Minutes from FHIR RDF (Aug 12): Brad Simons, FHIR RDF experience and suggestions

Minutes are here:
https://www.w3.org/2021/08/12-hcls-minutes.html
And below in plain text.

   ---------------------------------

                              – DRAFT –
                                 FHIR RDF

12 August 2021

    [2]IRC log.

       [2] https://www.w3.org/2021/08/12-hcls-irc

Attendees

    Present
           Brad Simons, Darrell Woelk, David Booth, Emily Pfaff,
           EricP, Gopi, Guoqian Jiang, Harold Solbrig, Sajjad

    Regrets
           -

    Chair
           David Booth

    Scribe
           dbooth

Contents

     1. [3]Brad Simons, SureScripts
     2. [4]FHIR RDF R4 issues collected by Harold Solbrig
     3. [5]Summary of action items

Meeting minutes

   Brad Simons, SureScripts

    brad: Motivation for the project was to reuse info from C-CDA:
    strip out wanted data and get at it more effectively. Work is
    patented.
    … We take a FHIR RDF model and a SureScripts model.
    … We created our own full FHIR model: all resources, all
    property, all constraints, cardinalities, datatypes. Then added
    SureScripts model, to: 1. add properties.
    … Grahame's model does not have a system name on coding. We
    added one to make it more readable.
    … Also the SureScripts model has a whole mapping model -- what
    a C-CDA would be to FHIR.
    … Take in the FHIR model and SureScripts model and take all the
    possible xpath permutations, and breadcrumb trail of all
    resources and properties needed to populate it.
    … So an instance or attribute that contains a problem.code it
    knows what all the components are, so it can instantiate it.
    … I'm able to execute those to extract the relevant data to
    build all the RDF objects that you see, to populate them with
    the appropriate data.
    … Can also generate a list of instances w data values.
    … For coding value I can get the relevant info from the FHIR
    model and give it to HAPI, and HAPI will generate the proper
    code using reflection.

    sajjad: FHIR in RDF vs FHIR RDF? You have your own ont of FHIR.

    brad: the base FHIR model is our own ont, but if you lay it
    next to the FHIR ont, it is very similar.
    … My goal is to adopt yours.

    eric: The stuff you add is to make it more readable?

    brad: I also have my own mappings to get from C-CDA to FHIR,
    but also rules in that add-on model.

    sajjad: scalability and maintenance issue, when FHIR spec
    changes? Diff between FHIR RDF and FHIR in RDF.

    brad: Yes, and I want to get off of using my own model. Want to
    be able to use your FHIR RDF.

    sajjad: you're taking xpaths to populate your schema? Why not
    JSON into FHIR schema?

    brad: If the purpose was to go from XML to FHIR, you probably
    wouldn't need to go through RDF, but you cannot do rules
    processing on JSON.

    sajjad: There are rules reasoners available on RDF.

    brad: Can support augmentation, process breadcrumb trail,
    capture data from text section and auto-populate the coded
    section.

    brad: Ran into naming convention issues -- not consistent
    across FHIR RDF models.
    … Also ran into recursion issue.
    … contains can have a "contains" and the names keep being
    concatenated.

    eric: questionnaire response has that recursion problem too.

    harold: Yes, there are recursive structures in FHIR, and that's
    one of the reasons we need JSON-LD 1.1

    brad: You don't want to keep concatenating
    contains.contains.contains ....

    brad: Instead, we just had valueset expansion contains
    component and left it at that.

    harold: I think we've addressed this with JSON-D 1.1

    eric: Q about xpath annotations.

    brad: We have a mapping file, w a multitude of nodes with xpath
    segments, and those segments have an affiliation w a particular
    FHIR resource property.
    … When I churn through that stuff, I dynamically build full
    xpath from breadcrumb trail.

    eric: Do those end up on instance data, like Sally's diagnosis,
    or on metadata.

    brad: The xpath that I built is captured in a binary file, and
    access them at parse time. They're never passed through to
    anybody.
    … Point is to generate a FHIR rep of the C-CDA data, but
    there's too much unnecessary stuff in C-CDA.

    eric: Could we see one of the instances, populated with your
    extra stuff?

    guoqian: When you convert C-CDA to RDF, how many FHIR resources
    do you cover?

