Reference Implementation for the Gravity use cases specified at https://confluence.hl7.org/display/FHIR/2021-01+Gravity+SDOH+Clinical+Care+Track. Current supported IG version is 1.1.0 (STU 2 ballot): http://hl7.org/fhir/us/sdoh-clinicalcare/2022Jan/
All reference implementations are usually available for testing during connectathons. There is a high chance at any other time that the apps have been undeployed to reduce costs. If so - try to deploy them locally.
- The EHR app is running at https://ri-sdoh-exchange-ehr.herokuapp.com. To log in please request access to the Logica Sandbox at https://sandbox.logicahealth.org/GravitySandboxNew from the Track leads.
- The CP app is running at https://ri-sdoh-exchange-cp.herokuapp.com. To log in please request access to the Logica Sandbox at https://sandbox.logicahealth.org/GravitySDOHCBRO from the Track leads.
- The CBO app is running at https://ri-sdoh-exchange-cbo.herokuapp.com. Creentials: user/user.
Interaction prototype between Provider and Patient:
Provider/ Complete questionnaire regarding social risks https://invis.io/2J10RH2AKAR3#/462516921_Complete_Questionnaire_Regarding_Social_Risks-_1
Patient/ Complete questionnaire regarding social risks
https://invis.io/87115OS1XTCG#/462518145_Complete_Questionnaire_Regarding_Social_Risks-_14
Provider/ Collect information for a service
https://invis.io/2J10RH2AKAR3#/462518690_Collect_Information_For_A_Service-_1
Patient/ Collect information for a service
https://invis.io/87115OS1XTCG#/462519058_Collect_Information_For_A_Service-_16
Provider/ Information regarding service
https://invis.io/2J10RH2AKAR3#/462519533_Information_Regarding_Service-_1
Patient/ Information regarding service
https://invis.io/87115OS1XTCG#/462519895_Information_Regarding_Service-_13
Provider/ Schedule appointment for service requested created and sent to the performer
Patient/ Schedule appointment for service requested created and sent to the performer
Provider/ Provide patient with service performer contact information
Patient/ Provide patient with service performer contact information
Provider/ Provide feedback on service delivered
https://invis.io/2J10RH2AKAR3#/462587973_Provide_Feedback_On_Service_Delivered-_1
Patient/ Provide feedback on service delivered
https://invis.io/87115OS1XTCG#/462604660_Provide_Feedback_On_Service_Delivered_1## Local Testing
To configure the EHR and CP apps to use custom Sandbox URLs - set the following system variables:
Replace {APP} with either ehr or cp.
| Variable | Description |
|---|---|
| {APP}.fhir-server-uri | Secured URI of the underlying FHIR server. Used for an authorized access for a specific user data (Patient or Practitioner). |
| {APP}.open-fhir-server-uri | Open URI of the underlying FHIR server. Used by the system to perform scheduled read/write operations in the background outside of a user context. Usually a 'Client Credentials' flow is used, but it is not supported by the Logica Sandbox. |
| spring.security.oauth2.client.registration.{APP}-client.client-id | OAauth2 Client ID. |
| spring.security.oauth2.client.registration.{APP}-client.client-secret | OAauth2 Client Secret. Leave empty for public clients. |
| spring.security.oauth2.client.provider.{APP}-provider.token-uri | OAuth2 Token endpoint. Defaults to the Logica Token ednpoint. |
| spring.security.oauth2.client.provider.{APP}-provider.authorization-uri | OAuth2 Authorization endpoint. Defaults to the Logica Authorization ednpoint. |
| spring.security.oauth2.client.provider.{APP}-provider.user-info-uri | OAuth2 UserInfo endpoint. Defaults to the Logica UserInfo ednpoint. |
| spring.security.oauth2.client.provider.{APP}-provider.jwk-set-uri | JSON Web Key Set endpoint. Defaults to the Logica JWKS ednpoint. |
In CBO app the source FHIR Servers are added dynamically through UI, so no any configuration is needed on start.
Latest Java and Maven have to be installed. Just run a command from a base directory:
mvn clean installjava -Dserver.port=8080 -jar ehr/app/target/app-1.0-SNAPSHOT.jarjava -Dserver.port=8082 -jar cp/app/target/app-1.0-SNAPSHOT.jar#The -Dapp.url parameter value should match the identifier of the CBO organization resource stored at CP FHIR server.
java -Dserver.port=8084 -Dapp.url=http://localhost:8084 -jar cbo/app/target/app-1.0-SNAPSHOT.jarChange port 8080 to any other port you want an application to listen to. Specify varaibles before the -jar flag in format -Dvariable=value.
EHR run command example:
java -Dserver.port=8080 -Dehr.fhir-server-uri=https://api.logicahealth.org/GravitySandboxNew/data -Dehr.open-fhir-server-uri=https://api.logicahealth.org/GravitySandboxNew/open -Dspring.security.oauth2.client.registration.ehr-client.client-id=1c4d149f-9995-4c5c-ac42-018150437355 -Dspring.security.oauth2.client.registration.ehr-client.client-secret=secret -jar ehr/app/target/app-1.0-SNAPSHOT.jarThis section is applicable for both EHR and CP apps. Run the following command to delete all data for a specific Resource type belonging to your test Patient resource:
DELETE https://{server base}/Task?patient={patient id}&_profile:contains={SDOH Profile or no string to match all}&_cascade=deleteAll SDOH profiles can be found in the official SDOH IG documetnation at http://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare
Recource types to delete:
- Task (this includes both Referrals and Patient Tasks)
- ServiceRequest
- Procedure
- Consent
- Condition
- Goal
- QuestionnaireResponse
Optional (if these resources have been updated in the IG artifacts page):
- Hunger Vital Sign Questionnaire
- Hunger Vital Sign StructureMap
Send a POST request to https://{EHR server base}/ with the following content. This will create an EHR Organization entry and link it to the performing Practitioner using the PractitionerRole resource. This practitioner with corresponding PractitionerRole resource and Organization referencing the current EHR, should be launching the EHR app, in other case the launch will fail. Please take into account that both resources should belong to the US-Core profile.
