1. HSPC Profiles: Conformance and Interoperability

2. Definitions

3. “Resource-level” Profiles: Profiles at the level at which FHIR defines resources (Patient, Observation, Procedure, Practitioner, Condition, etc.) “Detail-level” Profiles: Profiles at a more detailed level, e.g., profiles for Hematocrit, Glucose, Heart Rate, Body Weight, Diabetes, Pain, Ulcerative Colitis, Nausea, Rash, etc.

4. Definitions “Resource-level” Profiles: Profiles at the level at which FHIR defines resources (Patient, Observation, Procedure, Practitioner, Condition, etc.) “Detail-level” Profiles: Profiles at a more detailed level, e.g., profiles for Hematocrit, Glucose, Heart Rate, Body Weight, Diabetes, Pain, Ulcerative Colitis, Nausea, Rash, etc. HSPC intends to produce both levels of profiles.

5. Definitions (continued) “Narrow” a profile: Create a new profile that performs the following relative to an existing profile: Constrains value sets Constrains data type choices Specifies terminology bindings (where none was originally specified) Constrains cardinality Sets codes Declares “must support”

6. Definitions (continued) “Broaden” a profile: Create a new profile that performs the following relative to an existing profile: Adds extensions Expands value sets (where allowed)

7. Definitions (continued) “Broaden” a profile: Create a new profile that performs the following relative to an existing profile: Adds extensions Expands value sets (where allowed) Narrowing and Broadening may be done: Physically (new profile uses the original profile as the base) Logically (new profile is a sibling to the original profile and is only different from the original in “narrowing” ways)

8. Resource-Level Profiles

9. Notes of explanation

10. Resource-Level Profiles: DAF and HSPC Where necessary, HSPC will create derivatives of the DAF profiles with the intent of providing more generally-usable profiles to the community.

11. Resource-Level Profiles: Narrowing Where HSPC profiles “narrow” DAF profiles: Data that conform to the HSPC profiles will also conform to the DAF profiles. Not all DAF-conformant data will be HSPC-conformant.

12. Resource-Level Profiles: Broadening Where HSPC profiles “broaden” DAF profiles: Data that conform to the DAF profiles will also conform to the HSPC profiles. Not all HSPC-conformant data will be DAF-conformant.

13. Resource-Level Profiles: Broadening and Narrowing HSPC resource-level profiles will likely need to both narrow and broaden DAF profiles. Narrow: specify bindings constrain value sets and cardinalities Broaden: add extensions

14. Resource-Level Profiles: Broadening and Narrowing HSPC resource-level profiles will likely need to both narrow and broaden DAF profiles. Narrow: specify bindings constrain value sets and cardinalities Broaden: add extensions Consequently: Not all DAF-conformant data will be HSPC-conformant. Not all HSPC-conformant data will be DAF-conformant.

15. Resource-Level Profiles: Two Sets HSPC will support two sets of resource-level profiles: Set 1: The DAF profiles Set 2: The HSPC profiles that narrow and broaden DAF

16. Resource-Level Profiles: Two Sets HSPC will support two sets of resource-level profiles: Set 1: The DAF profiles Set 2: The HSPC profiles that narrow and broaden DAF Users of the two sets may not be interoperable. DAF profile instances won’t be conformant with HSPC profiles where HSPC profiles have made value set/code constraints. HSPC profile instances won’t be conformant with DAF profiles where HSPC profiles have added extensions.

17. Detail-Level Profiles

18. “True”Interoperability is delivered by detail-level HSPC profiles Specific Lab profiles Other observation profiles (heart rate, respiratory rate, pain, height, head circumference, etc.) Condition profiles (cancer, diabetes, Crohn’s disease, etc.) Procedure profiles (hysterectomy, colonoscopy, gastric bypass, etc.)

19. Detail-Level Profiles “True”Interoperability is delivered by detail-level HSPC profiles Specific Lab profiles Other observation profiles (heart rate, respiratory rate, pain, height, head circumference, etc.) Condition profiles (cancer, diabetes, Crohn’s disease, etc.) Procedure profiles (hysterectomy, colonoscopy, gastric bypass, etc.) Detail-level profiles constrain Resource-level profiles consequently, instances will not be conformant with Resource-level profiles.

20. Summary HSPC Members may use any one of three sets of profiles:

21. Summary HSPC Members may use any one of three sets of profiles: Detail-level profiles are necessary for true, plug- and-play interoperability.

22. Summary HSPC Members may use any one of three sets of profiles: Detail-level profiles are necessary for true, plug- and-play interoperability. NOT INTEROPERABLE

23. Risks Getting ONC-sponsored groups collaborating Carving the pertinent part out of their work and harmonizing (or not harmonizing) with it Mapping CIMI models and FHIR profiles Scalability of detail-level profile creation process Getting detail-level profiles reviewed A moving FHIR spec