FHIR has revolutionized the healthcare industry by providing a standardized data model for building healthcare applications and promoting data exchange between different healthcare systems. As the FHIR standard is based on modern API-driven approaches, making it more accessible to mobile and web developers. However, interacting with FHIR APIs can still be challenging especially when it comes to querying data using natural language.

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Surely you have all heard about FHIR as the panacea and solution to all interoperability and compatibility problems between systems. Right here we can see one of his classic defenders holding a FHIR resource in his hand and enjoying it immensely:

But for the rest of us mortals we are going to make a small introduction.

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We resume our series of articles on the FHIR Adapter tool available to HealthShare HealthConnect and InterSystems IRIS users.

In the previous articles we have presented the small application on which we set up our workshop and showed the architecture deployed in our IRIS instance after installing the FHIR Adapter. In today's article we will see an example of how we can perform one of the most common CRUD (Create - Read - Update - Delete) operations, the reading operation, and we will do it by recovering a Resource.

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Problem

In a fast-paced clinical environment, where quick decision-making is crucial, the lack of streamlined document storage and access systems poses several obstacles. While storage solutions for documents exist (e.g, FHIR), accessing and effectively searching for specific patient data within those documents meaningfully can be a significant challenge.

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Motivation

The motivation behind the InterLang project is rooted in the innovative integration of LangChain chatbot agents with the Fast Healthcare Interoperability Resources (FHIR) framework to revolutionize conversational social prescriptions in healthcare. This project aims to leverage the rich and standardized data available through FHIR, an emerging standard in healthcare data exchange, to inform and empower these advanced chatbot agents.

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We return with our example of using the FHIR Adapter, in this article we are going to review how we can configure it in our IRIS instances and what the result of the installation is.

The steps taken to configure the project are the same as indicated in the official documentation, you can review them directly here. Well, let's get to work!

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InstallFoundation method is missing (IRIS 2023.2+)

Recently IRIS 2023.2 was released. This version removed this method InstallFoundation from this class HS.HC.Util.Installer. This was a private method and it was not documented. But it was widely used by the community to install FHIR server.

So if you encounter this error:

<METHOD DOES NOT EXIST> *InstallFoundation,HS.HC.Util.Installer

While build a demo our your own FHIR server, you can fix it by replacing this line:

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The objective of the article is to provide the reader with the following informations:

  • Configure and use the FHIR server
  • Create an OAuth2 Authorization Server
  • Bind the FHIR server to the OAuth2 Authorization Server for support of SMART on FHIR
  • Use the interoperability capabilities of IRIS for Health to filter FHIR resources
  • Create a custom operation on the FHIR server

Schema of the article:

Schema

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I have challenged to create a bot application using Azure Bot that can retrieve and post data to IRIS for Health.

A patient's data has already been registered in the FHIR repository of IRIS for Health.

The patient's MRN is 1001. His name is Taro Yamada. (in Japanese :山田 太郎)

This bot can post new pulse oximeter readings as an observation resource linked to the patient.

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Introduction

This article aims to explore how the FHIR-PEX system operates and was developed, leveraging the capabilities of InterSystems IRIS.

Streamlining the identification and processing of medical examinations in clinical diagnostic centers, our system aims to enhance the efficiency and accuracy of healthcare workflows. By integrating FHIR standards with InterSystems IRIS database Java-PEX, the system help healthcare professionals with validation and routing capabilities, ultimately contributing to improved decision-making and patient care.

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Article
· Jul 7, 2023 8m read
Iris FHIR Python Strategy

Description

With InterSystems IRIS FHIR Server you can build a Strategy to customize the behavior of the server (see documentation for more details).

Image

This repository contains a Python Strategy that can be used as a starting point to build your own Strategy in python.

This demo strategy provides the following features:

  • Update the capability statement to remove the Account resource
  • Simulate a consent management system to allow or not access to the Observation resource
    • If the User has sufficient rights, the Observation resource is returned
    • Otherwise, the Observation resource is not returned
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Article
· Feb 1 2m read
Mind map your FHIR patient data

According Wikipedia a mind map is a diagram used to visually organize information into a hierarchy, showing relationships among pieces of the whole. It is often created around a single concept, drawn as an image in the center of a blank page, to which associated representations of ideas such as images, words and parts of words are added. Major ideas are connected directly to the central concept, and other ideas branch out from those major ideas.

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We conclude this series of SMART On FHIR articles with Auth0 and InterSystems IRIS FHIR Repository by reviewing our application developed in Angular 16.

Let's remember what the architecture defined for our solution is like:

Our front-end application corresponds to the second column and as you can see it will be in charge of two things:

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We return to the attack with our EMPI!

In previous articles we have seen how to configure and customize our EMPI, we have seen how we can include new patients in our system through HL7 messaging, but of course, not everything is HL7 v.2 in this life! How could we configure our EMPI instance to work with FHIR messaging?

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In the last article we presented the architecture of our SMART On FHIR project, so it's time to get down to business and start configuring all the elements that we are going to need.

We will first start with Auth0.

AUTH0 configuration

We will start by creating an Auth0 account with a valid email, once registered we will have to create our first application, and we will do it from the menu on the left:

Application menu

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I created this application considering how to convert images such as prescription forms into FHIR messages

It recognizes the text in the image through OCR technology and extracts it, which is then transformed into fhir messages through AI (LLA language model).

Finally, sending the message to the fhir server of IntereSystems can verify whether the message meets the fhir requirements. If approved, it can be viewed on the select page.

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Background

In 2021, I participated as an InterSystems mentor in a hackathon, where a newcomer to FHIR asked me if there was a tool to transform generic JSON data containing basic patient information into FHIR format. I informed her that I didn't know anything like that, unfortunately.

But that idea stays in my mind...

Several months later, in 2022, I came up with an idea to experiment: to train a named entity recognition (NER) to identify FHIR elements into generic texts. The training involved synthetic FHIR data generated by Synthea and the spaCy Python library.

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Hello again everyone.

In our previous article we saw how to configure our EMPI to receive FHIR messages. To do this we installed the FHIR Adapter that InterSystems made available to us that configured a REST endpoint to which we could send our FHIR message. We would then get the message and transform it to a %String that we would send via TCP to the output of our EMPI configured in our HSPIDATA namespace.

Alright, it's time to see how we retrieve the message, transform it back to a %DynamicObject and parse it to the class used by the EMPI to store the information.

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In the context of HL7 FHIR (Fast Healthcare Interoperability Resources), the terms "id" and "identifier" refer to specific elements used for identifying resources within the FHIR data model. For a newbie, these terms can be confusingly similar, but they serve distinct purposes.

Look at the below Patient resource for August T. Faulkner:

The resource has an id of “1” — generated by the FHIR server when the resource was created.
Patient August T. Faulkner also has a identifier (Medical Record Number) — possibly provided by the hospital — of 78510398960

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