Foundation
This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
STU
3).
(v3.3.0:
R4
Ballot
2).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
R2
|
FHIR
Infrastructure
Work
Group
|
Maturity Level : N/A | Ballot Status : Informative |
The FHIR specification defines a set of resources, and an infrastructure for handling resources. In order to use FHIR to create solutions for integration requirements, implementers must map their problems to resources and their content.
The
resources
are
classified
into
6
sections:
Clinical
:
The
content
Resource
List
provides
views
of
a
clinical
record
Identification
:
Supporting
entities
involved
in
the
care
process
Workflow
:
Manage
the
healthcare
process
Financial
:
Resources
that
support
the
billing
resources
organized
in
several
different
ways,
and
payment
parts
of
FHIR
Conformance
:
Resources
use
is
the
primary
entry
point
to
manage
specification,
development
and
testing
of
FHIR
solutions
Infrastructure
:
General
functionality,
and
resources
for
internal
FHIR
requirements
the
resources.
This page describes the resources and their functional intent in more detail to assist implementers to understand their purpose and scope, and their supporting classifications.
Where to find common concepts in this specification:
| Concept | Example | Where to find |
| Clinical Findings | ||
| Laboratory Results | Blood panels such as CBC with Differential, Liver Panel, etc. | DiagnosticReport with Observations |
| Imaging Study Findings | CT Scans, MRI, Plain Radiographs, Ultrasounds) | DiagnosticReport (some with Observations ) |
| Diagnostic Test Results | EKG, pulmonary function test, EEG | Observations (and maybe a DiagnosticReport ) |
| Vital Signs | Temperature, Blood Pressure, Heart Rate, Respiratory Rate | Observation |
| Other Physical Exam Findings | Auscultation findings | Observation |
| Pulmonary Artery Catheter readings | Pulmonary artery pressure | Observation |
| Patient Problems, Allergies and Adverse Events | ||
| Allergy | Food or drug allergies | AllergyIntolerance |
| Clinical Diagnosis | Diabetes, Congestive Heart Failure | Condition |
| Adverse Event | Adverse reaction to an agent, falls, adverse surgical events, hospital infections | AdverseEvent |
| Patient History | ||
| Chief Complaint | Cough, Pain, Fever, Fatigue | Condition |
| Past Surgical History | Appendectomy, Hernia repair | Procedure |
| Past Medical History | Diabetes, Congestive heart failure | Condition |
| MAR (Medication Administration Record) | Warfarin 5mg PO administered on 12/10/2013 at 3pm | MedicationAdministration |
| Home Meds | Warfarin 5mg, 30 day supply, dispensed on 12/01/2013 | MedicationStatement |
| Social History | Sexual behavior, Smoking status, Alcohol intake, Illicit drug use | Observation |
| Family History | Mother has diabetes | FamilyMemberHistory |
| Signs & Symptoms | from a review of systems- Pain, Fever | Condition |
| Suggested Physician Orders | ||
| Proposal for a laboratory test | A blood panel, a stool analysis |
|
| Proposal for an imaging procedure | CT Scan, MRI, X-Rays |
|
| Proposed Diet Order | An oral diet order | NutritionOrder |
| Proposed respiratory order | Oxygen delivery | Not done yet |
| Proposed Medications | Aspirin, Lisinopril | MedicationRequest |
| Proposed Supply | Wheel Chair, Food Tray | SupplyRequest |
| Interdisciplinary Care Planning | ||
| Patient Goal | Reduce risk of falls, lose weight | Goal (as part of a CarePlan ) |
| Intervention | Patient assessments |
|
In addition, to the information on this page, see also Common Use Cases .
AllergyIntolerance
,
Condition
,
and
Procedure
are
common
resources
that
appear
throughout
the
patient
record
-
summaries
of
the
patient
status
or
history.
FamilyMemberHistory
tracks
significant
health
issues
for
relatives
of
the
patient,
since
these
are
significant
risk
factors
for
the
patient.