{
"resourceType": "Bundle",
"id": "bundle-transaction",
"type": "transaction",
"entry": [
{
"fullUrl": "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a",
"resource": {
"resourceType": "Organization",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"active": true,
"name": "Good EHR"
},
"request": {
"method": "POST",
"url": "Organization"
}
},
{
"fullUrl": "urn:uuid:05efabf0-4be2-4561-91ce-51548425acb9",
"resource": {
"resourceType": "PractitionerRole",
"id": "14604",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"
]
},
"active": true,
"practitioner": {
"reference": "Practitioner/smart-Practitioner-71482713",
"type": "Practitioner",
"display": "Susan Clark"
},
"organization": {
"reference": "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a",
"display": "Good EHR"
},
"code": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/practitioner-role",
"code": "doctor"
}
]
}
],
"specialty": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "408443003",
"display": "General medical practice"
}
]
}
],
"availableTime": [
{
"daysOfWeek": [
"mon",
"tue",
"wed"
],
"availableStartTime": "09:00:00",
"availableEndTime": "16:30:00"
},
{
"daysOfWeek": [
"thu",
"fri"
],
"availableStartTime": "09:00:00",
"availableEndTime": "12:00:00"
}
],
"notAvailable": [
{
"description": "Susan will be on extended leave during May 2021",
"during": {
"start": "2021-05-01",
"end": "2021-05-20"
}
}
],
"availabilityExceptions": "Susan is generally unavailable on public holidays and during the Christmas/New Year break"
},
"request": {
"method": "POST",
"url": "PractitionerRole"
}
}
]
}Send a POST request to https://{EHR server base}/ with the following content. This will create a CP Organization entry with a corresponding Endpoint. Please take into account that currently only OPEN FHIR endpoints are supported.
{
"resourceType": "Bundle",
"id": "bundle-transaction",
"type": "transaction",
"entry": [
{
"fullUrl": "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a",
"resource": {
"resourceType": "Organization",
"type": [
{
"coding": [
{
"system": "http://hl7.org/gravity/CodeSystem/sdohcc-temporary-organization-type-codes",
"code": "cp",
"display": "Coordination Platform"
}
]
}
],
"name": "Good Health Clinic",
"endpoint": [
{
"reference": "urn:uuid:05efabf0-4be2-4561-91ce-51548425acb9"
}
]
},
"request": {
"method": "POST",
"url": "Organization"
}
},
{
"fullUrl": "urn:uuid:05efabf0-4be2-4561-91ce-51548425acb9",
"resource": {
"resourceType": "Endpoint",
"status": "active",
"connectionType": {
"system": "http://terminology.hl7.org/CodeSystem/endpoint-connection-type",
"code": "hl7-fhir-rest"
},
"name": "Health Intersections CarePlan Hub",
"managingOrganization": {
"reference": "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a"
},
"contact": [
{
"system": "email",
"value": "[email protected]",
"use": "work"
}
],
"period": {
"start": "2014-09-01"
},
"address": "https://api.logicahealth.org/GravitySDOHCBRO/open"
},
"request": {
"method": "POST",
"url": "Endpoint"
}
}
]
}Health Concern Observation resources are expected to be generated by the Hunger Vital Sign StructureMap from a QuestionnaireResponse resource. This step is automated and available as a REASTful API call:
curl --location --request POST 'https://sdoh-exchange-ri-ehr.herokuapp.com/administration/$extract' \
--header 'Content-Type: application/json' \
--data-raw '{QuestionnaireResponse resource}'All examples can be found at http://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/artifacts.html#examples. A Health Concern should refererence a QuestionnaireResponse resource it is derived from. And a QuestionnaireResponse resource will contain a reference to Group Observation resource tree (find examples in the IG Artifacts page).
Instuctions are the same as for the EHR. Just put the proper CP organization name, and set type to:
"type": [
{
"coding": [
{
"code": "cp",
"display": "Community Platform",
"system": "http://hl7.org/gravity/CodeSystem/sdohcc-temporary-organization-type-codes"
}
]
}
]Send a POST request to https://{CP server base}/Organization with the following content. This will create a CBO Organization entry with a corresponding name and identifier.
⚠️ The identifier should match the -Dapp.url parameter specified at the CBO application start.
{
"id": "16180",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "https://sdoh-exchange-ri-cbo.herokuapp.com"
}
],
"meta": {
"lastUpdated": "2021-12-02T13:45:18.000+00:00",
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
],
"source": "#mmPINEJ9JJ0CRPPV",
"versionId": "1"
},
"name": "Social Alliance",
"resourceType": "Organization",
"type": [
{
"coding": [
{
"code": "cbo",
"display": "Community Based Organization",
"system": "http://hl7.org/gravity/CodeSystem/sdohcc-temporary-organization-type-codes"
}
]
}
]
}- Update handling of Race/Ethnicity according to STU2
- Review latest changes in STU2 and synchronize them with code
- Task.restriction.period should be used instead of Task.execution
- Support other types of Patient tasks
- Support (or just verify) EHR-to-CBO exchange