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25 changes: 13 additions & 12 deletions README.md
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<!-- markdownlint-disable MD001 MD033 MD041 -->

# HL7 Swiss FHIR Implementation Guide for generic laboratory order forms

## CI Build
Expand Down Expand Up @@ -35,7 +37,7 @@ Order & Referral by Form - Implementation Guide (CH:ORF) <http://fhir.ch/ig/ch-o

Download JDK from Oracle website:

https://www.oracle.com/java/technologies/downloads/
<https://www.oracle.com/java/technologies/downloads/>

```bash
cat /etc/fedora-release or $ cat /usr/lib/os-release
Expand All @@ -58,7 +60,6 @@ There are 3 programs which provide 'java'.
Enter to keep the current selection[+], or type selection number:
```


### IG Publisher

Look at <https://confluence.hl7.org/display/FHIR/IG+Publisher+Documentation>
Expand Down Expand Up @@ -115,7 +116,7 @@ after running IG publisher:

## further procedure

look at 'https://fhirblog.com/clinicians-on-fhir-workshop/'
look at '<https://fhirblog.com/clinicians-on-fhir-workshop/>'

1. Description of Problem (use cases from CDA-CH)

Expand Down Expand Up @@ -207,35 +208,35 @@ If a new release is ready, it needs to be tested again on the develop branch. Be
### LOINC for in vitro Diagnostics (LLIVD)
DSTU2 U.S. Data Access Framework (DAF) DiagnosticOrder Profile
'https://www.hl7.org/fhir/dstu2/daf/diagnosticorder-daf.html'
'<https://www.hl7.org/fhir/dstu2/daf/diagnosticorder-daf.html>'
Digital Format for Publication of LOINC to Vendor IVD Test Results by IICC:
'http://ivdconnectivity.org/wp-content/uploads/delightful-downloads/2017/06/IICC_LIVD_Digital_Format_2017_06_01_R2.pdf'
'<http://ivdconnectivity.org/wp-content/uploads/delightful-downloads/2017/06/IICC_LIVD_Digital_Format_2017_06_01_R2.pdf>'
LIVD example bundle
'http://hl7.org/fhir/uv/livd/2019Sep/livd-example.html'
'<http://hl7.org/fhir/uv/livd/2019Sep/livd-example.html>'
Roche qualitative LIVD example bundle 'http://hl7.org/fhir/uv/livd/2019Sep/livd-example-roche-qual.html#root'
Roche qualitative LIVD example bundle '<http://hl7.org/fhir/uv/livd/2019Sep/livd-example-roche-qual.html#root>'
### Structured data capture
'https://wiki.ihe.net/index.php/Retrieve_Form_for_Data_Capture'
'<https://wiki.ihe.net/index.php/Retrieve_Form_for_Data_Capture>'
ITI QRPH Supplement – Structured Data Capture:
'https://ihe.net/uploadedFiles/Documents/QRPH/IHE_QRPH_Suppl_SDC.pdf'
'<https://ihe.net/uploadedFiles/Documents/QRPH/IHE_QRPH_Suppl_SDC.pdf>'
HL7 FHIR Implementation guide: 'http://hl7.org/fhir/uv/sdc/2018Sep/index.html'
HL7 FHIR Implementation guide: '<http://hl7.org/fhir/uv/sdc/2018Sep/index.html>'
Request for diagnostic report 'http://hl7.org/fhir/servicerequest.html'
Request for diagnostic report '<http://hl7.org/fhir/servicerequest.html>'
[Laboratory ask at order entry panel](https://loinc.org/89543-3)
[Universal Lab Orders Value Set from LOINC](https://loinc.org/file-access/download-id/9825/)
### Order and Referral by Form (ORF)
'http://build.fhir.org/ig/ahdis/ch-orf/'
'<http://build.fhir.org/ig/ahdis/ch-orf/>'
[LOINC Document Ontology](https://loinc.org/document-ontology/)
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3 changes: 3 additions & 0 deletions _updatePublisher.sh
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Expand Up @@ -117,13 +117,16 @@ if [[ $skipPrompts == true ]] || [[ $response =~ ^[yY].*$ ]]; then

