Exchange data using FHIR model

As explained earlier, the iCure data model offers you the needed flexibility in order to represent your medical data. To have more information about it and understand fully the possibilities of it, we encourage you to visit this page.

However, it can seem difficult for you at the beginning to understand how to "map" your own data to the iCure data model. As said earlier, iCure Data Model has been built in order to be compatible with higher level Medical Data conceptual Data Models. That's why you have the possibility to make requests to iCure using FHIR format, in order to exchange your data in a more "familiar" / common way.

If you decide to use the FHIR APIs, iCure will by itself transform it to the corresponding iCure Data Model representation.

At the end of this tutorial, you will be able to exchange FHIR Patient and Observation data, using the iCure - FHIR Bridge API.

Register on iCure platform

Make sure you created your iCure environment, and that you possess the following information :

Your iCure user login - password;
Your iCure user private encryption key;

Load private encryption key in local storage

To guarantee the security of your data, iCure encrypts all of them, based on the keys pair you generated during your registration.

As your private encryption key is not stocked in iCure, you will need to provide it first in your web session to the iCure - FHIR Bridge API before making your requests.

Prepare for iCure - FHIR Bridge API requests

import fetch from "node-fetch";

const host = 'https://dxm.icure.dev';
const hcpId = '2d205ac4-c8c9-428b-b68e-d9381da235d2';

let key = {
    key: '308204bd02...8b40fdc0bc'
}

let credentials = 'Y3ZAdGFrdG...MzOGY1MTQ='

let keyPutInCache = await fetch(`${host}/rest/icdx/v1/keychain/${hcpId}`, {
    method: 'POST',
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    },
    body: JSON.stringify(key)
})
    .then(response => response.json());

console.log(`Key put in cache : ${keyPutInCache}`)

In the above example, do not forget to :

Use your own login - password;
Use your private encryption key;

Supported FHIR APIs

Based on the FHIR Specification, iCure is currently supporting the following FHIR APIs :

FHIR Resource Id

For Create requests, the id provided in FHIR resources will be transformed as a new identifier, using system https://dxm.icure.dev. At its place, iCure will provide its own generated id to guarantee the data coherence.

Create a patient

Import a new patient in your iCure environment, based on FHIR r4 Patient. All the references you are passing into the patient (generalPractitioner, organization, ...) need to be previously imported into the iCure environment.

Create FHIR Patient

let patientToCreate = {
    resourceType: "Patient",
    id: "pat1",
    text: {
        status: "generated",
        div: "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      \n      <p>Patient Donald DUCK @ Acme Healthcare, Inc. MR = 654321</p>\n    \n    </div>"
    },
    identifier: [
        {
            use: "usual",
            type: {
                coding: [
                    {
                        system: "http://terminology.hl7.org/CodeSystem/v2-0203",
                        code: "MR"
                    }
                ]
            },
            system: "urn:oid:0.1.2.3.4.5.6.7",
            value: "654321"
        }
    ],
    active: true,
    name: [
        {
            use: "official",
            family: "Donald",
            given: [
                "Duck"
            ]
        }
    ],
    gender: "male",
    photo: [
        {
            contentType: "image/gif",
            data: "R0lGODlhEwARAPcAAAAAAAAA/+9aAO+1AP/WAP/eAP/eCP/eEP/eGP/nAP/nCP/nEP/nIf/nKf/nUv/nWv/vAP/vCP/vEP/vGP/vIf/vKf/vMf/vOf/vWv/vY//va//vjP/3c//3lP/3nP//tf//vf///////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////yH5BAEAAAEALAAAAAATABEAAAi+AAMIDDCgYMGBCBMSvMCQ4QCFCQcwDBGCA4cLDyEGECDxAoAQHjxwyKhQAMeGIUOSJJjRpIAGDS5wCDly4AALFlYOgHlBwwOSNydM0AmzwYGjBi8IHWoTgQYORg8QIGDAwAKhESI8HIDgwQaRDI1WXXAhK9MBBzZ8/XDxQoUFZC9IiCBh6wEHGz6IbNuwQoSpWxEgyLCXL8O/gAnylNlW6AUEBRIL7Og3KwQIiCXb9HsZQoIEUzUjNEiaNMKAAAA7"
        }
    ],
    contact: [
        {
            relationship: [
                {
                    coding: [
                        {
                            system: "http://terminology.hl7.org/CodeSystem/v2-0131",
                            code: "E"
                        }
                    ]
                }
            ],
            organization: {
                reference: "Organization/1",
                display: "Walt Disney Corporation"
            }
        }
    ],
    managingOrganization: {
        reference: "Organization/1",
        display: "ACME Healthcare, Inc"
    },
    link: [
        {
            other: {
                reference: "Patient/pat2"
            },
            type: "seealso"
        }
    ]
}

