NM"Introduction
This page describes the mapping between the HL7v2 segments that DDS can ingest and the FHIR Resources (TODO link to profiles) that DDS uses to represent them internally.
There are two kinds ways that values are written into the internal FHIR store when mapping from an inbound HL7v2 message -
- Dynamic values - here the raw value from the inbound HL7v2 message is copied into a property on a FHIR resource
- Fixed values - here the value that is inserted into a FHIR resource is fixed and is not copied from the source message. Instead the value that is inserted is likely to be contingent on the presence and/or value of a field from the source message
The relationship between HL7v2 segments and the FHIR resources that they populate is also diagrammed in the Entity Relationship section.
Dynamic Values
PID - Patient Identification
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| PID:3 | PID:3.1 | Encounter | patient | Patient | |
| PID:3 | PID:3.1 | EpisodeOfCare | patient | Patient | |
| PID:3 | PID:3.1 | Patient | identifier.value | if PID:3.4 == "MRN" then set to PID:3.1 | |
| PID:3 | PID:3.4 | Patient | identifier.system | ||
| PID:3 | PID:3.1 | Patient | identifier.value | if PID:3.4 == "NHS" then set to PID.3.1 | |
| PID:5 | PID:5.1 | Patient | name.family | ||
| PID:5 | PID:5.2 | Patient | name.given | ||
| PID:5 | PID:5.3 | Patient | name.middle | ||
| PID:5 | PID:5.5 | Patient | name.prefix | ||
| PID:7 | PID:7.1 | Patient | birthDate | ||
| PID:8 | PID:8.1 | Patient | gender | ||
| PID:11 | PID:11.1 | Patient | address.line | ||
| PID:11 | PID:11.2 | Patient | address.line | ||
| PID:11 | PID:11.3 | Patient | address.city | ||
| PID:11 | PID:11.5 | Patient | address.postalCode | ||
| PID:11 | PID:11.6 | Patient | address.country | ||
| PID:11 | PID:11.9 | Patient | address.district | ||
| PID:13 | PID:13.1 | Patient | telecom.value | ||
| PID:13 | PID:13.2 | Patient | telecom.use | if PID:13.2 == 'PRS' then set to "mobile"
if PID:13.2 == 'PRN' then set to "home" | |
| PID:13 | PID:13.4 | Patient | telecom.value | if PID:13.2 == 'NET' then set to PID:13.4 | |
| PID:14 | PID:14.1 | Patient | telecom.value | ||
| PID:14 | PID:14.4 | Patient | telecom.value | if PID:14.2 == 'NET' then set to PID:14.4 | |
| PID:15 | PID:15.1 | Observation | code.coding.code | Patient | if PID:15.1 is not empty then look up core concept from Information Model and insert into property |
| PID:15 | PID:15.4 | Observation | code.coding.code | Patient | |
| PID:17 | PID:17.1 | Observation | code.coding.code | Patient | if PID:17.1 is not empty then look up core concept from Information Model and insert into property |
| PID:18 | PID:18.1 | Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.code | Patient | |
| PID:22 | PID:22.1 | Patient | http://endeavourhealth.org/fhir/StructureDefinition/primarycare-ethnic-category-extension | ||
| PID:29 | PID:29.1 | Patient | deceased |
PD1 - Patient Additional Demographic
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| PD1:3 | PD1:3.1 | Organization | identifier.name | ||
| PD1:3 | PD1:3.3 | Organization | identifier.value | ||
| PD1:3 | PD1:3.3 | Patient | careProvider | Organization | |
| PD1:4 | PD1:4.1 | Patient | careProvider | Practitioner |
PV1 - Patient Visit
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| PV1:2 | PV1:2.1 | Encounter | class | ||
| PV1:3 | PV1:3.9 | Encounter | location (current) | Location | |
| PV1:3 | PV1:3.9 | Location | identifier | ||
| PV1:3 | PV1:3.9 | Location | name | ||
| PV1:3 | PV1:3.9 | Location | description | ||
| PV1:4 | PV1:4.1 | Encounter | contained.Parameters.parameter.name | if PV1:4 is not empty then set to "DM_methodOfAdmssion" | |
| PV1:4 | PV1:4.1 | Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.code | ||
