Møte 17 i FHIR fagforum

FHIR fagforum (FFF) er et åpent forum om bruk og implementering av HL7 FHIR i Norge. FFF er åpent for alle.

Agenda: Gravitate Health and CAPABLE

Intro and HL7 Norway Thomas T Rosenlund & Øyvind Aassve (5 min)
Gravitate health intro, Anne Moen, UiO (5 min)
FHIR resources used in Gravitate-Health; IGs and opportunities from participation in HL7 accelerators to expedite transition - Craig Anderson Pfizer and Catherine Chronaki, HL7 Europe (25 min)
Collaboration activities to populate EU ePI Common Standard (where HL7 ePI IG plays a role) - contributions by Adam Kover, Felleskatalogen, CAPABLE and Gravitate-Health (25 min)
CAPABLE use of HL7 FHIR, including EU ePI Common Standard to support Gravitate-Health testing scenarios Petter Hurlen, AHUS and Knut Skifjeld, Norsk e-helse (25 min)
Open DIPS: An open developer sandbox for digital healtchare innovations, Bjørn Fjukstad, DIPS (25 min)
Eventuelt og diskusjon (10 min)

40 partners in Europe and US
Norsk e-helse technical partner from Norway, Trifork og FrisQ fra Danmark og Sverige
More relevant information about medication
Key output is to enable relevant medicinal information
- G-lens prototype for focussion on relevant product information
- Vulcan cross border product info
- User experience
Gravitate health hackathon on Vitalis Gothenborg, Sweden 21-23 may 2023

ePI objectives - Valuable info from pdf to FHIR framework (structured data)
Gravitate health IPS IG
Example1 Graph of the electronic product information and relationships
Example2 ePI and the IPS: Connections between the IPS info and the ePI (electronic Product information)
Example3 IDMP Pharmaceutical Product Identifier
Example4 FHIR Connectation Focusing, highlight and supress based on the patients profile

Information about adverse event in the ePI?
- In the ePI there is ways of connecting interaction services to adverse events
There are some functionality in Felleskatalogen for this
- In the program looking into two way communication
How is the highlighting/suppressing of information in the app, rule-based or otherwise?
- Peter Hurlen is presenting this later

Electronic package leaflet in Felleskatalogen
Source material of the pdf documents from SLV and EMA (eropean medicines agency)
- FEST has direct link to the pdf
Download the pdf sources and identify changes in the pdf
- Also show differences between versions
- import CMS info in the CMS of Felleskatalogen XML
  - Recognize sections, convert to XML and as for human review
Patterns described for relevant sections
Connection to structured data using identifiers
Structured data from FEST by SLV (statens legemiddelverk)
Other data sources is merged in the applications
Capabilities
- Web: advanced search in the package information
- Web: adding content like video and high resolution images
- Web: medication dictionary
Felleskatalogen and ePI
- Structured document instead of pdf
- Connect structuread data sources like FEST and SPOR
- Felleskatalogen can be a plattform for additional capabilities (search, images and video)

Maybe obvious, but I have to ask anyway: The aim here is to create a FHIR-standard for these leaflets that the Pharmaceutical companies will issue themselves right? The choice of value sets (and code systems) will be crucial. Do you have any documentation on deliberations of the choices made so far, that you can post here?
- Correct. The ideal is that all companies will issue the leaflets in FHIR format. Prefer to have them centrally available in dictionaries like Felleskatalogen rather than spread across all the different company websites though.
- Agree about value sets being critical. We have recommendations and examples in the Implementation Guide but needs more work. Happy to have more help/advice on this topic
MedDRA for conditions since it is driven by EMA and other health authorities

Oversettelse til nynorsk og samisk?
- Ikke på nåværende tidspunkt, men det kan bli i neste versjon.

Two kinds of users
- Tecnical Inventors and makers - realize ideas
- Healthcare providers using the systems - better user experience
DIPS - used in most hospitals in Norway
Open DIPS is a sandbox
- developer portal
- sandbox
- community
API explorer
- FHIR based API’s
- Try the API’s on the web or using a FHIR client
SMART on FHIR apps
- Authorizing, Authentication and integration in your system
- RetinaRisk iClinic app
  - An app for risc analysis
  - Plugged into DIPS using SMART on FHIR
  - Collecting data from DIPS and storing data to DIPS using the FHIR API’s
- Also on GitHub/hello-open-dips SMART on FHIR app (open source)
Heart-rate monitor integrated using open DIPS - demonstration

Support for CDS hooks?
- No suppport for CDS hooks at the moment, but will try to integrate this in later versions
Reduced kidney function app
- This might be possible to integrate
Support for LOINC codes
- vital signs
Prøvesvar integration with journal systems, diagnostic report read and search, would you support POST?
- Search, there might be POST support in later versions
Question
- Patients data and they should have the right to acces the data. Today the data is siloed into the EHR data and no access for the patient
One of the driving ideas on Gravitate health to share data in a more efficient way, advance the agenda to make users capable of interaction with data. Interactions with the doctor and dispense of medication could change from the information contained in the actual prescription
In dips arena can a researcher run a cohort? To run a research study.
- The solution is not made for research study support
Create cohorts in primary care solutions using