let createdPatient = await fetch(`${host}/rest/fhir/r4/Patient`, {
    method: 'POST',
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    },
    body: JSON.stringify(patientToCreate)
})
    .then(response => response.json());

console.log(`Created FHIR patient : ${JSON.stringify(createdPatient, null, ' ')}`)

Read a patient

Find a patient, using either its FHIR id or its iCure id.

Read FHIR Patient

let fetchedPatient = await fetch(`${host}/rest/fhir/r4/Patient/pat1`, {
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    }
})
    .then(response => response.json());

console.log(`Fetched FHIR patient : ${JSON.stringify(fetchedPatient, null, ' ')}`)

Delete a patient

Delete a patient, using either its FHIR id or its iCure id.

Delete FHIR Patient

let deletedPatient = await fetch(`${host}/rest/fhir/r4/Patient?name=Donald`, {
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    }
});

Search patients

Search patients based on FHIR Specification. For now, iCure permits you to search patients by :

_id;
gender;
name;
_has:Observation:_tag;
_has:Observation:code;

Search FHIR patients

let searchedPatients = await fetch(`${host}/rest/fhir/r4/Patient?_id=pat2&name=Donald&_has%3AObservation%3A_tag=http%3A%2F%2Floinc.org%7C718-7`, {
    headers: {
        'Content-Type': 'application/json',
        'Accept': 'application/json',
        'Authorization': `Basic ${credentials}`
    }
})
    .then(response => response.json());

console.log(`Searched FHIR patients : ${JSON.stringify(searchedPatients, null, ' ')}`)

Create an observation

Import a new observation in your iCure environment, based on FHIR r4 Observation.

All the references you are passing into the observation (subject, ...) need to be previously imported into the iCure environment.

Create FHIR Observation

let observationToCreate = {
    "resourceType": "Observation",
    "id": "f001",
    "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: f001</p><p><b>identifier</b>: 6323 (OFFICIAL)</p><p><b>status</b>: final</p><p><b>code</b>: Glucose [Moles/volume] in Blood <span>(Details : {LOINC code '15074-8' = 'Glucose [Moles/volume] in Blood', given as 'Glucose [Moles/volume] in Blood'})</span></p><p><b>subject</b>: <a>P. van de Heuvel</a></p><p><b>effective</b>: 02/04/2013 9:30:10 AM --&gt; (ongoing)</p><p><b>issued</b>: 03/04/2013 3:30:10 PM</p><p><b>performer</b>: <a>A. Langeveld</a></p><p><b>value</b>: 6.3 mmol/l<span> (Details: UCUM code mmol/L = 'mmol/L')</span></p><p><b>interpretation</b>: High <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation code 'H' = 'High', given as 'High'})</span></p><h3>ReferenceRanges</h3><table><tr><td>-</td><td><b>Low</b></td><td><b>High</b></td></tr><tr><td>*</td><td>3.1 mmol/l<span> (Details: UCUM code mmol/L = 'mmol/L')</span></td><td>6.2 mmol/l<span> (Details: UCUM code mmol/L = 'mmol/L')</span></td></tr></table></div>"
    },
    "identifier": [
        {
            "use": "official",
            "system": "http://www.bmc.nl/zorgportal/identifiers/observations",
            "value": "6323"
        }
    ],
    "status": "final",
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "15074-8",
                "display": "Glucose [Moles/volume] in Blood"
            }
        ]
    },
    "subject": {
        "reference": "9a106b7f-2fa1-4b54-b3cb-c29cbfebe2ee",
        "display": "P. van de Heuvel"
    },
    "effectivePeriod": {
        "start": "2013-04-02T09:30:10+01:00"
    },
    "issued": "2013-04-03T15:30:10+01:00",
    "performer": [
        {
            "reference": "Practitioner/f005",
            "display": "A. Langeveld"
        }
    ],
    "valueQuantity": {
        "value": 6.3,
        "unit": "mmol/l",
        "system": "http://unitsofmeasure.org",
        "code": "mmol/L"
    },
    "interpretation": [
        {
            "coding": [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                    "code": "H",
                    "display": "High"
                }
            ]
        }
    ],
    "referenceRange": [
        {
            "low": {
                "value": 3.1,
                "unit": "mmol/l",
                "system": "http://unitsofmeasure.org",
                "code": "mmol/L"
            },
            "high": {
                "value": 6.2,
                "unit": "mmol/l",
                "system": "http://unitsofmeasure.org",
                "code": "mmol/L"
            }
        }
    ]
}