| PV1:6 | PV1:6.9 | Encounter | location (prior) | Location | |
| PV1:6 | PV1:6.9 | Location | identifier | ||
| PV1:7 | PV1:7.1 | Encounter | participant (attending clinician) | Practitioner | |
| PV1:7 | PV1:7.1 | Practitioner | identifier.value | ||
| PV1:7 | Practitioner | identifier.system | if PV1:7 is not empty then set to ? (need to find a type system) | ||
| PV1:7 | PV1:7.2 | Practitioner | name.family | ||
| PV1:7 | PV1:7.3 | Practitioner | name.given | ||
| PV1:7 | PV1:7.4 | Practitioner | name.given | ||
| PV1:7 | PV1:7.6 | Practitioner | name.prefix | ||
| PV1:8 | PV1:8.1 | Encounter | participant (consulting clinician) | Practitioner | |
| PV1:8 | PV1:8.1 | Practitioner | identifier.value | ||
| PV1:8 | PV1:8.2 | Practitioner | name.family | ||
| PV1:8 | PV1:8.3 | Practitioner | name.given | ||
| PV1:8 | PV1:8.4 | Practitioner | name.given | ||
| PV1:8 | PV1:8.6 | Practitioner | name.prefix | ||
| PV1:9 | PV1:9.1 | EpisodeOfCare | careManager | ||
| PV1:9 | PV1:9.1 | Encounter | participant (referring clinician) | Practitioner | |
| PV1:9 | PV1:9.1 | Practitioner | identifier.value | ||
| PV1:9 | PV1:9.2 | Practitioner | name.family | ||
| PV1:9 | PV1:9.3 | Practitioner | name.given | ||
| PV1:9 | PV1:9.4 | Practitioner | name.given | ||
| PV1:9 | PV1:9.6 | Practitioner | name.prefix | ||
| PV1:14 | PV1:14.1 | Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.code | ||
| PV1:18 | PV1:18.1 | Encounter | type | ||
| PV1:19 | PV1:19.1 | Encounter | episodeOfCare | EpisodeOfCare | |
| PV1:36 | PV1:36.1 | Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.code | ||
| PV1:37 | PV1:37.1 | Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.code | ||
| PV1:44 | PV1:44.1 | Encounter | period.start | ||
| PV1:44 | PV1:44.1 | EpisodeOfCare | startDt | ||
| PV1:45 | PV1:45.1 | Encounter | period.end | ||
| PV1:45 | PV1:45.1 | EpisodeOfCare | endDt |
MSH - Message Header
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| MSH:3 | MSH:3.1 | EpisodeOfCare | managingOrganization | Organization | |
| MSH:3 | MSH:3.1 | Organization | identifier.name | ||
| MSH:3 | MSH:3.3 | Organization | identifier.value | ||
| MSH:7 | MSH:7.1 | DiagnosticReport | issued | if MSH.9.1 == "R01" |
AL1 - Patient Allergy Information
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| AL1:2 | AL1:2.1 | AllergyIntolerance | category | ||
| AL1:3 | AL1:3.1 | AllergyIntolerance | substance.coding.code | ||
| AL1:3 | AL1:3.2 | AllergyIntolerance | substance.coding.display | ||
| AL1:3 | AL1:3.3 | AllergyIntolerance | substance.coding.system | ||
| AL1:4 | AL1:4.1 | AllergyIntolerance | reaction[].severity.code | ||
| AL1:5 | AL1:5.1 | AllergyIntolerance | reaction[].manifestation.coding.code | ||
| AL1:5 | AL1:5.2 | AllergyIntolerance | reaction[].manifestation.coding.display | ||
| AL1:5 | AL1:5.3 | AllergyIntolerance | reaction[].manifestation.coding.system | ||
| AL1:6 | AL1:6.1 | AllergyIntolerance | reaction[].onset |
DG1 - Diagnosis
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| DG1:3 | DG1:3.1 | Condition | substance.coding.code | ||
| DG1:3 | DG1:3.2 | Condition | substance.coding.display | ||
| DG1:3 | DG1:3.3 | Condition | substance.coding.system | ||
| DG1:4 | DG1:4.1 | Condition | reaction[].severity.code | ||
| DG1:5 | DG1:5.1 | Condition | reaction[].manifestation.coding.code | ||
| DG1:16 | DG1:16.1 | Condition | asserter | Practitioner | |
| DG1:16 | DG1:16.1 | Practitioner | identifier.value | ||
| DG1:16 | DG1:16.2 | Practitioner | name.family | ||
| DG1:16 | DG1:16.3 | Practitioner | name.given | ||
| DG1:16 | DG1:16.4 | Practitioner | name.given | ||
| DG1:16 | DG1:16.6 | Practitioner | name.prefix | ||
| DG1:17 | DG1:17.1 | Condition | requires a new extension |
PR1 - Procedures
