FHIR Bundle StructureDefinition-OPConsultRecord - Procedure

ABDM FHIR Resources
#1

Can we send multiple Procedure resource type in StructureDefinition-OPConsultRecord JSON.
e.g Composition.section:Procedure

We have multiple Procedures for single-patient data.

Top reference Procedure section

“section”: [
{
“title”: “Procedures”,
“code”: {
“coding”: [
{
“system”: “https://projecteka.in/sct”,
“code”: “371525003”,
“display”: “Clinical HIP Procedure Report”
}
]
},
“entry”: [
{
“reference”: “Procedure/fcb0d877-2f6d-4b2a-94ed-5eec40c65b46”
}
]
},
{
“title”: “Procedures”,
“code”: {
“coding”: [
{
“system”: “https://projecteka.in/sct”,
“code”: “371525003”,
“display”: “Clinical Knee Procedure Report”
}
]
},
“entry”: [
{
“reference”: “Procedure/fcb0d877-2f6d-4b2a-94ed-5eec40c65b47”
}
]
},

JSOn Procedure details:

“fullUrl”: “Procedure/fcb0d877-2f6d-4b2a-94ed-5eec40c65b46”,
“resource”: {
“resourceType”: “Procedure”,

“fullUrl”: “Procedure/fcb0d877-2f6d-4b2a-94ed-5eec40c65b47”,
“resource”: {
“resourceType”: “Procedure”,

#2

Data sent successfully, but unable to view in PHR mobile app

2021-05-04 17:34:12 [102] INFO NDHMHelper - [HealthInformationNotify] JSON : {“requestId”:“71477155-a927-4c7f-84bf-5fbcdb382b35”,“timestamp”:“2021-05-04T12:04:12.4017181Z”,“notification”:{“consentId”:“a9b136c0-59a8-4967-95d9-c7cbdd086b5f”,“transactionId”:“dda9ff48-8d1c-4fc5-9547-f90d54e7b1f6”,“doneAt”:“2021-05-04T12:04:12.4017181Z”,“notifier”:{“type”:“HIU”,“id”:“prakash456@sbx”},“statusNotification”:{“sessionStatus”:“TRANSFERRED”,“hipId”:“Sandeep-1986”,“statusResponses”:[{“careContextReference”:“Hip Primary (L)”,“hiStatus”:“OK”,“description”:“Care Response has been given”}]}}}

2021-05-04 17:34:12 [106] INFO NDHMHelper - [HealthInformationNotify] JSON : {“requestId”:“3c0bf9ba-21a4-474e-b7e7-03f777d880a1”,“timestamp”:“2021-05-04T12:04:12.5726925Z”,“notification”:{“consentId”:“c4ad325f-66a5-4762-968e-8b92639931ef”,“transactionId”:“8d1a6767-0fa4-46e3-b364-5bcb2f578a62”,“doneAt”:“2021-05-04T12:04:12.5726925Z”,“notifier”:{“type”:“HIU”,“id”:“prakash456@sbx”},“statusNotification”:{“sessionStatus”:“TRANSFERRED”,“hipId”:“Sandeep-1986”,“statusResponses”:[{“careContextReference”:“Hip Primary ®”,“hiStatus”:“OK”,“description”:“Care Response has been given”}]}}}

#3

Hi @mdubey

  1. We are now able to send multiple procedures in op-consult report format but not able to send multiple values in single procedure resource.
    Ex :

    {
    “fullUrl”: “Procedure/1”,
    “resource”: {
    “resourceType”: “Procedure”,
    “id”: “1”,
    “meta”: {
    “profile”: [
    “https://nrces.in/ndhm/fhir/r4/StructureDefinition/Procedure”
    ]
    },
    “text”: {
    “status”: “generated”,
    “div”: “<div xmlns=“http://www.w3.org/1999/xhtml”>ABC”
    },
    “status”: “completed”,
    “code”: {
    “coding”: [
    {
    “system”: “http://snomed.info/sct”,
    “code”: “713130009”,
    “display”: “ddd”
    },
    {
    “system”: “http://snomed.info/sct”,
    “code”: “713130010”,
    “display”: “eee”
    },
    {
    “system”: “http://snomed.info/sct”,
    “code”: “713130011”,
    “display”: “fff”
    }
    ]
    },
    “subject”: {
    “reference”: “Patient/1”
    },
    “performedDateTime”: “2019-05-12”,
    “followUp”: [
    {
    “coding”: [
    {
    “system”: “http://snomed.info/sct”,
    “code”: “394725008”,
    “display”: “Diabetes medication review”
    }
    ]
    }
    ]
    }
    },

Please suggest how to send multiple values in single procedure resource

2)We also tried to add data inside div element of text object in Procedure resource but not able to see anything added in it
ex :
{
“fullUrl”: “Procedure/1”,
“resource”: {
“resourceType”: “Procedure”,
“id”: “1”,
“meta”: {
“profile”: [
“https://nrces.in/ndhm/fhir/r4/StructureDefinition/Procedure”
]
},
“text”: {
“status”: “generated”,
“div”: “<div xmlns=“http://www.w3.org/1999/xhtml”>ABC”
},

#4

Hi @bhilendra,

Could you please elaborate what do you mean by this. You should ideally send multiple procedure values in different procedure resources, present in entries field of Procedure section.

