Making Electronic Data More available for Research and Public Health (MedMorph)
1.0.0 - STU 1 United States of America flag

This page is part of the Making EHR Data MOre available for Research and Public Health (MedMorph) (v1.0.0: STU1 Release 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

Health Data Exchange App (HDEA) Server Application - (MedMorph backend services app)

This CapabilityStatement defines the expected capabilities of the HDEA actor when conforming to the MedMorph RA IG and playing the role of a server that receives messages from Data Receivers using FHIR Messaging.

Health Data Exchange App (HDEA) Client Application - (MedMorph backend services app)

This CapabilityStatement defines the expected capabilities of the HDEA actor when conforming to the MedMorph RA IG and playing the role of a client initiating the interactions with both Data Sources and Data Receivers/TTP.

Example MedMorph Data Source CapabilityStatement

This is an example CapabilityStatement that defines the expected capabilities of the Data Source actor. This CapabilityStatement is an example for Content IG creators on how to create a capability statement for a Data Source actor.

Knowledge Artifact Repository

This CapabilityStatement defines the expected capabilities of the Knowledge Artifact Repository actor when conforming to the MedMorph RA IG. This actor is responsible for allowing creation, modification, and hosting of the Knowledge Artifacts.

Example Data Receiver Capability Statement

This example CapabilityStatement defines the expected capabilities of the Data Receiver actor when conforming to the MedMorph RA IG. The actor is responsible for defining Knowledge Artifacts, receiving reports, and submitting responses back to health care organizations. The specific knowlege artifacts, reports and responses to be supported by the Data Receiver will be defined by the Content IGs.

Trust Service Provider

This CapabilityStatement defines the expected capabilities of the Trust Service Provider actor when conforming to the MedMorph RA IG. This actor is responsible for providing trust services. (e.g., Pseudonymization, Anonymization, De-identification, Re-identification).

Trusted Third Party (TTP)

This CapabilityStatement defines the expected capabilities of the TTP actor when conforming to the MedMorph RA IG. This actor is responsible for receiving messages and forwarding messages from health care organizations to a public health authority (PHA) or Research Organization (RO) and send responses back from PHA/RO to health care organizations.

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

Generate Anonymized Bundle

Generates an anonymized bundle taking an instance of a Bundle containing Protected Health Information (PHI)/personally identifiable information (PII) data. The anonymization algorithm to be used is left to the implementers of the operation.Errors during the execution of the operation can be returned as OperationOutcome per the FHIR spec as a return parameter.

Generate De-Identified Bundle

Generates a de-identified bundle taking an instance of a Bundle containing PHI/PII data. The de-identification algorithm to be used is left to the implementers of the operation. Errors during the execution of the operation can be returned as OperationOutcome per the FHIR spec as a return parameter.

Generate Hashed Bundle

Generates a hashed bundle taking an instance of a Bundle containing Protected Health Information (PHI)/personally identifiable information (PII) data. The hashing algorithm to be used is left to the implementers of the operation. Hashing will be used to de-duplicate patient records. Errors during the execution of the operation can be returned as OperationOutcome per the FHIR spec as a return parameter.

Generate Pseudonymized Bundle

Generates a pseudonymized bundle taking an instance of a Bundle containing PHI/PII data. The pseudonymization algorithm to be used is left to the implementers of the operation.Errors during the execution of the operation can be returned as OperationOutcome per the FHIR spec as a return parameter.

Generate Re-Identified Bundle

Generates a re-identified bundle containing PHI/PII data​ ​from an instance of a previously de-identified bundle. When the re-identification algorithm is not specified by the Content IG, implementers can choose specific algorithms based on use case needs and other program/policy requirements.Errors during the execution of the operation can be returned as OperationOutcome per the FHIR spec as a return parameter.

Get Knowledge Artifact

The operation is used to retrieve the knowledge artifact associated with the PlanDefinition.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

US Public Health Content Bundle

Bundle Resource profile for organizing the content of the Public Health Message to be exchanged with a Public Health Agency.

US Public Health Reporting Bundle

Bundle Resource profile for exchanging a public health report to be submitted to a PHA.

US Public Health Response Bundle

Bundle Resource profile for exchanging a public health response to be submitted from a Data Receiver to a Data Source.

US Public Health Specification Bundle

Bundle Resource profile for exchanging a Knowledge Artifact.

MedMorph Encounter End Subscription

This profile describes the US Public Health Encounter End Subscription to be used for MedMorph based plandefinition actions.

