This article describes the mapping of EMIS published data into the intermediate FHIR store.
Clinical Observations
Content dependent rules
CareRecord_Observation contains data which is mapped to multiple FHIR resource types. The target resource type is decided by the following rules, using the Read2 code and CodeType from the Coding_ClinicalCode file (looked up using the CodeId from CareRecord_Observation) and the Value field from CareRecord_Observation.
| Rule | Target profile |
|---|---|
|
If the Value is empty, and the CodeType is one of (Biochemistry Cyology_Histology, Haematology, Immunology, Microbiology, Radiology, Health_Management)
|
DiagnosticReport |
|
Test |
Action |
|
If the Value is empty, and the CodeType is one of: Biochemistry Cyology_Histology Haematology Immunology Microbiology Radiology Health_Management
|
Map to DiagnosticReport |
|
If the Value is not empty or the CodeType is one of: Biochemistry Biological_Values Cyology_Histology Haematology Health_Management Immunology Microbiology Radiology Symptoms_Findings Procedure (note, the codes is this category aren't actually "procedures") Adminisation_Documents_Attachments Body_Structure //dental structures Care_Episode_Outcome Dental_Finding Diagnostics Discharged_From_Service EMIS_Qualifier Ethnicity HMP Intervention_Category Intervention_Target KC60 Marital_Status Nationality Nursing_Problem Nursing_Problem_Domain Obsteterics_Birth Person_Health_Social Planned_Dental Problem_Rating_Scale Reason_For_Care Referral_Activity Referral_Rejected Referral_Withdrawn Regiment Religion Trade_Branch Unset
|
Map to Observation |
|
If the CodeType is Conditions_Operations_Procedures and the Code is in these branches: 6.... Preventive procedures 7.... Operations, procedures, sites 8.... Other therapeutic procedures
|
Map to Procedure |
|
If the CodeType is Conditions_Operations_Procedures and the Code is in these branches: A.... Infectious and parasitic diseases B.... Neoplasms C.... Endocrine, nutritional, metabolic and immunity disorders D.... Diseases of blood and blood-forming organs E.... Mental disorders F.... Nervous system and sense organ diseases G.... Circulatory system diseases H.... Respiratory system diseases J.... Digestive system diseases K.... Genitourinary system diseases M.... Skin and subcutaneous tissue diseases N.... Musculoskeletal and connective tissue diseases
|
Map to Condition* |
|
If the CodeType is Conditions_Operations_Procedures
|
Map to Observation |
|
If the CodeType is any of: Allergy_Adverse_Drug_Reations Allergy_Adverse_Reations
|
Map to AllergyIntolerance |
|
If the CodeType is any of: Dental_Disorder Dental_Procedure
|
Map to Condition* |
|
If the CodeTyps is Family_History
|
Map to FamilyMemberHistory |
|
If the CodeType is Immunisations
|
Map to Immunization |
|
If the CodeType is Investigation_Requests
|
Map to DiagnosticOrder |
|
If the CodeType is Pathology_Specimen
|
Map to Specimen |
|
If the CodeType is Referral |
Map to ReferralRequest |
- If the CareRecord_Observation is linked to by a CareRecord_Problem record, then the Condition resource uses the “problem” profile, otherwise it uses the “condition” profile.
In addition to the above mappings, if the target resource selects is not condition, but the CareRecord_Observation is linked to by a CareRecord_Problem record, then a condition resource will also be created, with the “problem” profile.
Prescribing_DrugRecord End Dates
The Prescribing_DrugRecord file contains both a Boolean active indicator (IsActive) and the medication end date (CancellationDate). Within Emis Web, it’s the IsActive indicator that is used to determine whether medication is active or not, the CancellationDate just providing additional information for ended medication. Analysing the received data has highlighted that there are a number of cases where the CancellationDate doesn’t match what the IsActive flag states:
- IsActive = true but a CancellationDate is present;
- IsActive = false but a CancellationDate is absent.
From the dates of affected data, these appear to be related to either a service moving to Emis Web from another GP system, and are an artefact of that transfer.
To ensure consistency in the FHIR MedicationStatements created from this file, the Cancellation date will only be carried over if the DrugRecord is non-active. If no cancellation date is present, it will be derived from the medication start and course length (found from the associated Prescribing_IssueRecord file).