    brad: A lot of the resources are reused: Allergy, Med, Immun,
    Problems, Condition, OBservations (incl familiy history,
    vitals, etc.), insurance.

    guoqian: Do you have issues with your FHIR RDF to the XML
    representation?

    brad: None. Part of the reason I'm converting to FHIR, is a lot
    of vendors (Epic, etc.) want to consume FHIR. Meaningful Use
    caused vendors to use C-CDA, but it didn't tell them how, so
    the C-CDAs differ.
    … I want to be able to pass on only the info that is needed, to
    maintain privacy.

    guoqian: No issues w HAPI FHIR? brad: None.

    brad: I'm using HAPI to take my FHIR RDF and produce JSON, and
    using reflection it produces everything, with only hundreds of
    lines of code.

    brad: I'm generating metadata that a colleague uses to generate
    from POJOs in HAPI.

    eric: C-CDA diversity was the shortcoming? And will that be any
    better with FHIR?

    brad: Probably more structured, but not better.
    … Consider Allergies. people will codify your Allergies, or
    your lab results, with ranges, etc.
    … But if you go into the doc's office and say which meds you
    are taking, they never look up the codes. Allergies are even
    worse: 9/10 times its coded in the text section -- never
    codified.
    … But here, I'm able to extract info like that and put it into
    the codified section.

    gopi: Our EHR only provides text fields for the user, so it's
    not codified

    david: How to improve FHIR RDF model?

    brad: We compared w ours, and matched it as much as possible.
    … We saw that if we could fix the recursion and standardize on
    naming, we could drop our model and go with yours.

    david: Got the list of diffs between yours and ours?

    brad: I had a few data augmentations that I put into the base
    FHIR model that are not relevant to you -- branch points.

    david: Lists?

    brad: We have lists of lists.

    Action: Brad to find the comparison of their FHIR RDF to ours

    sajjad: Suppose you have Organization w a name, assume it is 0
    or 1. How would you define the cardinality in RDF?

    brad: We use OWL to capture the cardinality.

    sajjad: For usability, from C-CDA, vendors are more interested
    in being in FHIR. When you transform C-CDA to FHIR, how do you
    deal w templating? E.g. family history? They all go to
    Observation. Specialized rules/templates?

    brad: i have mappings defined for specific sections like Family
    History. They're driven off of LOINC code in C-CDA for the
    section.

    sajjad: There is a mapping from C-CDA to FHIR:

    Link from sajjad: [6]https://github.com/GoogleCloudPlatform/
    healthcare-data-harmonization/tree/master/mapping_configs/
    cda_fhir_r4

       [6] 
https://github.com/GoogleCloudPlatform/healthcare-data-harmonization/tree/master/mapping_configs/cda_fhir_r4

    brad: Our models are very close.

    eric: From working w this at NHS, one challenge I've seen in
    usability is the lenght of the predicates and the lack of
    connection betweeen similar predicates.
    … FHIR folks have make a big effort to harmonize them. We're
    now looking at using just the last segment of the predicates.
    Does that alarm you or okay with it?

    brad: I'll have to see.

   FHIR RDF R4 issues collected by Harold Solbrig

    [7]https://github.com/fhircat/fhir_rdf_validator/tree/master/
    tutorial

       [7] 
https://github.com/fhircat/fhir_rdf_validator/tree/master/tutorial

    We'll discuss these on a future call, but wanted to give you
    the link, to start looking at them.

    ADJOURNED

On 8/10/21 5:37 PM, David Booth wrote:
> FHIR RDF teleconference
> Thursday 11am (Boston timezone)
> Zoom URL: http://tinyurl.com/fhirrdfzoom
> 
> Agenda:
> 
>   - Brad Simons (SureScript) will discuss his experiences with FHIR RDF, 
> challenges he faced, and suggestions for the R5 version
> 
>   - Other FHIR RDF issues we hope to address in R5 to improve ease of use
> 
> More info:
> URL: https://confluence.hl7.org/pages/viewpage.action?pageId=66922543
> 
> Download a calendar invite for this weekly teleconference:
> https://confluence.hl7.org/download/attachments/66922543/fhir-rdf-weekly-teleconference.ics?api=v2 
> 
> 
> Thanks,
> David Booth, Chair
> 

Received on Friday, 13 August 2021 14:14:35 UTC