FHIR Patient Resource Response does not map to FHIRModel.R4.Patient

Question

Question

Scott Roth · Jul 8

#DTL #FHIR #JSON #HealthShare #InterSystems IRIS for Health #Health Connect #InterSystems IRIS

I am receiving a FHIR response bundle back with a resource of patient. Using fromDao, I attempted to take the stream and put it into FHIRModel.R4.Patient but it is not mapping correctly. When I attempt to take FHIRModel.R4.Patient and write it out using toString(), all I am seeing is the resource

{"resourceType":"Patient"}

so the response is not mapping correctly to FHIRModel.R4.Patient. How have others handled this? Do I need to translate it to an SDA since it does fit the model format?

Product version: IRIS 2024.1

$ZV: IRIS for UNIX (Red Hat Enterprise Linux 8 for x86-64) 2024.1 (Build 267_2U) Tue Apr 30 2024 16:06:39 EDT [HealthConnect:7.2.0-1.r1]

Discussion (6)2

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Ashok Kumar T · Jul 8

The HS.FHIRModel.R4.Patient class in IRIS directly represents the FHIR R4 Patient resource as defined. When a FHIR Bundle is loaded using HS.FHIRModel.R4.Bundle.fromDao(), each resource in the bundle's entry.resource is automatically mapped to the correct HS.FHIRModel.R4.* subclass (e.g., Patient, Encounter, AllergyIntolerance) based on its resourceType. There’s no need for manual casting — the object model handles the typing internally.

here is the sample code

Set bundle={"resourceType":"Bundle","type":"searchset","total":3,"entry":[{"fullUrl":"https://example.org/fhir/Patient/patient-1","resource":{"resourceType":"Patient","id":"patient-1","name":[{"family":"Doe","given":["John"]}],"gender":"male","birthDate":"1985-02-15"},"search":{"mode":"match"}},{"fullUrl":"https://example.org/fhir/Encounter/encounter-1","resource":{"resourceType":"Encounter","id":"encounter-1","status":"finished","class":{"system":"http://terminology.hl7.org/CodeSystem/v3-ActCode","code":"AMB","display":"ambulatory"},"subject":{"reference":"Patient/patient-1"},"period":{"start":"2023-07-01T10:00:00Z","end":"2023-07-01T10:30:00Z"}},"search":{"mode":"include"}},{"fullUrl":"https://example.org/fhir/AllergyIntolerance/allergy-1","resource":{"resourceType":"AllergyIntolerance","id":"allergy-1","clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical","code":"active"}]},"verificationStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/allergyintolerance-verification","code":"confirmed"}]},"type":"allergy","category":["food"],"criticality":"high","code":{"coding":[{"system":"http://snomed.info/sct","code":"227493005","display":"Cashew nuts"}],"text":"Allergy to cashews"},"patient":{"reference":"Patient/patient-1"},"reaction":[{"manifestation":[{"coding":[{"system":"http://snomed.info/sct","code":"271807003","display":"Skin rash"}]}],"severity":"moderate"}]},"search":{"mode":"include"}}]}                                                                                             
set fhirModelBundle = ##class(HS.FHIRModel.R4.Bundle).fromDao(bundle)  
;
Zwrite fhirModelBundle.entry.list.size()
3
;
Zwrite fhirModelBundle.entry.list.get(0).toDao() ; patient
{"fullUrl":"https://example.org/fhir/Patient/patient-1","resource":{"resourceType":"Patient","id":"patient-1","name":[{"family":"Doe","given":["John"]}],"gender":"male","birthDate":"1985-02-15"},"search":{"mode":"match"}}  ; <DYNAMIC OBJECT>                        
;
Zwrite fhirModelBundle.entry.list.get(1).toDao() ; encounter
{"fullUrl":"https://example.org/fhir/Encounter/encounter-1","resource":{"resourceType":"Encounter","id":"encounter-1","status":"finished","class":{"system":"http://terminology.hl7.org/CodeSystem/v3-ActCode","code":"AMB","display":"ambulatory"},"subject":{"reference":"Patient/patient-1"},"period":{"start":"2023-07-01T10:00:00Z","end":"2023-07-01T10:30:00Z"}},"search":{"mode":"include"}}  ; <DYNAMIC OBJECT>                                                                                                                         
;
Zwrite fhirModelBundle.entry.list.get(2).toDao() ; Allergy
{"fullUrl":"https://example.org/fhir/AllergyIntolerance/allergy-1","resource":{"resourceType":"AllergyIntolerance","id":"allergy-1","clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical","code":"active"}]},"verificationStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/allergyintolerance-verification","code":"confirmed"}]},"type":"allergy","category":["food"],"criticality":"high","code":{"coding":[{"system":"http://snomed.info/sct","code":"227493005","display":"Cashew nuts"}],"text":"Allergy to cashews"},"patient":{"reference":"Patient/patient-1"},"reaction":[{"manifestation":[{"coding":[{"system":"http://snomed.info/sct","code":"271807003","display":"Skin rash"}]}],"severity":"moderate"}]},"search":{"mode":"include"}}  ; <DYNAMIC OBJECT>

