Guidance on writing Profiles of FHIR

This is an outline only, details will be added as requested (send email to JohnMoehke@gmail.com)

Current Guidance on 'use' of FHIR

FHIR is an emerging standard from HL7. It is currently at "Standard for Trial Use" (STU). This is an acceptable stage for IHE Profile use, but would be less stable than a Normative standard. Sometimes IHE will Profile a STU standard because it is the best fit. See Standards Selection Process

An IHE Profile that is using a STU standard must stay at "Trial Implementation". That is the IHE Profile can not progress to "Final Text" until the underlying standard is "Normative". See IHE Profile Phases of Development. See Final Text Process

Because FHIR is seen as unstable by some, we agree the FMM of the used FHIR parts should be exposed prominently within the IHE Profile supplement. (see below)

Current Guidance on writing Profiles of FHIR

• First priority is supplement form like any other IHE Profile - It is the Normative content
  • Yes this is a PDF publication mechanism, but it is what we have as approved Governance
  • Supplement should expose the FHIR Maturity Model (FMM) evaluation of the parts (e.g. Resources) used from FHIR. This helps expose to the reader of the supplement the level of maturity. A lower number means less stable FHIR specification.
    • Title page have text at 12 point (smaller than other text on the title page) "HL7® FHIR® STU 3",
    • and the range of FMM (this example is 1-5) -- "Using Resources at FMM Levels 1-5"
    • Introduction to the Supplement - should explain this FMM in more detail
    • See MHD as an example
  • Volume 1 is very close to what is visualized for FHIR Implementation Guide. Defining Actors, Transactions, Options; and showing how they work together.
  • Volume 2+ should be kept to minimum, but must include ALL normative requirements (SHALL) of the profile
  • wiki Profiles page
    • This is very important for FHIR profiles, at this time, as it will be the place where links to additional resources
• Second priority is FHIR conformance resources: -- Informative at this time
  • Published on IHE FTP site in the Implementation Material See below for more detail on FTP site layout, filenames, and URL
  • wiki Profiles page should have a "FHIR Implementation Guide" section that itemizes
  • URLs for your conformance resources would be http://ihe.net/fhir/<Resource>/<yourfilename>
    • e.g. http://ihe.net/fhir/StructureDefinition/IHE.PDQm.Patient
  • StructureDefinition to hold constraints on each FHIR Resource
    • Cardionality constraints
    • vocabulary (valueset) constraints
    • mapping
    • etc???
  • CapabilityStatement to show minimal conformance requirements per Actor
    • Query parameters that must be supported
    • Resources must be supported (or will be used)
    • ???
• Third priority is examples
  • For any Resource in your profile, there should be an example on the IHE FTP Implementation Materials
  • Any publicly available FHIR reference implementation server that you know supports your profile should also be mentioned in your Profiles wiki page "FHIR Implementation Guide" section

Not forbidden from experimenting beyond

FHIR us of IHE FTP Directory

There are two different things we will publish in the Implementation Materials.

1. Example resources, messages, interactions
   • These will use the layout specific to domain/profile
   • for example Any examples published by ITI are published on the FTP in
     • for example PDQm examples would be found in ftp://ftp.ihe.net/TF_Implementation_Material/ITI/examples/PDQm/
2. FHIR conformance resources (StructureDefinition, CapabilityStatement, ValueSet, etc)
   • These are going to be registered on the FHIR Registry, and that will be the primary way they will be discovered.
   • All of these, regardless of domain will need to exist in the same directory, following the FHIR URL convention.
   • Eventually this FTP may be replaced by GIT, or may be reflected directly onto http://ihe.net/fhir
   • The Implementation Materials has a 'fhir' directory for all of these
     • StructureDefinition directory for all of the StructureDefinitions
       • your filename for your StructureDefinition will be "IHE."<Profile-acronym>+"."+<Resource-name>+".structuredefinition"+[".json"|".xml"]
       • your identifier (StructureDefinition.url) will be "http://ihe.net/fhir"+filename (without the +".structuredefinition"+[".json"|".xml"])
         • example filename: IHE.QEDm.Provenance.structuredefinition.xml
         • example url "http://ihe.net/fhir/structuredefinition/IHE.QEDm.Provenance
     • CapabilityStatement directory for all the CapabilityStatements
       • CapabilityStatement filename: <Profile-acronym>+<actor-name>+".capabilitystatement.xml"+[".json"|".xml"]
       • your filename for your CapabilityStatement will be "IHE."<Profile-acronym>+"."+<actor-name>+".capabilitystatement"+[".json"|".xml"]
       • your identifier (CapabilityStatement.url) will be "http://ihe.net/fhir"+filename (without the +".capabilitystatement"+[".json"|".xml"])
     • ValuSet directory for all the ValueSets

Near Future

The following are some items the IHE-FHIR-wg is close to having a recommendation. These should be considered experimental, but likely to become guidance.

• Guidance on how to link your conformance resources on HL7 FHIR Registry
• Use of GIT for publication rather than FTP
• Use of ClinFHIR as a tool to capture Volume 1 like material

Future

These are also potential items the IHE-FHIR-wg might further develop. These are less likely to become recommended, and an Profile author should be very cautious with these items.

• Implementation Guide publication is not mature enough to support IHE governance
  • Experience with FHIR ImplementationGuide resource and various tooling shows that it not ready for use