curl -L $gencont_sh_url -o /tmp/_gencontinuous.new
cp /tmp/_gencontinuous.new _gencontinuous.sh
chmod +x _gencontinuous.sh
rm /tmp/_gencontinuous.new

curl -L $gen_sh_url -o /tmp/_genonce.new
cp /tmp/_genonce.new _genonce.sh
chmod +x _genonce.sh
rm /tmp/_genonce.new

curl -L $update_sh_url -o /tmp/_updatePublisher.new
cp /tmp/_updatePublisher.new _updatePublisher.sh
chmod +x _updatePublisher.sh
rm /tmp/_updatePublisher.new
fi
2 changes: 2 additions & 0 deletions input/fsh/ALIASES.fsh
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Expand Up @@ -2,6 +2,7 @@
Alias: $sct = http://snomed.info/sct
Alias: $loinc = http://loinc.org
Alias: $v2-0203 = http://terminology.hl7.org/CodeSystem/v2-0203
Alias: $v2-0038 = http://terminology.hl7.org/CodeSystem/v2-0038 // orderStatus
Alias: $v2-0371 = http://terminology.hl7.org/CodeSystem/v2-0371
Alias: $v2-0373 = http://terminology.hl7.org/CodeSystem/v2-0373
Alias: $v2-0487 = http://terminology.hl7.org/CodeSystem/v2-0487
Expand All @@ -16,6 +17,7 @@ Alias: $launchContext = http://hl7.org/fhir/uv/sdc/CodeSystem/l
Alias: $microbiol-procedures = http://fhir.ch/ig/ch-lab-order/ValueSet/MicrobiolProcedures
Alias: $shareablevalueset = http://hl7.org/fhir/StructureDefinition/shareablevalueset
Alias: $launchContext = http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext
Alias: $condition-clinical = http://terminology.hl7.org/CodeSystem/condition-clinical
// Alias: $L-Forms = http://terminology.hl7.org/3.1.0/CodeSystem/forms-codes

// ---- Patient
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Instance: LabOrder-ServiceRequest-container-example
InstanceOf: ChLabOrderSRContainer
Title: "LabOrder Service Request for Electrolytes in Serum"
Title: "LabOrder Service Request for Creatinine Clearance and Electrolytes in Serum"
Description: "Example for Service Request as container for multiple Service Requests"
Usage: #example
* id = "LabOrder-container-example"
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Instance: LabOrder-ServiceRequest-creatinine-clearance
InstanceOf: ChLabOrderSRSingletest
InstanceOf: ChLabOrderSRContainer
Title: "LabOrder Service Request for Creatinine clearance"
Description: "Example for Service Request of Creatinine [Moles/volume] and 24h Urin Creatinen"
Usage: #example
* id = "LabOrder-creatinine-clearance"
* identifier[placerOrderIdentifier].type = $v2-0203#PLAC "Placer Identifier"
* identifier[placerOrderIdentifier].system = "urn:oid:2.16.756.5.30"
* identifier[placerOrderIdentifier].value = "123"
* instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-creatinine-clearance"
// * instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/procedure-creatinine-clearance"

* instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/creatinine-clearance"

// der SR referenziert auf 3 weitere SR
* basedOn[0] = Reference(LabOrder-ServiceRequest-urine24h-creatinine)
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Expand Up @@ -14,7 +14,7 @@ Usage: #example
// der SR referenziert auf 3 weitere SR
* basedOn[0] = Reference(LabOrder-ServiceRequest-sodium)
* basedOn[+] = Reference(LabOrder-ServiceRequest-potassium)
* basedOn[+] = Reference(LabOrder-ServiceRequest-chloride) // TODO
* basedOn[+] = Reference(LabOrder-ServiceRequest-chloride)

