What's new in stu3 (grahame)

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What’s new in STU3

Grahame GrieveFHIR Developer DaysNovember 16, 2016


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Who am I?

Name: Grahame Grieve Company: Health Intersection Pty Ltd Background:

Biochemist / Clinical Lab / Medical Research Clinical Application Development / Interoperability Plays the Piano & the Didgeridoo


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FHIR Progression DSTU1: Sept 2014

First early draft (stake in the ground) – Infrastructure + Patient Summary

DSTU2: Oct 2015 Building Engagement, iterating implementation experience Adding more functionality

STU3 : Feb 2017 (planned) Solidifying Infrastructure, Building the eco-system Adding more functionality

STU4+: 2018…? First Normative Content


Changes in STU3

How to find what’s changed What hasn’t changed What has changed


How to find what’s changed

Change page / R2 Diff http://build.fhir.org/diff.html

All structural differences New Types Renamed elements Changed cardinalities / types

No comparison of text Text Definitions Narrative parts of Specification

http://build.fhir.org/diff.html



How to find out what’s changed

Uses W3C HTML Diff engine Occasionally broken (ongoing HTML

validation game) HTML Differencing is hard, renders poorly But captures the text differences Not working at all at the moment


Other approaches

Text Diff on schema Text Diff on html pages directly (example)

Changes are starting to get too big to make sense of

All significant changes go through gForge – look at the task list in gForge

Change list in Version History: http://build.fhir.org/history.html#history

http://build.fhir.org/history.html#history


What hasn’t changed

Infrastructure is still the same shape RESTful API works the same way

1 new operation: PATCH Lots of behaviour clarifications to get

interoperability Fix various error codes Add new use for Prefer: header

Overall structure and function of resources hasn’t changed


What has changed

Move Implementation Guides out of Specification

Introduction of Modules Add Turtle + JSON-LD format 1000s of changes in response to

implementation experience Internal consistency/quality work Review by implementation guide authors / partners

Add Mapping language


RESTful API Changes Change the FHIR mime type to application/fhir+xml|json

instead of application/xml|json+fhir Add new uses for the Prefer header Deprecate use of the OPTIONS command to retrieve the

CapabilityStatement Add support for conditional references to the transaction

interaction Add reverse chaining The _sort parameter has been reworked New or extended search parameters for read, search or

history: _type, _at, _summary, _elements

http://build.fhir.org/http.html#mime-type

http://build.fhir.org/search.html#sort


Conformance Layer Changes Introduce CodeSystem Rework how ValueSet imports other

valuesets Type Handling: Changes to how the

structure definition types work CompartmentDefinition Many refinements as we compare the

functionality of various tools


Implementation Guides

Write Conformance Resources Code Systems, Value Sets & Concept Maps Profiles & Extension Definitions Capability Statements, Operations, Search

Parameters Example Resources

Write HTML – any structure you want Publish – generates HTML + formal

structures used by FHIR tooling


Patient

Patient.contact.relationship Change value set from http://hl7.org/fhir/ValueSet/patient-contact-relationship to http://hl7.org/fhir/ValueSet/v2-0131

Patient.communication.language

Change binding strength from required to extensible, Change value set from http://tools.ietf.org/html/bcp47 to http://hl7.org/fhir/ValueSet/languages

Patient.generalPractitioner Renamed from careProvider to generalPractitionerPatient.link.other Add Reference(RelatedPerson)


Encounter

Encounter.status Change value set from http://hl7.org/fhir/ValueSet/encounter-state to http://hl7.org/fhir/ValueSet/encounter-status

Encounter.statusHistory.status

Change value set from http://hl7.org/fhir/ValueSet/encounter-state to http://hl7.org/fhir/ValueSet/encounter-status

Encounter.class Type changed from code to Coding Change binding strength from required to extensible, Change value set from http://hl7.org/fhir/ValueSet/encounter-class to http://hl7.org/fhir/ValueSet/v3-ActEncounterCode

Encounter.length Type changed from Quantity{http://hl7.org/fhir/StructureDefinition/Duration} to Duration

Encounter.account added


Observation

Observation.category Max Cardinality changed from 1 to *

Observation.comment Renamed from comments to comment

Observation.referenceRange.meaning

Max Cardinality changed from 1 to *

Observation.related.target Add Reference(Sequence)

Observation.component.interpretation

added


Condition

Condition.clinicalStatus Add Binding http://hl7.org/fhir/ValueSet/condition-clinical (required)

Condition.category Max Cardinality changed from 1 to *Condition.subject Renamed from patient to subject

Add Reference(Group)Condition.context Renamed from encounter to context

Add Reference(EpisodeOfCare)Condition.onset[x] Remove Quantity{http://hl7.org/fhir/StructureDefinition/Age}, Add Age

Condition.abatement[x] Remove Quantity{http://hl7.org/fhir/StructureDefinition/Age}, Add Age

Condition.assertedDate addedCondition.asserter Add Reference(RelatedPerson)Condition.note Renamed from notes to note

Max Cardinality changed from 1 to * Type changed from string to Annotation

Condition.dateRecorded deleted


New Resources

Diagnostics ImagingManifest Sequence

Clinical Trials ResearchStudy ResearchSubject

Workflow RequestGroup Task

General / Clinical CareTeam Consent Linkage PractitionerRole

Conformance MessageDefinition Endpoint ExpansionProfile TestReport

Decision Support / Measures ActivityDefinition GuidanceResponse Library Measure MeasureReport MetadataResource PlanDefinition ServiceDefinition


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Maturity Model

When content is first added, it is very draft (Level 1) Changes rapidly, lots of arguments about scope

Gradually grows more mature Some systems test it, implement it (Levels 2-3)

Systems start using it in production Can’t change it easily Wide agreement required for change (levels 4-5)

Becomes Normative


What’s new in STU3

Questions

Healthcare

What's new in stu3 (grahame)