US Veterans Administration FHIR Map Set Implementation Guide - Local Development build (v0.51.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Official URL: http://va.gov/fhir/ImplementationGuide/va.maps				Version: 0.51.0
Draft as of 2024-05-11				Computable Name: VAMapsIG

This implementation guide (IG) provides maps from Veterans Health Administration (VHA) data sources – primarily but not exclusively VistA – to Fast Healthcare Interoperability Resources (FHIR). The maps are asserted in the StructureDefinition resources that profile FHIR US Core R4 profiles, where available, and R4 core FHIR resources where no R4 US Core profile is defined.

Developers of FHIR interfaces for specific clinical purposes, whether they develop IGs or not, can use these maps to ensure that their assumptions about data equivalence are shared by other VHA stakeholders and partners.

It is anticipated that these maps may be specified more formally as StructureMap resources, but this will require consensus on representing VistA data as StructureDefinition files. Since clients to date have used a variety of interfaces to VistA (including Vx130 via CDW, VPR, VPR via VDIF, VIA, and HDR), it is not clear that this more strictly enforceable approach would actually support better governance.

Note: These maps are based on current analysis and review, and they are subject to future revision. The date of publication is in the page header. A feedback channel is being prepared and will link from here.

How to Read This Guide

If you wish to map VistA to FHIR, there are three ways to search this specification.

1. If you are familiar with FHIR, or comfortable browsing, look for a profile with a name that matches your interest.
2. Consult the Classes table for VistA file-to-FHIR Resource correspondences.
3. Search “my term” site: . This method will not work while the site is hosted at github.io.

The resource profile of interest will have a tab at the top of the page including the link “Mappings.” This links to a page of all the mappings defined for the profile. Many of these mappings are inherited from the base specification, but the VistA mappings (and other VA-sources mappings, as available) will be found there.

Note that the publication tool infers that any mapped element is of interest. These elements are the ones that appear on the main page of the profile, even though the profile asserts no constraints on them.

The guide also contains concept maps for generating valid coded elements based on VistA content. [links not yet implemented]

Other data sources may be added to this specification as needed.

If you find what you need, please let the VA FHIR Community of Practice (link) know, so that we may understand how widely the maps are being used, and so that we may notify you if any changes are contemplated at the enterprise level.

How to Improve This Guide

If you do not find what you need, please contact the VA FHIR Community of Practice (link) for assistance in creating new maps that will support your use case. If you have already created maps, please let us know so that we can publicize your work and encourage consensus.

If you identify a problem or issue, feel free to bring it to the VA FHIR Community of Practice (see Process Guidance).

Methods used

The VistA data dictionary has over 70,000 entries, so we are not able to map all fields. Map creation is driven by business need. Most cases to date have involved mapping to commonly understood elements outside the enterprise, so the elements required or constrained in the US Core IG have been the first priority.

For more information on the mapping process and design assumptions, see Design Guidance.

For more information on engaging with the CoP team, see Process Guidance.

Dependencies

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.bulkdata#2.0.0 FHIR based approach for exporting large data sets from a FHIR server to a client application (built Fri, Nov 26, 2021 05:56+1100+11:00)

Package hl7.fhir.r4.examples#4.0.1 Example resources in the R4 version of the FHIR standard

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package hl7.fhir.us.core#5.0.1 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Wed, Jun 22, 2022 19:44+0000+00:00)