0 0

score 0 · Answer 1 · 2025-07-08T13:26:04-04:00

It seems that you're encountering an issue with mapping the FHIR response inside FHIRModel.R4.Patient. Based on provided references, here are some relevant approaches to address this:

When working with FHIR responses, it's essential to use the appropriate method to map and handle the response. Utilize the HS.FHIR.DTL.vR4.Model.Resource.Bundle.FromJSON method for parsing the JSON stream of your FHIR response. This method converts the JSON stream into a class object that you can navigate programmatically:
```
Set BundleObject = ##class(HS.FHIR.DTL.vR4.Model.Resource.Bundle).FromJSON(pHttpResponse.Data, "vR4")
```
After converting to a Bundle, you can explore its entry elements to locate and manipulate the Patient resource [1].
If you're considering transforming FHIR responses into SDA (Summary Document Architecture), you can use HS.FHIR.DTL.Util.API.Transform.FHIRToSDA3 for converting FHIR messages to the SDA structure. However, note that this specific transformation expects certain configurations and may involve handling additional fields that might not directly belong to a FHIR request [2][3].
If the Patient resource isn't being fully populated, validate the FHIR payload against the expected schema. Ensure all mandatory fields and structures align with the FHIRModel.R4.Patient class requirements. In certain cases, mapping issues occur due to missing fields or format mismatches.
Lastly, the Quick Stream ID might also be relevant for identifying and processing the incoming FHIR response correctly. Ensure you're interacting with the response appropriately:
```
Set quickStreamIn = ##class(HS.SDA3.QuickStream).%OpenId(tResponse.QuickStreamId)
Set responseObject = ##class(%DynamicObject).%FromJSON(quickStreamIn)
```

These approaches can help debug and refine your handling of the FHIR Patient resource. If further clarification on specific methods is needed, let me know! [4][5][1].

Sources:

1.FHIR payload to FHIR message class

2.Handling FHIR Responses in InterSystems – Transforming to SDA

3.How to convert fhir R4 to SDA through iris, is there any specific link

4.Help Needed: Empty Bundle When Converting CCDA to FHIR in InterSystems IRIS

5.Using FHIR Adapter to offer FHIR services over legacy systems - Reading a Resouce

score 0 · Answer 2 · 2025-07-08T16:18:04-04:00

Hello @Scott Roth

I directly import JSON via fromDao method and It works for me. Did you get any errors while importing?

