Specifying a Pathology Structured Report with HL7® FHIR®
An approach towards standardization
A. Essenwanger, G. Haroske, T. Hoelter, A. Bartschke, S. Thun
Berlin
16.06.22
Medical Informatics Initiative �Structured Pathology Report
Specifying a Pathology Structured Report with HL7® FHIR®
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To the repository
IHE Pathology and Laboratory Medicine (PaLM) �Anatomic Pathology Structured Report (APSR)
Specifying a Pathology Structured Report with HL7® FHIR®
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What is FHIR®?�
Specifying a Pathology Structured Report with HL7® FHIR®
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Fast
Healthcare
Interoperability
Resources
Set of XML/JSON health data resources + REST API
FHIR Interoperability Paradigms
PLUS: Storage & Analysis
What is FHIR®?�
Specifying a Pathology Structured Report with HL7® FHIR®
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What is FHIR®?�
Specifying a Pathology Structured Report with HL7® FHIR®
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FHIR resource
“container” of information that represent something in the real world
Link between resources
Pathology Report on FHIR® �
Specifying a Pathology Structured Report with HL7® FHIR®
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To the repository
Pathology Report on FHIR®
Microscopic observation
�Histologic type: DUCTAL.�Nottingham combined histologic grade: 1 of 3.�Tubule formation score: 2. �Nuclear pleomorphism score: 2.�Mitotic rate score: 1.
Specifying a Pathology Structured Report with HL7® FHIR®
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…
"hasMember": [
{
"reference": "Observation/histologic-type"
},
{
"reference": "Observation/nottingham-histologic-grade„
},
{
"reference": "Observation/tubule-formation-score"
},
{
"reference": "Observation/nuclear-pleomorphism-score"
},
{
"reference": "Observation/mitotic-rate-score"
},
],
"specimen": {
"reference": "Specimen/right-breast"
}
…
Microscopic Grouper
Pathology Report on FHIR®
Microscopic observation
�Histologic type: DUCTAL.�Nottingham combined histologic grade: 1 of 3.�Tubule formation score: 2. �Nuclear pleomorphism score: 2.�Mitotic rate score: 1.
Specifying a Pathology Structured Report with HL7® FHIR®
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…
"code": {
"coding": [
{
"code": "44638-5",
"system": "http://loinc.org",
"display": "Histologic type in Breast tumor"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"code": "82711006",
"system": "http://snomed.info/sct",
"display": "Infiltrating duct carcinoma (morphologic abnormality)"
}
]
},
…
Microscopic Pathology Finding
Does structured mean better?
Specifying a Pathology Structured Report with HL7® FHIR®
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Andrea Essenwanger
Research Fellow for Medical Informatics
Berlin Institute of Health at Charité
(BIH@Charité)