MedMorph Encounter Start Subscription

This profile describes the US Public Health Encounter Start Subscription to be used for MedMorph based plandefinition actions.

MedMorph PlanDefinition

This PlanDefinition profile defines the logic and rules for creating a specific content IG plan definition instance. This is an example that can be used as a pattern to create other plan definition instances in the content IGs.

US Public Health CodeSystem

This profile describes the US Public Health CodeSystem.

US Public Health Computable Library

The computable library profile sets the minimum expectations for a computable CQL library.

US Public Health Computable ValueSet

Defines a computable value set as one that SHALL have an expression-based definition (i.e. a value set defined intensionally using expressions of the code systems involved) and MAY have an expansion included. The expression-based definition SHALL be represented in only one of three ways; using the compose element, using the expression extension, or using the rules-text extension to provide a step-by-step process for expanding the value set definition

US Public Health Executable Library

This profile sets the minimum expectations for an executable CQL library. Specifically, the profile requires that the library contain one of ELM XML or JSON content, the compiled representation of the CQL logic.

US Public Health Executable ValueSet

Defines an executable value set as one that SHALL have an expansion included, as well as a usage warning indicating the expansion is a point-in-time snapshot and must be maintained over time for production usage.

US Public Health MessageDefinition

This is the MessageDefinition Resource profile for the IG.

US Public Health MessageHeader

This is the MessageHeader Resource profile for the IG.

US Public Health Organization

This Organization profile represents an organization involved in public health. It is based on the US Core Organization profile and establishes the core elements, extensions, vocabularies and value sets for representing organizations for public health.

US Public Health PlanDefinition

This profile describes the US Public Health PlanDefinition.

US Public Health Supplemental ValueSet Library

Defines the library containing the US Public Health supplemental value sets.

US Public Health Supplemental ValueSet

This profile describes the US Public Health Supplemental value set.

US Public Health Triggering ValueSet Library

Defines the library containing the US Public Health triggering value sets.

US Public Health Triggering ValueSet

This profile describes the US Public Health Triggering value set.

US Public Health ValueSet Library

Defines the library containing US Public Health value sets.

US Public Health ValueSet

This profile describes US Public Health value sets.

USPublicHealthEndpoint

This is the Endpoint Resource profile for the IG used to specify receivers addresses

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

US Public Health Async Indicator Extension

A value of true indicates that the messages resulting from the PlanDefinition are expected to be processed asynchronously

US Public Health CodeSystem Property Binding Extension

A reference to a CodeSystem or ValueSet that establishes the allowable values for a code system property

US Public Health Data Encrypted Extension

Indicates whether the data in the content bundle is encrypted or not.

US Public Health Data Encryption Algorithm

Indicates the algorithms that would be acceptable for encryption of the data prior to submitting to the Data Receiver.

US Public Health Expected Response Time Extension

Indicates the maximum time the sender has to wait to get a response, beyond which the message is assumed to have failed to reach the destination.

US Public Health FHIR Query Pattern Extension

Supports communicating the FHIR query for a given data requirement. The query is server-specific, and will need to be created as informed by a CapabilityStatement. The $data-requirements operation should be extended to be able to provide an Endpoint or CapabilityStatement to provide this information. If no endpoint or capability statement is provided, the capability statement of the server performing the operation is used. This is not a resolveable URL, and that it will contain 1) No base canonical (so it’s a relative query), and 2) Parameters using tokens that are denoted using double-braces and the context parameters are dependent solely on the subjectType, according to the following: Patient: context.patientId, Practitioner: context.practitionerId, Organization: context.organizationId, Location: context.locationId, Device: context.deviceId

US Initiation Type Extension

This Extension profile represents that the report was either manually initiated or alternately initiated by the provider.

US Public Health Named Event Type Extension

Indicates the types of named events to subscribe to from the EHR.

US Public Health Receiver Endpoint

Indicates the endpoint address where the report has to be sent.

US Public Health Receiver JWKS Url Extension

Indicates the location of the Public Key that needs to be used for encryption when sending data to the receiver.

US Public Health Related Data Extension

The relatedData extension allows indicating that an input to a parent action is an input to specific child actions. It also allows the output of one action to be identified as the input to a different action.

US Public Health Trust Service Endpoint

Indicates the endpoint address which implements Trust Services and can be used by specific actions requiring trust services with appropriate authorities and policies.

US Public Health Usage Warning Extension

An extra warning about the correct use of the value set.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

US Public Health Message Types

The US Public Health Message Types Value Set is a ‘starter set’ of codes for uniquely identifying messages in MessageHeader instances contained within a reporting bundle.