// ---- grouperID, must be repeated in all dependent SR ----
* requisition.type = $v2-0203#PLAC "Placer Identifier"
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Instance: LabOrder-ServiceRequest-urine24h-creatinine
InstanceOf: ChLabOrderSRSingletest
Title: "LabOrder Service Request for Clinical Chemistry Tests"
Description: "Example for Service Request of Creatinine [Moles/volume] in Serum or Plasma"
Description: "Example for Service Request of Creatinine [Moles/volume] in Urine"
Usage: #example
* id = "LabOrder-u24-creatinine"
* identifier[placerOrderIdentifier].type = $v2-0203#PLAC "Placer Identifier"
Expand Down
2 changes: 1 addition & 1 deletion input/fsh/instances/LabOrder-form.fsh
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Expand Up @@ -893,7 +893,7 @@ Usage: #example
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#4598005 "Osteomalacia (disorder)"
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#737295003 "Transplanted kidney present (finding)"
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#707206008 "Assessment for bariatric surgery (procedure)"
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#443731004 "Assessment using falls risk assessment score for the elderly (procedure)"
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#443731004 "Assessment using Falls Risk Assessment Scale for the Elderly (procedure)"
* item[=].item[=].item[=].item[=].item[=].item[=].answerOption[+].valueCoding = $sct#66999008 "Hyperparathyroidism (disorder)"

// ---- choice of clinical focus
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Instance: procedure-d-dimer
InstanceOf: ActivityDefinition
Description: "Service Short Fibrin D-dimer FEU and DDU panel"
Usage: #example
* meta.profile = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/LabProcedureDefinition"
* language = #en-US
* url = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-d-dimer"
* identifier.use = #official
* identifier.value = "Cl_serum_test"
* version = "0.1.0"
* name = "D-DimerMeasurementProcedure"
* title = "Procedure - d-dimer measurement on in vitro blood serum"
* status = #draft
* experimental = true
* date = "2020-01-24T14:00:00+02:00"
* contact.telecom.system = #url
* contact.telecom.value = "http://hl7.org/Special/committees/orders"
* description = "Chloride measurement procedure on in-vitro serum specimen"
* jurisdiction = http://unstats.un.org/unsd/methods/m49/m49.htm#001
* purpose = "This _ActivityDefinition_ specifies the input specimens and observations needed to perform chloride level test on serum, and the output observation. It is referenced by any _PlanDefinition_ representing a lab service focusing on this test."

* effectivePeriod.start = "2020-04-01"
* effectivePeriod.end = "2020-12-25"

* topic[0] = $loinc#18720-3 "Coagulation studies (set)" // LOINC Specialty code
* topic[+] = $sct#86236002 "Circulating anticoagulant assay (procedure)" // not shure correct code

* kind = #ServiceRequest
* code = $loinc#91556-1 "Fibrin D-dimer DDU [Mass/volume] in Blood by Immunoassay"
* priority = #routine
* timingDuration = 30 'mn' "minutes"
// * specimenRequirement = Reference(SpecimenDefinition/single-test-serum-venous)
// * observationResultRequirement = Reference(ObservationDefinition/observation-serum-chloride)
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Expand Up @@ -35,11 +35,11 @@ Usage: #example
* useContext[=].valueCodeableConcept.text = "(Verdacht) nicht traumatische Fraktur"

* useContext[+].code = http://terminology.hl7.org/CodeSystem/usage-context-type#focus
* useContext[=].valueCodeableConcept = $sct#443731004 "Assessment using falls risk assessment score for the elderly (procedure)"
* useContext[=].valueCodeableConcept = $sct#443731004 "Assessment using Falls Risk Assessment Scale for the Elderly (procedure)"
* useContext[=].valueCodeableConcept.text = "Beurteilung und Behandlung nach unklarem Sturzereignis bei Patienten ≥ 65 Jahren"

