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General notes:

Except when explicitly indicated, FHIR entities' attributes use to be optional... and since they benefit of the expansion mechanism, there is no real limitation when it comes to map openIMIS entities (tables) to the FHIR corresponding one.

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openIMIS tableFHIR corresponding/related resources

tblInsuree & tblFamilies

Person

"Demographics and administrative information about a person independent of a specific health-related context."

Highlights:

  • "The Person resource serves as a linkage resource that may provide a reference set of common demographics for an individual (human or animal) across multiple roles (Patient, Practitioner,...)."
  • Patient may have several identifiers
  • Warning "RelatedPerson" (here under) doesn't point (directly) to Person!

Group

"Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization."

Highlights:

Grouping persons, but not with the 'families' semantic: it has its meaning in the health service scope (patients for a group therapy,...)

Patient

"Demographics and other administrative information about an individual or animal receiving care or other health-related services."

Highlights:

  • "A Patient record is generally created and maintained by each organization providing care for a patient. A patient or animal receiving care at multiple organizations may therefore have its information present in multiple Patient Resources."
  • Patient may have several identifiers
  • Patients are "Linked" to each other, according a LinkType... but this is NOT the equivalent of tblFamilies: it is used to depict patient entity merge (replaced-by, replaces,...), that master entity for information is another one (refer),...
  • One can link Patients (in the tblFamilies meaning) via contact.relationship (supposed to be "partner", "friend",...) but contact detail is a very "weak" reference (keep a name, telecom,... but it is not a formal other Patient entity)

RelatedPerson

"Information about a person that is involved in the care for a patient, but who is not the target of healthcare, nor has a formal responsibility in the care process."

Highlights:

  • RelatedPerson refer to ONE "Patient" (and not Person as its name seem to indicated it)
  • RelatedPerson does hold the name, telecom(,...) of the actual "person" it represent (it is NOT the equivalent of the 'tblFamilies' concept in openIMIS

"Significant health conditions for a person related to the patient relevant in the context of care for the patient."

Highlights:

  • Refers to ONE "Patient"
  • Used for contextual (can be vague) information (like 'had some sort of cancer')



tblPolicy & tblInsureePolicy

Contract

"Legally enforceable, formally recorded unilateral or bilateral directive i.e., a policy or agreement."

Highlights:

  • Contract is a rather complex resource in FHIR. It holds info like expiration, author, signer, terms, offer (with acceptation decision,....),...
  • It looks like, all product (InsurancePlan) info is expected to be copied (as a 'snapshot') to the contract at creation (contract holds its 'rules')

tblProduct

Image Added

InsurancePlan

"Details of a Health Insurance product/plan provided by an organization."

tblClaim

Claim

"A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement."

Highlights:

  • Mandatory attributes:
    • Patient (↔ tblInsuree)
    • Provider {Practitioner | PractitionerRole | Organization} (↔ tblClaim.HFID)
    • Insurance(s) ... no direct relation between tblClaim and tblInsureePolicy... or "PolicyID"... but this is not a FK !?!
    • Item(s) (↔ tblClaimItems)... note: tblClaimItems are "first citizen entities" in openIMIS... and (complex) nested structure in FHIR

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