If you see the OpConsultation Record, the bundle can have one section about Procedure and there could be multiple (0..*) entries for this section. So you can attach entries as Procedure/1, Procdure/2 etc and defien them as seperate resource in the same bundle.

On a high level it could look like this:

{
  "resourceType": "Bundle",
  "entry": [
    {
      "fullUrl": "Composition/1",
      "resource": {
        "resourceType": "Composition",
        "id": "1",        
        "section": [ 
          {
            "title": "Procedure",
            "code": {
              "coding": [
                {
                  "system": "http://snomed.info/sct",
                  "code": "371525003",
                  "display": "Clinical procedure report"
                }
              ]
            },
            "entry": [
              {
                "reference": "Procedure/1"
              },
              {
                "reference": "Procedure/2"
              }
            ]
          }
        ]
      }
    }, 
... Other needed resources
    {
      "fullUrl": "Procedure/1",
      "resource": {
        "resourceType": "Procedure",
        "id": "1",
        ....Other Details about procedure
      }
    },
    {
      "fullUrl": "Procedure/2",
      "resource": {
        "resourceType": "Procedure",
        "id": "2",
        ....Other Details about procedure
      }
    }
  ]
}

I hope this clarifies.

Thank you

#5

Thanks @mdubey.

I have one more query on the same procedure JSON.
I have added all elements in the Procedure JSON, But in the PHR mobile application only showing reasonCode & bodySite elements values, Can you please guide me on this why other elements are not showing.
See the below example.

{
“fullUrl”: “Procedure/1”,
“resource”: {
“resourceType”: “Procedure”,
“id”: “1”,
“meta”: {
“profile”: [
“https://nrces.in/ndhm/fhir/r4/StructureDefinition/Procedure”
]
},
“text”: {
“status”: “generated”,
“div”: “<div xmlns=“http://www.w3.org/1999/xhtml”>ABC”
},
“status”: “completed”,
“statusReason”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10000”,
“display”: “Procedure Status Reason Coding”
}
],
“text”: “Procedure Status Reason text”
},
“category”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10001”,
“display”: “Procedure category Coding”
}
],
“text”: “Procedure category text”
},
“performer”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10002”,
“display”: “Procedure performer Coding”
}
],
“text”: “Dr Pachore & Dr. Bhalodia”
},
“reasonCode”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10003”,
“display”: “Procedure reasonCode Coding”
}
],
“text”: “Procedure reasonCode”
},
“bodySite”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10004”,
“display”: “Procedure bodySite Coding”
}
],
“text”: “Procedure bodySite”
},
“outcome”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10005”,
“display”: “Procedure outcome Coding”
}
],
“text”: “Procedure outcome”
},
“code”: {
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “10006”,
“display”: “Placement of stent in coronary artery”
}
],
“text”: “Placement of stent in coronary artery”
},
“subject”: {
“reference”: “Patient/1”
},
“performedDateTime”: “2021-05-05”,
“followUp”: [
{
“coding”: [
{
“system”: “http://snomed.info/sct”,
“code”: “394725008”,
“display”: “Diabetes medication review”
}
]
}
]
}
},

#6

Hi @bhilendra,

The PHR app is a generic Patient Viewer app, which is showing a basic representation of all the resources. As of now the following things are displayed on the PHR Viewer

  • Complications
  • Bodysite
  • Reason
  • Notes

Let us know if you have more questions on this.

Thank you

#7

Thanks @mdubey

We have show to below patient details in the PHR app.

Patient Details
Patient Identifier
Operation Details
Surgeon Details
Procedure Details
Surgical Approach
Procedure Details
Component Selection

#8

Hi @bhilendra,

Right now the plan is not to incorporate any new fields in the Patient Viewer APP. However it is upto other HIUs to include fields based on their use case.

Any specific reason you want to have more fields in the Procedure Resource? Please let us know.

Thank you

#9

Hi @mdubey

I have added Patient details in the OPConsult JSON, But the PHR mobile application not showing Patient details?

See the below example.

{
“fullUrl”: “Patient/1”,
“resource”: {
“resourceType”: “Patient”,
“id”: “1”,
“meta”: {
“versionId”: “1”,
“lastUpdated”: “2020-07-09T14:58:58.181+05:30”,
“profile”: [
“https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient”
]
},
“text”: {
“status”: “generated”,
“div”: “<div xmlns=“http://www.w3.org/1999/xhtml”>ABC, 41 year, Male”
},
“identifier”: [
{
“type”: {
“coding”: [
{
“system”: “http://terminology.hl7.org/CodeSystem/v2-0203”,
“code”: “MR”,
“display”: “Medical record number”
}
]
},
“system”: “https://healthid.ndhm.gov.in”,
“value”: “22-7225-4829-5255”
}
],
“name”: [
{
“text”: “ABC”
}
],
“telecom”: [
{
“system”: “phone”,
“value”: “+919818512600”,
“use”: “home”
}
],
“gender”: “male”,
“birthDate”: “1981-01-12”
}
}

#10

Hi @bhilendra,

The patient details are used what is already stored in the PHR platform for that healthid. The patient details will be redundant to show as part of each bundle.

Let us know if there is any specific question here.

Thank you