* useContext[+].code = http://terminology.hl7.org/CodeSystem/usage-context-type#focus
* useContext[=].valueCodeableConcept = $sct#391040000 "At risk of osteoporotic fracture (finding)" // snomed CT: At increased risk of osteoporotic fracture (finding)
* useContext[=].valueCodeableConcept = $sct#391040000 "At increased risk of osteoporotic fracture (finding)"
* useContext[=].valueCodeableConcept.text = "bei anamnestisch erhöhtem Frakturrisiko bei Patienten ≥ 65 Jahre"

* useContext[+].code = http://terminology.hl7.org/CodeSystem/usage-context-type#focus
Expand Down
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Expand Up @@ -6,10 +6,10 @@ Usage: #example
* language = #en-US
* extension[0].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/CatalogReference"
* extension[=].valueReference = Reference(Composition/Gantenbein-Catalog-Header)
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode" // Analysen-Liste Code
* extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Chloride, serum"
// * extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode" // Analysen-Liste Code
// * extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Chloride, serum"
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1229.00 "Chlorid"
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1229.00 "Chlorid" // Analysen-Liste Code
* extension[+].extension[0].url = "textualSummary"
* extension[=].extension[=].valueMarkdown = "no notable particularity for billing"
* extension[=].extension[+].url = "reimbursabilitySummary"
Expand Down
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Expand Up @@ -16,7 +16,7 @@ Usage: #example
* extension[=].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/BillingSummary"
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ScheduleSummary"
* extension[=].valueString = "Daily ; report on D0"
* url = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/creatinine-clearance"
* url = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/creatinine-clearance" // Canonical identifier
* version = "0.1.0"
* name = "UrineCreatinineClearancePanel"
* title = "24-hour urine creatinine clearance panel"
Expand All @@ -26,7 +26,7 @@ Usage: #example
* date = "2020-02-12T19:00:00+01:00"
* contact.telecom.system = #url
* contact.telecom.value = "http://hl7.org/Special/committees/orders"
* description = "This 24-hour urine creatinine clearance panel is reusing the procedures from the serum creatinine test as well as the procedure from the 24h urine creatinine panel."
* description = "This 24-hour urine creatinine clearance panel is reusing the procedures from the serum creatinine test as well as the procedure from the 24h urine creatinine panel."
* useContext.code = http://terminology.hl7.org/CodeSystem/usage-context-type#task
* useContext.valueCodeableConcept = $v3-ActCode#LABOE // "laboratory test order entry task"
* useContext.valueCodeableConcept.text = "this panel is orderable"
Expand Down Expand Up @@ -54,6 +54,6 @@ Usage: #example
* action.timingDuration = 2 'h' "hours"
* action.groupingBehavior = #logical-group
* action.selectionBehavior = #all
* action.definitionCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-urine24h-creatinine-clearance"
* action.definitionCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-urine24h-creatinine-clearance"
* action.action[0].definitionCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-creatinine-serum"
* action.action[+].definitionCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/ActivityDefinition/procedure-urine24h-creatinine"
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Expand Up @@ -6,10 +6,10 @@ Usage: #example
* language = #en-US
* extension[0].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/CatalogReference"
* extension[=].valueReference = Reference(Composition/Gantenbein-Catalog-Header)
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
* extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Potassium, serum"
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode" // Analysen-Liste Code
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1479.00
// * extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
// * extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Potassium, serum"
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1479.00 // Analysen-Liste Code
* extension[+].extension[0].url = "textualSummary"
* extension[=].extension[=].valueMarkdown = "no notable particularity for billing"
* extension[=].extension[+].url = "reimbursabilitySummary"
Expand Down
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Expand Up @@ -6,10 +6,10 @@ Usage: #example
* language = #en-US
* extension[0].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/CatalogReference"
* extension[=].valueReference = Reference(Composition/Gantenbein-Catalog-Header)
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode" // Analysen-Liste Code
* extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Sodium, serum"
// * extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
// * extension[=].valueCodeableConcept = http://www.ama-assn.org/go/cpt#CPTfakecode "Sodium, serum"
* extension[+].url = "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ServiceBillingCode"
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1479.00 "Kalium Grosslabor"
* extension[=].valueCodeableConcept = https://medcodesearch.ch/de/AL/laboratory_analyses#1479.00 "Kalium Grosslabor" // Analysen-Liste Code
* extension[+].extension[0].url = "textualSummary"
* extension[=].extension[=].valueMarkdown = "no notable particularity for billing"
* extension[=].extension[+].url = "reimbursabilitySummary"
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25 changes: 25 additions & 0 deletions input/fsh/instances/practitioner/ArminAhrens.fsh
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Instance: ArminAhrens
InstanceOf: CHCorePractitioner
Title: "Armin Ahrens"
Description: "Practitioner, works in Arztpraxis, refers to 6-histopath"
Usage: #example
* identifier[0].system = "urn:oid:2.51.1.3"
* identifier[=].value = "7601000050700"
* identifier[+].system = "urn:oid:2.16.756.5.30.1.123.100.2.1.1" // ZSR
* identifier[=].value = "A123309"
* name.use = #official
* name.family = "Ahrens"
* name.given = "Armin"
* name.prefix = "Dr. med."
* name.prefix.extension.url = "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier"
* name.prefix.extension.valueCode = #AC
* telecom[0].system = #phone
* telecom[=].value = "033 123 22 11"
* telecom[=].use = #work
* telecom[+].system = #email
* telecom[=].value = "[email protected]"
* telecom[=].use = #work
* qualification.code.coding.system = "urn:oid:2.16.756.5.30.1.127.3.5"
// CodeSystem: ch-ehealth-codesystem-medreg
* qualification.code.coding.code = #1021
* qualification.code.text = "Dermatology and venereology"
2 changes: 1 addition & 1 deletion input/fsh/profiles/ChLabOrderDiagnosisCondition.fsh
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Expand Up @@ -10,7 +10,7 @@ Description: "Definition for the Diagnosis Condition resource in the context of
Instance: ProblemItem-renal-failure
InstanceOf: ChLabOrderDiagnosisCondition
Description: "Problem or Diagnosis from problem list"

