Frequently Asked Questions

Owned by Erik Nielsen
Last updated: 30-07-2024 by malthe lange
5 min read

Provides questions and answers for developing Telemedicine Solutions for the eHealth Infrastructure.

FHIR

FHIR modelling questions

  1. Question: Plans. Which parts of a plan can be adapted to the individual citizen? Both when the plan is activated and subsequently.

    1. Answer: It is the definitions that are being rolled out. Technically, the things that have been transferred to CarePlan and ServiceRequest can be changed.

  2. Question: Plans. Are titles and descriptions of plan definitions copied into the care plan when this is created?

    1. Answer: No these are currently not copied.

  3. 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?

    1. 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.

  4. Question: Starting rules. How should they be handled in the citizen solution and whether all options should be supported?

    1. Answer: Not all options are supported in KAM. KAM uses a subset of the legal values ​​in https://ehealth.sundhed.dk/fhir/StructureDefinition-ehealth-plandefinition-definitions.html#PlanDefinition.action.relatedAction.relationship
      The following values ​​are currently used: concurrent, after-start, after, after-end

  5. Question: Seamless activities

    1. Answer: The platform sees the activities of the seamless group as separate activities and therefore separate tasks to be acknowledged.

  6. 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.

    1. Answer: Remember to set the header ”Prefer: return=representation"

  7. 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? Is it possible to record the original raw measurement value anywhere?

    1. Answer: No. This is not possible. See Preparing and Submitting Measurements | Ensuring Use of Proper Units

  8. Question: Measurement. How does an e.g. employee solution support the employee attaching a comment to received measurements/answers?

    1. Answer: Consider using ehealth-communication. If clinical relevance then consider ehealth-clinicalimpression (DK.EHEALTH.SUNDHED.FHIR.IG.CORE\ehealth-clinicalimpression - FHIR v4.0.1)

  9. Question: Triaging. Is it possible to see exactly which limit value led to the triaging result?

    1. Answer: No this is currently not possible. However, the limit values ​​are available on the observation.

  10. Question: Triaging. Is the triaging creation of tasks synchronous or asynchronous?

    1. Answer: Asynchronous - Measurement service receives synchronously, which however sends events to task service that takes the task asynchronously.

  11. 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://ehealth.sundhed.dk/fhir/ValueSet-ehealth-device-measuring-quality.html)?

    1. Answer: No. It is currently not possible to additional quality parameters, and it is a fixed set of codes

  12. Question: ClinicalImpression. How should the codes in the value-set ClinicalImpressionFindingCodes be interpreted about the triage colours red, yellow, and green when it comes to measurements?

    1. Answer: The Color is on ClinicalImpression which is the result of the triaging. This then generates a Task with a 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 are as follows: STAT and ASAP as red, URGENT is yellow, and ROUTINE is green

  13. Question: Consent. How is consent stored/edited in the infrastructure? How is this expected to be filled in? What are the processes around withdrawal and possibly regretting this?

    1. Answer: Consent is described here: https://ehealth.sundhed.dk/fhir/StructureDefinition-ehealth-consent.html . The infrastructure does not relate to the withdrawal of Consent. See https://ehealth.sundhed.dk/fhir/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 the status to "rejected" or "inactive" upon withdrawal?

  14. Question: Episode of care. Is there is place to indicate the name of an episode-of-care?

    1. Answer: No there is no name or description in FHIR episode-of-care. Maybe diagnosis be used for the name.

  15. Question: ServiceRequest. How long must a ServiceRequest be exceeded before a Task is created?

    1. 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 Behind the Scenes.

  16. 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?

    1. 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.

  17. 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?

    1. 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 the previous 30 days. There are no limitations in days in the future.

Design and Architecture

  1. Question: How are components from KAM reused in Telemedicine solutions? Are they published as NPM packages?

    1. Answer: No. KAM is a micro frontend architecture and is loaded and integrated runtime in the browser. See Architecture of Clinical Administrative Module (Danish: Klinisk Administrativt Modul aka KAM)

  2. 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?

    1. 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.

Security and Login

Questions regarding security and login:

  1. Question: User not log on after the solution has been deployed to production?

    1. Answer: Please check if you have set the kc_idp_hint query parameter. The parameter is used in Keycloak to allow clients to override the default identity provider. If the client overrides the default identity provider by setting the kc_idp_hint to either a value or empty, the automatic redirect to SEB does not work. See also Server Administration Guide (keycloak.org)

Development and deployment lifecycle

Questions regarding development and deployment lifecycle:

  1. Question: Where do I find a description of responsibilities and workflow on how to deploy a new application on the infrastructure?

    1. Answer: See Development and deployment cycle.

  2. Question: Docker basic images are available from eHealth DK's docker registry. How are these accessed (username and password are required)?

    1. Answer: To get access you need to be registered as a supplier. Contact FUT-S. See Contact Information.

  3. 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 sent?

    1. Answer: Contact FUT-S. See Contact Information.

  4. 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.

    1. Answer: The Telemedicine Solution provider shall configure Helmsman.