HSPC Profiles:Conformance and Interoperability

Definitions

Definitions“Resource-level” Profiles:

Profiles at the level at which FHIR defines resources (Patient, Observation, Procedure, Practitioner, Condition, etc.)

“Detail-level” Profiles:Profiles at a more detailed level, e.g., profiles for

Hematocrit, Glucose, Heart Rate, Body Weight, Diabetes, Pain, Ulcerative Colitis, Nausea, Rash, etc.

Definitions“Resource-level” Profiles:

Profiles at the level at which FHIR defines resources (Patient, Observation, Procedure, Practitioner, Condition, etc.)

“Detail-level” Profiles:Profiles at a more detailed level, e.g., profiles for

Hematocrit, Glucose, Heart Rate, Body Weight, Diabetes, Pain, Ulcerative Colitis, Nausea, Rash, etc.

HSPC intends to produce both levels of profiles.

Definitions (continued)“Narrow” a profile:

Create a new profile that performs the following relative to an existing profile:Constrains value setsConstrains data type choicesSpecifies terminology bindings (where none was

originally specified)Constrains cardinalitySets codesDeclares “must support”

Definitions (continued)“Broaden” a profile:

Create a new profile that performs the following relative to an existing profile:Adds extensionsExpands value sets (where allowed)

Definitions (continued)“Broaden” a profile:

Create a new profile that performs the following relative to an existing profile:Adds extensionsExpands value sets (where allowed)

Narrowing and Broadening may be done:Physically (new profile uses the original profile as

the base)Logically (new profile is a sibling to the original

profile and is only different from the original in “narrowing” ways)

Resource-Level Profiles

Notes of explanation

• The Data Access Framework (DAF) group, the Clinical Quality Framework (CQF) group, and other ONC-sponsored groups are creating profiles.

• For the most part, these are “resource-level” profiles.

• We strongly advocate that these groups work together to co-develop a single set of profiles (or at least a single set + constraints).

• Where possible, HSPC will use/endorse this set.

• Where necessary, HSPC will create derivatives of these.

• The common ONC profiles we hope will result are referred to in these slides as “DAF profiles.”

• The following slides discuss the relationship of HSPC “resource-level” profiles to these common ONC profiles.

Resource-Level Profiles: DAF and HSPC

Where necessary, HSPC will create derivatives of the DAF profiles with

the intent of providing more generally-usable profiles to the

community.

Resource-Level Profiles: Narrowing

Where HSPC profiles “narrow” DAF profiles:Data that conform to the HSPC profiles will also

conform to the DAF profiles.Not all DAF-conformant data will be HSPC-

conformant.

Resource-Level Profiles: Broadening

Where HSPC profiles “broaden” DAF profiles:Data that conform to the DAF profiles will also

conform to the HSPC profiles.Not all HSPC-conformant data will be DAF-

conformant.

Resource-Level Profiles:Broadening and Narrowing

HSPC resource-level profiles will likely need to both narrow and broaden DAF profiles.Narrow:

specify bindingsconstrain value sets and cardinalities

Broaden:add extensions

Resource-Level Profiles:Broadening and Narrowing

HSPC resource-level profiles will likely need to both narrow and broaden DAF profiles.Narrow:

specify bindingsconstrain value sets and cardinalities

Broaden:add extensions

Consequently:Not all DAF-conformant data will be HSPC-

conformant.Not all HSPC-conformant data will be DAF-

conformant.

Resource-Level Profiles:Two Sets

HSPC will support two sets of resource-level profiles:Set 1: The DAF profilesSet 2: The HSPC profiles that narrow and

broaden DAF

Resource-Level Profiles:Two Sets

HSPC will support two sets of resource-level profiles:Set 1: The DAF profilesSet 2: The HSPC profiles that narrow and broaden

DAF

Users of the two sets may not be interoperable.DAF profile instances won’t be conformant with

HSPC profiles where HSPC profiles have made value set/code constraints.

HSPC profile instances won’t be conformant with DAF profiles where HSPC profiles have added extensions.

Detail-Level Profiles

Detail-Level Profiles“True”Interoperability is delivered by detail-

level HSPC profilesSpecific Lab profilesOther observation profiles (heart rate, respiratory

rate, pain, height, head circumference, etc.)Condition profiles (cancer, diabetes, Crohn’s

disease, etc.)Procedure profiles (hysterectomy, colonoscopy,

gastric bypass, etc.)

Detail-Level Profiles“True”Interoperability is delivered by detail-level

HSPC profilesSpecific Lab profilesOther observation profiles (heart rate, respiratory

rate, pain, height, head circumference, etc.)Condition profiles (cancer, diabetes, Crohn’s

disease, etc.)Procedure profiles (hysterectomy, colonoscopy,

gastric bypass, etc.)

Detail-level profiles constrain Resource-level profilesconsequently, instances will not be conformant

with Resource-level profiles.

Summary

DAF resource-level profiles

HSPC detail-level profiles +HSPC resource-level profiles

HSPC resource-level profiles

HSPC Members may use any one of three sets of profiles:

Summary

DAF resource-level profiles

HSPC detail-level profiles +HSPC resource-level profiles

HSPC resource-level profiles

HSPC Members may use any one of three sets of profiles:

Detail-level profiles are necessary for true,

plug-and-play interoperability.

Summary

DAF resource-level profiles

HSPC detail-level profiles +HSPC resource-level profiles

HSPC resource-level profiles

HSPC Members may use any one of three sets of profiles:

Detail-level profiles are necessary for true,

plug-and-play interoperability.

NOT INTEROPERABLE

NOT INTEROPERABLE

RisksGetting ONC-sponsored groups collaborating

Carving the pertinent part out of their work and harmonizing (or not harmonizing) with it

Mapping CIMI models and FHIR profiles

Scalability of detail-level profile creation process

Getting detail-level profiles reviewed

A moving FHIR spec