These
resources
may
be
found
in
patient,
episode,
discharge
summaries,
and
consultation
records.
ClinicalImpression
(aka
ClinicalAssessment)
records
the
core
of
a
clinical
consultation/assessment/impression.
When
a
single
text
note
is
inserted
directly
in
the
patient
record,
this
is
typically
a
ClinicalImpression.summary.
A
RiskAssessment
is
an
assessment
-
usually,
but
not
necessarily,
by
a
decision
support
engine
of
the
likely
outcomes
of
some
course
of
action
for
a
patient.
A
DetectedIssue
is
an
active
alert
that
there
is
a
clinical
issue
with/between
one
or
more
active
or
proposed
clinical
actions
for
a
patient.
One
way
it
may
be
used
is
as
part
of
an
error
message
in
response
to
an
attempted
operation.
Resource
Category
RIM
Lifecycle
AllergyIntolerance
Ongoing
Act
This
has
a
Current
List
Condition
Ongoing
Act
This
has
a
Current
List
Procedure
Past
Act
Clinical
Workflow
FamilyMemberHistory
Past
Act
ClinicalImpression
Past
Act
RiskAssessment
Present
Act
Clinical
Workflow
DetectedIssue
Present
Act
2.33.2.2
Care
Provision
These
resources
support
planning
of
care
provision
-
care
and
treatment
plans.
CarePlan
and
Goal
are
the
primary
structures
around
which
future
planning
for
the
patient
is
based.
These
are
used
to
define
care
and
treatment
planned
for
a
patient
in
the
future,
and
may
be
updated
and
adjusted
as
ongoing
care
is
provided.
ReferralRequest
is
the
basis
for
a
proposed/requested
transfer
of
care
from
one
clinician
to
another.
Typically,
these
are
associated
with
a
transfer
of
records,
and
a
physical
relocation
of
the
patient,
but
neither
of
these
are
required.
A
ProcedureRequest
records
a
request
for
a
procedure
to
be
carried
out.
NutritionOrder
is
a
request
to
supply
a
diet,
formula
feeding
(enteral)
or
oral
nutritional
supplement
to
a
patient
and
VisionPrescription
contains
the
details
of
visual
aids
requested
for
a
patient.
Resource
Category
RIM
Lifecycle
CarePlan
Ongoing
Act
Goal
Future
Act
Clinical
Workflow
ReferralRequest
Future
Act
Clinical
Workflow
ProcedureRequest
Future
Act
Clinical
Workflow
NutritionOrder
Future
/
Ongoing
Act
VisionPrescription
Future
Act
2.33.2.3
Medication
Management
Supports
the
medication
and
immunization
processes.
Some
points
of
note:
Prescription
=
a
MedicationRequest
In
some
records,
medication
orders,
administration,
and
statements
may
not
be
well
differentiated.
Generally,
use
MedicationStatement
if
records
are
unclear
A
medication
chart
(or
variants)
will
use
multiple
different
types
of
medication
resources
When
prescribing
is
done
by
an
external
system
(e.g.
most
ambulatory
e-prescribing),
the
Medication
resource
is
not
used.
It
is
generally
used
to
represent
information
in
formularies
and
to
describe
custom
formulations
Resource
Category
RIM
Lifecycle
Medication
Unrelated
Role
Medication
Medication
Act
Clinical
Workflow
MedicationDispense
Past
Act
Clinical
Workflow
MedicationRequest
Future
Act
Request/Order
.
This
has
a
current
List
MedicationStatement
Ongoing
/
Past
Act
Entity
Availability
Workflow
.
This
has
a
Current
List
Immunization
Past
Act
ImmunizationRecommendation
Future
Act
2.33.2.4
Diagnostics
Resources
concerned
with
observing
the
patient,
and
the
diagnostic
service
process
built
around
this.
The
Observation
resource
is
a
widely
used
general
purpose
tool.
Typical
uses
include
recording
the
following
kinds
of
data:
Laboratory
Results
Vital
Signs
(including
Blood
Pressure)
Physical
Examinations
Social
history
(e.g.
