fhir_scorecard provides a scorecard for a FHIR Patient Record (as Bundle). Achieving interoperability
of a Patient Healthcare Record within FHIR will require agreement on "best practices" beyond the base specification.
Those agreements could be in the form of an Implementation Guide, with associated Profiles, but fhir_scorecard
provides them in the form of testable rubrics.
This project borrows inspiration and rubrics from ccdaScorecard, a scorecard for C-CDA documents.
$ bundle exec rake fhir:score[fhir_bundle.json]
POINTS CATEGORY MESSAGE
------ -------- -------
10 bundle Patient Record is a FHIR Bundle.
10 patient Patient Record contains one FHIR Patient.
2 codes_exist 21% (282/1323) of codes, Codings, and CodeableConcepts had values. Maximum of 10 points.
4 codes_umls 42% (145/344) of SNOMED, LOINC, RxNorm, ICD9, and ICD10 validated against UMLS. Maximum of 10 points.
0 descriptions 7% (26/344) of SNOMED, LOINC, RxNorm, ICD9, and ICD10 codes use preferred descriptions. Maximum of 10 points.
17 completeness 85% of REQUIRED Resources and 9% of EXPECTED Resources were present. Maximum of 20 points.
10 cvx_immunizations 100% (6/6) of Immunization vaccine codes use CVX. Maximum of 10 points.
0 cvx_medications 0% (0/4) of Medication[x] Resource codes use CVX. Maximum of 10 point penalty.
3 iso8601_dates 30% (149/494) of date/time/dateTime/instant fields were populated with reasonable iso8601 values. Maximum of 10 points.
6 loinc_labs 68% (75/110) of Observations and DiagnosticReports validated against the LOINC Top 2000. Maximum of 10 points.
8 ucum_quantities 83% (80/96) of physical quantities used or declared UCUM. Maximum of 10 points.
4 references_resolve 43% (326/750) of all possible References resolved locally within the Bundle. Maximum of 10 points.
10 rxnorm_meds 100% (4/4) of Medication[x] Resource codes use RxNorm. Maximum of 10 points.
0 smoking_status The Patient Record should include Smoking Status (DAF-core-smokingstatus profile on Observation).
2 snomed_core 29% (5/17) of Condition Resource codes use the SNOMED Core Subset. Maximum of 10 points.
2 vital_signs 22% (2/9) of Vital Signs had at least one recorded Observation. Maximum of 10 points.
------
88 TOTAL
bundle_json = "{\"entry\":[{\"resource\":{\"resourceType\":\"Patient\"}}],\"resourceType\":\"Bundle\"}"
scorecard = FHIR::Scorecard.new
report = scorecard.score(bundle_json)
=> {:bundle=>{:points=>10, :message=>"Patient Record is a FHIR Bundle."},
:patient=>{:points=>10, :message=>"Patient Record contains one FHIR Patient."},
:points=>20}The scorecard requires some terminology files to operate several rubrics related
to codes. Download the files (requires accounts) and place them in ./terminology
-
https://www.nlm.nih.gov/research/umls/licensedcontent/umlsknowledgesources.html
-
When installing the metathesaurus, include the following sources:
CVX|CVX; ICD10CM|ICD10CM; ICD10PCS|ICD10PCS; ICD9CM|ICD9CM; LNC|LNC; MTHICD9|ICD9CM; RXNORM|RXNORM; SNOMEDCT_US|SNOMEDCT -
https://www.nlm.nih.gov/research/umls/Snomed/core_subset.html
-
http://loinc.org/usage/obs/loinc-top-2000-plus-loinc-lab-observations-us.csv
After downloading the files, run these rake tasks to post-process each terminology file:
> bundle exec rake fhir:process_umls
> bundle exec rake fhir:process_snomed
> bundle exec rake fhir:process_loinc
> bundle exec rake fhir:process_ucum
Copyright 2016 The MITRE Corporation
Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at
http://www.apache.org/licenses/LICENSE-2.0
Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.