployment lifecycle:
Question: Where do I find a description of responsibilities and workflow to on how to deploy a new application on the infrastructure?
Answer: See Development and deployment cycle.
Question: Docker basic images are available from eHealth DK's docker registry. How are these accessed (username and password are required)?
Answer: To get access you need to be registered as a supplier. Contact FUT-S. See Contact Information.
Question: The documentation states that images must be signed with a private key, and that the public key must be sent. How is the public key sendt?
Answer: Contact FUT-S. See Contact Information.
Question: It is described that the application or services shall be deployed in the eHealth Infrastructure with an official eHealth helm chart. It is unclear whether it is the the Telemedicine Solution provider who shall create the helm chart or whether this is the eHealth infrastructure owner's task?
Answer: It is the Telemedicine Solution provider task to create the helm chart.
Question: Helmsman config is mentioned in Development and deployment cycle . It is unclear whether this is something the supplier needs to deal with, or whether this is platform owner documentation for deploying applications?
Answer: The Telemedicine Solution provider shall configure Helmsman.