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| PR1:3 | PR1:3.1 | Procedure | code.coding.code | ||
| PR1:3 | PR1:3.2 | Procedure | code.coding.display | ||
| PR1:3 | PR1:3.3 | Procedure | code.coding.system | ||
| PR1:4 | PR1:4.1 | Procedure | code.text | ||
| PR1:5 | PR1:5.1 | Procedure | performedDateTime | ||
| PR1:6 | PR1:6.1 | Procedure | category |
NTE - Notes and Comments
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| NTE:3 | NTE:3.1 | Observation | comments | if MSH:3.1 == "RADIOLOGY" and this NTE segment immediately follows the last OBX segment under a parent OBR segment | |
| NTE:3 | NTE:3.1 | Observation | valueString | if MSH:3.1 != "RADIOLOGY" and this NTE segment immediately follows the last OBX segment under a parent OBR segment |
OBR - Observation Request
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| OBR:3 | OBR:3.1 | DiagnosticReport | identifier.value | ||
| OBR:24 | OBR:24.1 | DiagnosticReport | category.coding.system | ||
| OBR:4 | OBR:4.1 | DiagnosticReport | code.coding.code | ||
| OBR:4 | OBR:4.2 | DiagnosticReport | code.text | ||
| OBR:4 | OBR:4.2 | DiagnosticReport | code.coding.display | ||
| OBR:7 | OBR:7.1 | DiagnosticReport | effectiveDateTime | ||
| OBR:7 | OBR:7.1 | Observation | effectiveDateTime | Used if OBX:14.1 is not present | |
| OBR:16 | OBR:16.1 | DiagnosticReport | Diagnostic_Report_Filed_By | Practitioner | |
| OBR:16 | OBR:16.1 | Practitioner | identifier.value | ||
| OBR:16 | OBR:16.2 | Practitioner | name.family | ||
| OBR:16 | OBR:16.3 | Practitioner | name.given | ||
| OBR:16 | OBR:16.4 | Practitioner | name.given | ||
| OBR:16 | OBR:16.6 | Practitioner | name.prefix |
ORC - Common Order
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| ORC:21 | ORC:21.3 | DiagnosticReport | orderingOrganization | Organization | |
| ORC:21 | ORC:21.3 | Observation | performer | Organization | |
| ORC:21 | ORC:21.3 | Organization | identifier.value | if MSH:3.1 != "RADIOLOGY" | |
| ORC:21 | ORC:21.1 | Organization | name |
Note: the data path described in the ORC mappings is aspirational and has not been implemented in the current DDS codebase. (DDS uses the Organisation listed in the context instead currently).
OBX - Observation or result
OBX data is mapped differently depending upon whether or not the data represents a pathology, microbiology or a radiology result (see ORU R01: Unsolicited Observation for more details on how that distinction should be made).
Regardless of the type of result there are some mappings that are common
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| OBX:1 | OBX:1.1 | Observation | identifier.value | OBR:3.1 + OBX.1.1 creates a composite identifier for the Observation | |
| OBX:3 | OBX:3.1 | Observation | code | ||
| OBX:8 | OBX:8.1 | Observation | interpretation.coding.code | ||
| OBX:14 | OBX:14.1 | Observation | effectiveDateTime | Used in preference to OBR:7.1 | |
| OBX:16 | OBX:16.1 | Observation | Diagnostic_Report_Filed_By | Practitioner | |
| OBX:16 | OBX:16.1 | Practitioner | identifier.value | ||
| OBX:16 | OBX:16.2 | Practitioner | name.family | ||
| OBX:16 | OBX:16.3 | Practitioner | name.given | ||
| OBX:16 | OBX:16.4 | Practitioner | name.given | ||
| OBX:16 | OBX:16.6 | Practitioner | name.prefix |
Pathology results
Pathology results are divided into two categories -
Single textual report
In the case of a single textual report all related OBX segments (see here for detail on how this report type is identified) are aggregated into the same FHIR Observation instance. The value of each OBX:5.1 field is appended to the valueString property of that same Observation instance. It is also worth noting that NTE segments the follow directly after the parent OBR segment will also be appended on to the valueString (see here for NTE mapping strategy).
