Topic outline

• FHIR R4 Integration QuickStart

  FHIR R4 Integration QuickStart

  Content Type
  Exercise

  Duration
  10m

  Level
  Introductory

  InterSystems IRIS® for Health helps you build your HL7® FHIR® applications quickly and seamlessly.

  Through the use of FHIR and InterSystems IRIS for Health, you can easily:

  • Expose discrete resources, improving performance.
  • Convert data between FHIR and many other healthcare data formats such as HL7® V2 or HL7® CDA.
  • Route, transform, and orchestrate data between multiple disparate applications.
  • Store FHIR resources in a resource repository using InterSystems IRIS for Health as your FHIR application development environment.

  Watch the video, then try the exercise!

  Note: This QuickStart is only applicable for InterSystems IRIS for Health 2020.4+.

  • Want to see how this is done? Watch this demonstration.
    

  • Mark me "complete" for this exercise.

    Not available unless: Your ID number is not empty
• Start the Exercise

  Start the Exercise

  Using InterSystems IRIS for Health, within a single platform you can easily:

  • Retrieve or send small, discrete units of data known as FHIR resources.
  • Integrate applications that use different healthcare standards, such as FHIR and HL7 V2.
  • Store data to a FHIR resource repository.
  • Transform data for downstream systems.

  In this exercise, you will load a sample integration solution that consumes healthcare data—both FHIR resources and HL7 V2 messages—and stores it to a FHIR repository within InterSystems IRIS for Health. You will then retrieve small, discrete FHIR resources such as a patient or a medication, allowing you to optimize your application to work with just the data you need. Coding knowledge is not required to complete this tutorial.

  Launch the virtual machine (VM) below to begin working on the exercise. For responses to common questions on using VM-based Learning Labs, visit FAQ: Using Learning Services Virtual Machines.

  Your login information for the VM is the following:

  • Username: student
  • Password: LearningServices7

  •  You must be logged in to launch this VM.

    • Log in with your existing account.
    • Don't have an InterSystems account? Create a new account.
  • Set up
    

    Complete the following steps to create a FHIR server and load sample patient data into the server. 
    

    1. Open the Management Portal using the bookmark in Chrome, and login with the credentials tech and demo7. 
    2. Switch to the FHIRSERVER namespace and navigate to Health > FHIR Configuration > Server Configuration to create a FHIR R4 server endpoint that stores FHIR data as JSON in a FHIR resource repository. Click Add Endpoint and enter the following settings, then click Add:
       • Core HL7 FHIR package: hl7.fhir.r4.core@4.0.1
       • Additional Packages (optional): hl7.fhir.us.core@3.1.0
    3. Click the /csp/healthshare/fhirserver/fhir/r4 endpoint you just created, then Edit and set the Service Config Name to HS.FHIRServer.Interop.Service. Select Allow Unauthenticated Access and click Update.
    4. Again, in the Management Portal, switch to the FHIRServer namespace and view the pre-loaded production by going to Interoperability > Configure > Production. Click Start to run the production.
    5. Load sample data from patient Kris Herman into the FHIR server.
       1. Open an InterSystems IRIS Terminal by opening a new terminal window and running the following command:
          
          Begin code:

          docker exec -it I4H iris terminal iris

          End code.
       2. In the InterSystems IRIS terminal, type the following:
          
          Begin code:

          set $namespace = "FHIRSERVER"
          set sc = ##class(HS.FHIRServer.Tools.DataLoader).SubmitResourceFiles("/external/R4/data/fhir_json_data","FHIRServer", "/csp/healthshare/fhirserver/fhir/r4")
          write sc

          End code.
  • Retrieve discrete FHIR resources easily, optimizing speed and performance
    

    FHIR resources are especially useful for low-bandwidth situations, such as on mobile devices. Other healthcare standards often send more data than is needed. Using FHIR with InterSystems IRIS for Health, you can retrieve a single resource, such as a patient, medication, or observation. InterSystems IRIS for Health includes a flexible base implementation of a FHIR server that conforms to the official FHIR specification. See an example in the next several steps.