Set patient = {"resourceType":"Patient","id":"example","text":{"status":"generated","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">John Doe</div>"},"identifier":[{"use":"usual","type":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v2-0203","code":"MR","display":"Medical Record Number"}]},"system":"http://hospital.smarthealth.org","value":"123456"}],"active":true,"name":[{"use":"official","family":"Doe","given":["John"]}],"telecom":[{"system":"phone","value":"+1 555-123-4567","use":"mobile"},{"system":"email","value":"john.doe@example.com","use":"home"}],"gender":"male","birthDate":"1980-01-01","address":[{"use":"home","line":["123 Main Street"],"city":"Anytown","state":"CA","postalCode":"90210","country":"USA"}]}
Set r4Patient = ##class(HS.FHIRModel.R4.Patient).fromDao(patient)
Write r4Patient.toString()

score 0 · Answer 3 · 2025-07-08T16:51:35-04:00

I attempted that..

DEVCLIN>set patient = {"resourceType":"Bundle","type":"searchset","total":1,"link":[{"relation":"self","url":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient?identifier=OSUMRN|415012765"}],"entry":[{"link":[{"relation":"self","url":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient/efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3"}],"fullUrl":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient/efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3","resource":{"resourceType":"Patient","id":"efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3","extension":[{"valueCodeableConcept":{"coding":[{"system":"urn:oid:1.2.840.114350.1.13.172.3.7.10.698084.130.768080.39128","code":"male","display":"male"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/legal-sex"},{"valueCodeableConcept":{"coding":[{"system":"urn:oid:1.2.840.114350.1.13.172.3.7.10.698084.130.768080.35144","code":"male","display":"male"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/sex-for-clinical-use"},{"extension":[{"valueCoding":{"system":"http://terminology.hl7.org/CodeSystem/v3-NullFlavor","code":"UNK","display":"Unknown"},"url":"ombCategory"},{"valueString":"Unknown","url":"text"}],"url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"},{"extension":[{"valueString":"Unknown","url":"text"}],"url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"},{"valueCode":"248153007","url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex"},{"valueCodeableConcept":{"coding":[{"system":"http://loinc.org","code":"LA29518-0","display":"he/him/his/his/himself"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/calculated-pronouns-to-use-for-text"}],"identifier":[{"use":"usual","type":{"text":"CEID"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.3.688884.100","value":"OSRDR3259GL4948"},{"use":"usual","type":{"text":"EPI"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.5.737384.0","value":"E4377"},{"use":"usual","type":{"text":"EXTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.698084","value":"Z5151278"},{"use":"usual","type":{"text":"FHIR"},"system":"http://open.epic.com/FHIR/StructureDefinition/patient-dstu2-fhir-id","value":"TCPNfJueZx8Fjvm4g.lzD.vutNNRpQMfDXDRXJVlKkpcB"},{"use":"usual","type":{"text":"FHIR STU3"},"system":"http://open.epic.com/FHIR/StructureDefinition/patient-fhir-id","value":"efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3"},{"use":"usual","type":{"text":"INTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.698084","value":"  Z5151278"},{"use":"usual","type":{"text":"OSUMRN"},"system":"urn:oid:1.2.840.114350.1.13.172.2.7.5.737384.100","value":"415012765"},{"use":"usual","type":{"text":"WPRINTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.878082","value":"2545814"}],"active":true,"name":[{"use":"official","text":"Case Stontest","family":"Stontest","given":["Case"]},{"use":"usual","text":"Case Stontest","family":"Stontest","given":["Case"]}],"gender":"male","birthDate":"1995-02-27","deceasedBoolean":false,"managingOrganization":{"reference":"Organization/eQi5EjSoIVOTHT0BXoZ4mNA3","display":"WILSON HEALTH"}},"search":{"mode":"match"}}]}

DEVCLIN>set r4Patient = ##class(HS.FHIRModel.R4.Patient).fromDao(patient)

DEVCLIN>zwrite r4Patient.toString()
"{""resourceType"":""Bundle"",""link"":[{}]}"