Note that the DDS mapping logic will not attempt to insert any newline characters. Instead the Observation.valueString is simply built by concatenating the raw text in the order in which the OBX and NTE segments are encountered.
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| OBX:5 | OBX:5.1 | Observation | valueString | if OBX:2.1 == "ST"
OR if OBX:2.1 == "TX" OR if OBX:2.1 == "FT" |
Collection of individual results
Where an OBX segment encapsulates a single result (see for here detail on how this report type is identified) then each OBX will have an equivalent FHIR Observation instance created
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| OBX:5 | OBX:5.1 | Observation | valueQuantity | if OBX:2.1 == "NM" | |
| OBX:5 | OBX:5.1 | Observation | valueQuantity.value | if OBX:2.1 == "NM" | |
| OBX:6 | OBX:6.1 | Observation | valueQuantity.unit | if OBX:2.1 == "NM" | |
| OBX:6 | OBX:6.1 | Observation | referenceRange.low.unit | if OBX:2.1 == "NM" | |
| OBX:6 | OBX:6.1 | Observation | referenceRange.high.unit | if OBX:2.1 == "NM" | |
| OBX:7 | OBX:7.1 | Observation | referenceRange.low.value | if OBX:2.1 == "NM"
if OBX.7.1 matches the regex "([0-9a-zA-Z\.]+)-(.+)" take first capture group as value | |
| OBX:7 | OBX:7.1 | Observation | referenceRange.high.value | if OBX:2.1 == "NM"
if OBX.7.1 matches the regex "([0-9a-zA-Z\.]+)-(.+)" take second capture group as value |
Radiology results
A radiology result can contain one or multiple images. In each case the image(s) can be accompanied with a textual element.
- Single image OBX - In this case the image data are mapped to a single FHIR Observation instance and the valueAttachment property holds the image
- Multiple image OBX - In this case all individual image data are mapped to heir own component.valueAttachment instance that are all encapsulated within the same single Observation instance
- Textual OBX (one or multiple) - All textual OBX (and also any NTE segments directly following the parent OBR segment) are concatenated on to the comments property of the Observation instance. Note that the DDS mapping logic will not attempt to insert any newline characters.
Where an OBX holds a a recognised image (see here for detail on supported image types) then it is mapped to a
| Field | Component | Resource | Property | References | Condition |
|---|---|---|---|---|---|
| OBX:5 | OBX:5.1 | Attachment | data | ||
| OBX:5 | OBX:5.3 | Attachment | contentType |
Microbiology results
TODO
Fixed Values
PID - Patient Identification
| Resource | Property | Value |
|---|---|---|
| Patient | identifier.system | if PID:3.4 == "NHS" then set to "https://fhir.hl7.org.uk/Id/nhs-number" |
| Patient | address.use | if PID:11.7 == 'TEMPORARY' then set to 'temp' else set to 'home' |
| Patient | telecom.use | set to "work" |
| Patient | communication.preferred | if PID:15.1 is not empty then set to "true" |
| Patient | communication.preferred | if PID:15.4 is not empty then set to "false" |
| Encounter | contained.Parameters.parameter.name | if PID:18 is not empty then set to "CM_PatientFIN" |
| Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.system | if PID:18 is not empty then set to ? (need a code system here) |
PD1 - Patient Additional Demographic
| Resource | Property | Value |
|---|---|---|
| Organization | identifier.system | if PD1:3.3 is not empty then set to "http://fhir.nhs.net/Id/ods-organization-code" |
| Organization | identifier.type | if PD1:3.3 is not empty then set to "official" |
| Organization | type.system | if PD1:3.3 is not empty then set to "http://endeavourhealth.org/fhir/ValueSet/primarycare-organization-type" |
| Organization | type.code | if PD1:3.3 is not empty then set to "PR" |
| Organization | type.display | if PD1:3.3 is not empty then set to "GP Practices in England and Wales" |
PV1 - Patient Visit
| Resource | Property | Value |
|---|---|---|
| Location | status | if PV1:3.9 is not empty then set to "ACTIVE" |
| Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.system | if PV1:4 is not empty then set to ? (need a code system here) |
| Location | status | if PV1:6.9 is not empty then set to "ACTIVE" |