* clinicalStatus = $condition-clinical#active
* category.coding[0] = $sct#55607006 "Problem"
* category.coding[+] = $condition-category#problem-list-item
* code = $sct#90688005
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5 changes: 3 additions & 2 deletions input/fsh/profiles/ChLabOrderSRcontainer.fsh
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Expand Up @@ -130,15 +130,16 @@ Usage: #example

Instance: SR-CreaClearance
InstanceOf: ChLabOrderSRContainer
Title: "ChLabOrderSRContainer containing the Creatinin Clearance Panel"
Title: "ChLabOrderSRContainer containing the Creatinine Clearance Panel"
Description: "Example for Service Request for Creatinine-Clearance Container"
Usage: #example
* id = "CreaClearance"
* identifier[placerOrderIdentifier].type = $v2-0203#PLAC "Placer Identifier"
* identifier[placerOrderIdentifier].system = "urn:oid:2.16.756.5.30"
* identifier[placerOrderIdentifier].value = "123"

* instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/Creatinine-Clearance"
// * instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/Creatinine-Clearance"
* instantiatesCanonical = "http://fhir.ch/ig/ch-lab-order/lab-compendium/PlanDefinition/creatinine-clearance"

* basedOn = Reference(SR-Creatinine-Serum)
* basedOn = Reference(SR-Creatinine-24h-Urine)
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2 changes: 2 additions & 0 deletions input/pagecontent/casestudies-english.md
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@@ -1,3 +1,5 @@
<!-- markdownlint-disable MD001 MD033 MD041 -->

### Case study 1: Suspicion of deep vein thrombosis

A patient, Hans Guggindieluft, presents to Dr. med. Marc Mustermann at the Olten group practice on 09.03.2016. He verbally identifies himself via his master data as Hans Guggindieluft, 01.01.1981. He reports unclear leg pain in the left lower leg as well as simultaneously occurring respiratory pain and cough. The doctor carries out the anamnesis and physical examination and prescribes the following laboratory parameters:
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