US Public Health PlanDefinition Action

The US Public Health PlanDefinition Action Value Set is a ‘starter set’ of codes for uniquely identifying actions in PlanDefinition instances.

US Public Health Report Initiation Type

The US Public Health Message Types Value Set is a ‘starter set’ of codes to indicate how the messages were initiated within the health care organization.

US Public Health Response Message Processing Status Codes

The US Public Health Message Processing Status Codes Value Set is a ‘starter set’ of codes for identifying response message processing status for each message that was previously submitted from clinical care to PHA or Research Organizations.

US Public Health TriggerDefinition NamedEvent

The US Public Health TriggerDefinition NamedEvent Value Set is a ‘starter set’ of codes for uniquely identifying named events in TriggerDefinition instances contained within a PlanDefinition.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

US Public Health Report Initiation Type Codes

The US Public Health Report Initiation Type CodeSystem is a ‘starter set’ of codes supported for identifying how the message was initiated.

US Public Health Message Type Codes

The US Public Health Message Header Events CodeSystem is a ‘starter set’ of codes supported for identifying types of messages being exchanged.

US Public Health PlanDefinition Action Codes

The US Public Health PlanDefinition Actions CodeSystem is a ‘starter set’ of codes supported for identifying actions in PlanDefinition.

US Public Health CodeSystem for Response Message Processing Status Codes

The US Public Health Response Message Processing Status CodeSystem is a ‘starter set’ of codes supported for identifying response message processing status codes.

US Public Health TriggerDefinition Named Events

The US Public Health TriggerDefinition NamedEvents CodeSystem is a ‘starter set’ of codes supported for identifying named events to subscribe to in clinical workflows.

US Public Health CodeSystem for ValueSet Use Context Codes

The US Public Health UseContext CodeSystem is a ‘starter set’ of codes supported for identifying use context codes in ValueSet.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Encounter End Subscription Topic Example

Encounter End Subscription Topic Example

Encounter Start Subscription Topic Example

Encounter Start Subscription Topic Example

Patient 1 - Example

An example showing a Patient

Practitioner Example

An example showing a Practitioner

Public Health Organization Example

An example showing a Public Health Organization

Healthcare Organization Example

An example showing a HealthCare Organization

Public Health Organization Endpoint example

An example showing a Public Health Organization Endpoint

Healthcare Organization Endpoint example

An example showing a Healthcare Organization Endpoint

Plan Definition example for MedMorph

An example showing a Plan Definition for reporting use cases

MessageHeader example used in the Cancer Reporting Bundle sent from Healthcare org to PHA

MessageHeader example used in the Cancer Reporting Bundle sent from Healthcare org to PHA

Message Definition example used to define a cancer report message.

Message Definition example used to define a cancer report message.

ValueSet example for Cancer Reporting

An example showing a ValueSet for Cancer reporting

ValueSet example for a Triggering Valueset

An example showing a Triggering Valueset

ValueSet example for a Triggering Valueset Library

An example showing a Triggering Valueset Library

An example for a Supplemental Library

An example showing a Supplemental Library

ValueSet example for a Executable Valueset

An example showing a Executable Valueset

ValueSet example for a US PH Valueset

An example showing a US PH Valueset

ValueSet example for a Computable Valueset

An example showing a Computable Valueset

Example of a Content Bundle containing Patient Data

Example of a Content Bundle containing Patient Data

Example of a Reporting Bundle containing Message Header and Content Bundle

Example of a Reporting Bundle containing Message Header and Content Bundle

Example of a Specification Bundle for a Knowledge Artifact containing a PlanDefinition and ValueSet

Example of a Specification Bundle for a Knowledge Artifact containing a PlanDefinition and ValueSet

Example of a Response Bundle for a submitted message containing a communication resource.

Example of a Response Bundle for a submitted message containing a communication resource.

US Public Health Usage Context Example

This code system contains codes that identify the use context of a ValueSet or Library.

US Public Health Computable Library Example

Description of library

US Public Health Executable Library Example

Description of library

US Public Health Supplemental Valueset Example

This valueset is a valueset created for the purposes of demonstrating, by example, the US Public Health Supplemental ValueSet profile.

US Public Health ValueSet Library Example

Description of library

US Public Health Usage Context Type

This code system contains codes that identify the use context type of a ValueSet or Library.

US Public Health Usage Context

This code system contains codes that identify the use context of a ValueSet or Library.