    1. Open Postman using the icon in the taskbar on the left. Create a new request to get patient Kris Herman using the following values:
       Headers:
       • Accept: application/fhir+json
         
       HTTP Request: GET http://localhost:52773/csp/healthshare/fhirserver/fhir/r4/Patient?family=Herman&given=Kris
       
    2. From the result in the previous step, you can see patient Kris Herman's ID is 1. You can get any other information about him, including related resources such as AllergyIntolerance and Encounter, by adding $everything to the end of your URL:
       HTTP Request: GET http://localhost:52773/csp/healthshare/fhirserver/fhir/r4/Patient/1/$everything
  • Store FHIR resources centrally using InterSystems IRIS for Health
    

    In the previous section, you queried data that was already stored to the InterSystems IRIS for Health FHIR repository. Let’s see how easy it is to consume FHIR data, store it to the FHIR repository, and retrieve it again.

    1. Using your REST client, use the following HTTP request to store a new AllergyIntolerance resource:
       Headers:
       • Accept: application/fhir+json
         
       • Content-type: application/fhir+json
       HTTP Request: POST http://localhost:52773/csp/healthshare/fhirserver/fhir/r4/AllergyIntolerance
       
       Body: Copy the example from the HL7 FHIR website.
       
       If successful, you should get a 201 Created message.
       
       
    2. Retrieve the Allergy resource with high criticality you just stored to the FHIR repository:
       
       HTTP Request: GET http://localhost:52773/csp/healthshare/fhirserver/fhir/r4/AllergyIntolerance?criticality=high
  • Use integration tools to convert between FHIR and legacy HL7 V2 applications
    

    Need to expose your data as FHIR? Using InterSystems IRIS for Health, HL7 V2 data can be consumed, converted to FHIR, and stored in a FHIR repository or sent to other FHIR applications. In this step, you will consume an ADT_A01 HL7 V2 message, store it to the FHIR repository, and then use REST to query for the FHIR resource.
    
    

    Data is converted between FHIR and HL7 v2 or CDA formats using InterSystems IRIS for Health. Data coming from a FHIR app can be shared with legacy apps requiring HL7 or CDA formats, and vice versa.

    
    

    1. Open the Data folder from the Desktop. Copy the ADT_A01.txt file, with information about the patient Jane Carter, located in /data/SampleFiles, to the /data/In folder. InterSystems IRIS for Health so it can consume, convert the contents to FHIR resources, and store the data to the FHIR repository.
    2. Using the REST client again, search for Jane's resource:
       GET http://localhost:52773/csp/healthshare/fhirserver/fhir/r4/Patient?family=Carter
       All messages sent through InterSystems IRIS for Health are stored to an internal database, making it easy to track, follow, and troubleshoot messages.
    3. Open the Management Portal and go to Interoperability > View > Messages.
    4. Select the message with Source equal to EnsLib.HL7.Service.FileService.
    5. Click Trace on the right, then click View Full Trace.
       
       Note:

       This view shows how messages traverse the integration solution at every step. Notice that the EnsLib.HL7.Service.FileService service consumed the file and is the starting point for this trace. It then sends the HL7 V2 input message to the Demo.FHIRHL7ToFHIRRequestBPL process, which uses a BPL to extract Patient MRN from the incoming message and to subsequently transform the HL7 V2 message into a bundle of FHIR resources (via HS.FHIR.DTL.Util.HC.SDA3.FHIR.Process), using the Patient MRN as the patient resource ID. Then, the transformed output is sent to HS.FHIR.Interop.Operations, which internally stores the FHIR resources in the FHIR repository.
    6. Select the first Request message between HS.FHIRServer.Interop.Operation and HS.Util.Trace.Operations.
       The HS.Util.Trace.Operations component allows you to display the actual contents of the FHIR message in the Contents pane on the right. Can you find the given name of the patient?
       
       
       
       

    Going back to message list, you can see there is a message with Source equal to HS.FHIRServer.Interop.Service. This is because during initial setup, the FHIR server endpoint’s Service Config Name setting was set to HS.FHIRServer.Interop.Service, and this optional setting allows all FHIR REST messages (such as FHIR search requests) to flow through an interoperability production before reaching the internal FHIR server core.

• What's Next?

  What's Next?
  • Read about installing and configuring your FHIR server (documentation).
  • Learn more about the interoperability features within InterSystems IRIS (exercise, 10m).
    

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