Smoking
History)
and
many
more
things
beside.
Note
that
'everything
is
an
observation',
but
implementations
should
not
use
Observation
where
Condition
is
more
appropriate.
ProcedureRequest
and
DiagnosticReport
support
the
overall
diagnostic
process.
A
DiagnosticReport
connects
the
process
of
'reporting',
linking
process
identifiers,
visual
presentations
of
a
report,
and
conclusions/interpretations
with
the
Observations.
ProcedureRequests
capture
the
request
from
an
authorized
clinician
to
initiate
the
diagnostic
process.
Specimen
and
BodySite
are
used
to
record
the
details
of
specimen
collection
although
BodySite
can
also
be
used
with
other
resources
(e.g.
Operation
location
details
on
a
Procedure).
The
resources
ImagingManifest
and
ImagingStudy
frameworks
are
provided
to
make
links
to
diagnostic
images
available
within
the
clinical
record,
where
the
actual
images
will
be
provided
by
dedicated
systems
(the
Media
resource
is
intended
for
sharing
actual
images
directly,
which
is
not
generally
suitable
for
high
resolution,
high
volume
diagnostic
images).
Resource
Category
RIM
Lifecycle
Observation
Past
Act
DiagnosticReport
Past
Act
Entity
Availability
Workflow
ProcedureRequest
Future
Act
Request/Order
Specimen
Unrelated
Role
Entity
Availability
Workflow
BodySite
Unrelated
Role
ImagingManifest
Past
Act
ImagingStudy
Past
Act
2.33.3
Administrative
Resources
These
resources
provide
support
for
identifying
the
various
entities
involved
in
healthcare:
people,
organizations,
substances,
devices,
etc.
2.33.3.1
Individuals
The
Patient
resource
represents
the
recipient
of
healthcare.
This
concept
is
not
always
referred
to
as
a
'patient'
-
other
words
such
as
client,
customer,
resident,
etc.
are
commonly
used,
but
in
this
specification,
the
recipient
of
healthcare
is
simply
known
as
the
patient.
The
patient
resource
includes
basic
demographics
and
next
of
kin
information.
The
Practitioner
resource
is
used
to
identify
and
describe
any
person
(or
even
animal)
involved
in
the
provision
of
care,
including
doctors,
nurses,
clerical
staff,
specialist
support
staff,
etc.
RelatedPerson
is
used
to
describe
individuals
who
are
related
helping
to
understand
the
patient
who
are
involved
in
the
healthcare
process,
beyond
merely
being
next
of
kin
-
they
may
sign
documents,
administer
medications,
be
the
source
of
information,
or
simply
provide
care
by
chance
at
an
accident.
Resource
Category
RIM
Lifecycle
Patient
Unrelated
Role
Entity
Availability
Workflow
Practitioner
Unrelated
Role
RelatedPerson
Unrelated
Role
2.33.3.2
Groups
In
most
provision
of
healthcare,
some
Organization
is
responsible
and
accountable
for
the
care,
and
references
appear
throughout
the
clinical
record.
The
organization
is
a
legal
entity
that
may
operate
at
multiple
locations.
A
HealthcareService
represents
the
services
offered
by
one
or
more
organizations
at
a
single
location.
A
Group
is
used
to
describe
one
or
more
individuals
-
usually
people,
though
other
kinds
of
entities
are
allowed.
Typically,
these
are
used
with
aggregate
reporting,
though
sometimes
care
is
provided
to
a
set
of
individuals
at
once
(some
counseling
procedures,
public
health
procedures,
herds
of
cattle,
etc.).
Resource
Category
RIM
Lifecycle
Organization
Unrelated
Role
HealthcareService
Unrelated
Role
Group
Unrelated
Entity
2.33.3.3
Entities
Location
-
for
where
things
happen.
Locations
are
either
by
instance
(e.g.
this
particular
room
at
a
given
address
or
GPS
coordinates)
or
by
kind
(e.g.
the
back
of
some
ambulance).