| Practitioner | identifier.system | if PV1:8 is not empty then set to "http://endeavourhealth.org/fhir/Identifier/gmp-ppd-code" |
| Practitioner | identifier.system | if PV1:9 is not empty then set to "http://endeavourhealth.org/fhir/Identifier/gmp-ppd-code" |
| Encounter | contained.Parameters.parameter.name | if PV1:14 is not empty then set to "DM_sourceOfAdmission" |
| Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.system | if PV1:14 is not empty then set to ? (need a code system here) |
| Encounter | contained.Parameters.parameter.name | if PV1:36 is not empty then set to "DM_dischargeMethod" |
| Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.system | if PV1:36 is not empty then set to ? (need a code system here) |
| Encounter | contained.Parameters.parameter.name | if PV1:37 is not empty then set to "DM_destination" |
| Encounter | contained.Parameters.parameter.valueCodeableConcept.coding.system | if PV1:37 is not empty then set to ? (need a code system here) |
MSH - Message Header
| Resource | Property | Value |
|---|---|---|
| Organization | identifier.system | if MSH:3.3 is not empty then set to "http://fhir.nhs.net/Id/ods-organization-code" |
| Organization | identifier.system | if MSH:3.3 is not empty then set to "official" |
DG1 - Diagnosis
| Resource | Property | Value |
|---|---|---|
| Practitioner | identifier.system | if DG1:16.1 is not empty then set to TODO |
ORC - Common Order
| Resource | Property | Value |
|---|---|---|
| Organization | identifier.system | if ORC:23.1 is not empty then set to "http://fhir.nhs.net/Id/ods-site-code" |
OBR - Observation Request
| Resource | Property | Value |
|---|---|---|
| DiagnosticReport | identifier.system | if OBR:3.1 is not empty and if MSH.3.1 != "RADIOLOGY" then set to "https://fhir.hl7.org.uk/path/id/{MSH:4.1}"
if OBR:3.1 is not empty and if MSH.3.1 == "RADIOLOGY" then set to "https://fhir.hl7.org.uk/rad/id/{MSH:4.1}" |
| DiagnosticReport | category.coding.system | if OBR.24 is not empty then set to "http://hl7.org/fhir/v2/0074"
TODO - set a bespoke coding system for Radiology results |
| DiagnosticReport | category.coding.code | if MSH.3.1 == "RADIOLOGY" then set to "RAD" |
| DiagnosticReport | identifier.system | if OBR:3.1 is not empty and if MSH.3.1 != "RADIOLOGY" then set to TODO
if OBR:3.1 is not empty and if MSH.3.1 == "RADIOLOGY" then set to TODO |
| DiagnosticReport | status | if OBR:25 == "F" then set to "final"
if OBR:25 == "C" then set to "corrected" |
| Observation | identifier.system | if OBR:3.1 is not empty and if MSH.3.1 != "RADIOLOGY" then set to "https://fhir.hl7.org.uk/path/id/{MSH:4.1}"
if OBR:3.1 is not empty and if MSH.3.1 == "RADIOLOGY" then set to "https://fhir.hl7.org.uk/rad/id/{MSH:4.1}" |
| Observation | category.coding.system | if MSH.3.1 == "RADIOLOGY" then set to TODO
if MSH.3.1 != "RADIOLOGY" and then set to TODO |
OBX - Observation or result
| Resource | Property | Value |
|---|---|---|
| Observation | component.code.coding.system | if OBX:3.1 is not empty and if MSH.3.1 != "RADIOLOGY" then set to "TODO - UTL?"
if OBX:3.1 is not empty and if MSH.3.1 == "RADIOLOGY" then set to "TODO" |
| Observation | component.interpretation.valueCodeableConcept.coding.system | if OBX:3.1 is not empty then set to "http://hl7.org/fhir/ValueSet/observation-interpretation" |
| Observation | status | if OBX:11 == "F" then set to "final"
if OBX:11 == "C" then set to "corrected" |
Entity Relationship
The section describes how the references between FHIR resources are created. It shows where the references are sourced from in the original HL7v2 messages. This section is presented as a series of diagrams each centered around a main FHIR resource. On the left are the source segments mapping into the main FHRI resource in the middle. On the right are the FHIR resources that those mappings then reference. Note that the origin on the data held within each FHIR resource is detailed in the tables above - this section is purely concerned with references between resources.
Encounter
Patient
AllergyIntolerance, Condition and Procedure
All three of AllergyIntolerance, Condition and Procedure reference the same resources and use the same HL7 fields to create the relationship
EpisodeOfCare
DiagnosticReport
Observation