DEVCLIN>

score 0 · Answer 4 · 2025-07-08T16:53:08-04:00

I tried that however the zrwrite r4Patient.toString() didn't properly parse out the transaction

DEVCLIN>set patient = {"resourceType":"Bundle","type":"searchset","total":1,"link":[{"relation":"self","url":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient?identifier=OSUMRN|415012765"}],"entry":[{"link":[{"relation":"self","url":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient/efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3"}],"fullUrl":"https://ihismufhirnp.osumc.edu/fhir-poc/api/FHIR/R4/Patient/efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3","resource":{"resourceType":"Patient","id":"efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3","extension":[{"valueCodeableConcept":{"coding":[{"system":"urn:oid:1.2.840.114350.1.13.172.3.7.10.698084.130.768080.39128","code":"male","display":"male"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/legal-sex"},{"valueCodeableConcept":{"coding":[{"system":"urn:oid:1.2.840.114350.1.13.172.3.7.10.698084.130.768080.35144","code":"male","display":"male"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/sex-for-clinical-use"},{"extension":[{"valueCoding":{"system":"http://terminology.hl7.org/CodeSystem/v3-NullFlavor","code":"UNK","display":"Unknown"},"url":"ombCategory"},{"valueString":"Unknown","url":"text"}],"url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"},{"extension":[{"valueString":"Unknown","url":"text"}],"url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"},{"valueCode":"248153007","url":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex"},{"valueCodeableConcept":{"coding":[{"system":"http://loinc.org","code":"LA29518-0","display":"he/him/his/his/himself"}]},"url":"http://open.epic.com/FHIR/StructureDefinition/extension/calculated-pronouns-to-use-for-text"}],"identifier":[{"use":"usual","type":{"text":"CEID"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.3.688884.100","value":"OSRDR3259GL4948"},{"use":"usual","type":{"text":"EPI"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.5.737384.0","value":"E4377"},{"use":"usual","type":{"text":"EXTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.698084","value":"Z5151278"},{"use":"usual","type":{"text":"FHIR"},"system":"http://open.epic.com/FHIR/StructureDefinition/patient-dstu2-fhir-id","value":"TCPNfJueZx8Fjvm4g.lzD.vutNNRpQMfDXDRXJVlKkpcB"},{"use":"usual","type":{"text":"FHIR STU3"},"system":"http://open.epic.com/FHIR/StructureDefinition/patient-fhir-id","value":"efz6cSnh6If5cehlzObXZuO7BwSc77oXLYSL-92FLdec3"},{"use":"usual","type":{"text":"INTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.698084","value":"  Z5151278"},{"use":"usual","type":{"text":"OSUMRN"},"system":"urn:oid:1.2.840.114350.1.13.172.2.7.5.737384.100","value":"415012765"},{"use":"usual","type":{"text":"WPRINTERNAL"},"system":"urn:oid:1.2.840.114350.1.13.172.3.7.2.878082","value":"2545814"}],"active":true,"name":[{"use":"official","text":"Case Stontest","family":"Stontest","given":["Case"]},{"use":"usual","text":"Case Stontest","family":"Stontest","given":["Case"]}],"gender":"male","birthDate":"1995-02-27","deceasedBoolean":false,"managingOrganization":{"reference":"Organization/eQi5EjSoIVOTHT0BXoZ4mNA3","display":"WILSON HEALTH"}},"search":{"mode":"match"}}]}

DEVCLIN>set r4Patient = ##class(HS.FHIRModel.R4.Patient).fromDao(patient)

DEVCLIN>zwrite r4Patient.toString()
"{""resourceType"":""Bundle"",""link"":[{}]}"

DEVCLIN>

score 0 · Answer 5 · 2025-07-09T14:19:04-04:00

while writing to the screen works, I am trying to insert the Patient data into another data class to send back to an HL7 DTL so it can update the HL7 message. When I attempt that in a DTL where I extract the Bundle then send it to the Patient model it is not producing results.