The
same
applies
to
Substance
,
for
some
kind
of
material
(e.g.
chemical)
used
in
healthcare
-
it
may
refer
to
an
identified
instance
(e.g.
bottle)
or
a
kind
of
chemical.
The
Person
resource
is
used
to
track
associations
between
different
patient
records
across
the
provision
of
healthcare
(e.g.
"master
patient
indexes").
Person
resources
are
not
referred
directly
from
other
resources;
their
use
is
for
dedicated
person
registries.
Resource
Category
RIM
Lifecycle
Location
Unrelated
Role
Entity
Availability
Workflow
Substance
Unrelated
Entity
Person
Unrelated
Entity
2.33.3.4
Device
Device
is
used
to
track
non-consumable
manufactured
materials
through
the
healthcare
process.
It
includes
implants,
large
instruments,
non-medical
things
(including
software),
and
containers.
Devices
-
and
therefore
the
device
resource
-
have
many
purposes,
including
stock
control,
locating
devices,
and
tracking
implants.
DeviceComponent
and
DeviceMetric
are
used
to
report
the
status
and
characteristics
of
the
kinds
of
medical
devices
that
produce
a
stream
of
one
or
more
data
points
(
Observations
),
usually
about
a
patient.
Resource
Category
RIM
Lifecycle
Device
Unrelated
Role
DeviceComponent
Unrelated
Role
DeviceMetric
Unrelated
Role
2.33.3.5
Research
ResearchStudy
is
used
to
capture
information
related
to
the
planning
and
execution
of
clinical
and
pre-clinical
studies.
It
covers
both
human
and
veterinary
studies
and
safety,
efficacy,
comparative
effectiveness
and
retrospective
trials.
ResearchSubject
capture
the
information
around
the
participation
of
a
specific
individual
(
Patient
)
provided
in
a
specific
ResearchStudy
.
This
information
includes
their
time
of
participation,
associated
study
arm,
status
within
the
study,
etc.
Resource
Category
RIM
Lifecycle
ResearchStudy
Unrelated
Act
ResearchSubject
Unrelated
Role
2.33.4
Work
Flow
2.33.4.1
Encounters
Encounter
tracks
an
interaction
between
a
patient
and
healthcare
provider(s).
Specifically,
this
resource
tracks
the
administrative
details
of
the
interaction,
not
the
clinical
details
(though
these
usual
link
to
it).
Aliases
for
this
include
'admission',
'consultation',
and
sometimes
'appointment'.
Encounters
may
be
nested
-
e.g.
when
the
patient
goes
to
physiotherapy
as
part
of
a
hospital
admission.
An
EpisodeOfCare
is
an
association
between
a
patient
and
a
care
provider
that
may
last
over
several
encounters.
The
purpose
of
EpisodeOfCare
is
track
a
provider
(person
or
organization)
that
has
an
interest
in
the
ongoing
care
of
the
patient.
A
Communication
is
a
record
of
a
formal
communication
with
a
patient
or
another
party
with
an
interest
in
their
care
-
a
letter,
email,
phone
call
etc.
A
Flag
is
warning
maintained
in
the
system
that
alerts
care
providers
to
potential
issues
they
should
be
aware
of
when
providing
care
to
a
patient,
or
at
a
location.
Resource
Category
RIM
Lifecycle
Encounter
Future
/
Ongoing
/
Past
Act
EpisodeOfCare
Act
Communication
Past
Act
Clinical
Workflow
Flag
Ongoing
Act
Entity
Availability
Workflow
2.33.4.2
Scheduling
These
resources
are
concerned
with
planning
times
and
locations
for
future
delivery
of
care:
specification:
®©
HL7.org
2011+.
FHIR
Release
3
(STU;
v3.0.2-11200)
Mixed
Nomative/Trial
Use
Ballot
(v3.3.0-13671)
generated
on
Thurs,
Oct
24,
2019
11:53+1100.
Tue,
Apr
3,
2018
12:19+1000.
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