let createdObservation = await fetch(`${host}/rest/fhir/r4/Observation`, {
    method: 'POST',
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    },
    body: JSON.stringify(observationToCreate)
})
    .then(response => response.json());

console.log(`Created FHIR observation : ${JSON.stringify(createdObservation, null, ' ')}`)

Read an observation

Find an observation, using either its FHIR id or its iCure id.

Read FHIR Observation

let fetchedObservation = await fetch(`${host}/rest/fhir/r4/Observation/f001`, {
    headers: {
        'Content-Type': 'application/json',
        'Authorization': `Basic ${credentials}`
    }
})
    .then(response => response.json());

console.log(`Fetched FHIR observation : ${JSON.stringify(fetchedObservation, null, ' ')}`)

Search observations

Search observations based on FHIR Specification. For now, iCure permits you to search observations by :

_tag;
code;
_has:Patient:_id;
_has:Patient:gender;
_has:Patient:name;

Search FHIR Observations

let searchedObservations = await fetch(`${host}/rest/fhir/r4/Observation?_tag=http%3A%2F%2Floinc.org%7C15074-8`, {
    headers: {
        'Content-Type': 'application/json',
        'Accept': 'application/json',
        'Authorization': `Basic ${credentials}`
    }
})
    .then(response => response.json());

console.log(`Searched FHIR observations : ${JSON.stringify(searchedObservations, null, ' ')}`)```

</div>

</div>

</div>

#### Batch transaction resource creation
If you need to create several resources, you can use the batch transaction resource creation and provide them
in a [FHIR Bundle](https://www.hl7.org/fhir/bundle.html).
From this bundle, iCure will create in that order :
- All patients entries;
- All observations entries;

<div data-gb-custom-block data-tag="tabs">

<div data-gb-custom-block data-tag="tab" data-title='Javascript'>

<div data-gb-custom-block data-tag="code" data-title='Bundle FHIR Resource transaction creation'>

```javascript
let bundleToCreate = {
    "type": "transaction",
    "entry": [{
        "resource": {
            "resourceType": "Patient",
            "id": "pat2",
            "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<p>Patient Donald D DUCK @ Acme Healthcare, Inc. MR = 123456</p>\n\t\t</div>"
            },
            "identifier": [
                {
                    "use": "usual",
                    "type": {
                        "coding": [
                            {
                                "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                                "code": "MR"
                            }
                        ]
                    },
                    "system": "urn:oid:0.1.2.3.4.5.6.7",
                    "value": "123456"
                }
            ],
            "active": true,
            "name": [
                {
                    "use": "official",
                    "family": "Donald",
                    "given": [
                        "Duck",
                        "D"
                    ]
                }
            ],
            "gender": "other",
            "_gender": {
                "extension": [
                    {
                        "url": "http://example.org/Profile/administrative-status",
                        "valueCodeableConcept": {
                            "coding": [
                                {
                                    "system": "http://terminology.hl7.org/CodeSystem/v2-0001",
                                    "code": "A",
                                    "display": "Ambiguous"
                                }
                            ]
                        }
                    }
                ]
            },
            "photo": [
                {
                    "contentType": "image/gif",
                    "data": "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"
                }
            ],
            "managingOrganization": {
                "reference": "Organization/1",
                "display": "ACME Healthcare, Inc"
            },
            "link": [
                {
                    "other": {
                        "reference": "Patient/pat1"
                    },
                    "type": "seealso"
                }
            ]
        }
    }, {
        "resource": {
            "resourceType": "Observation",
            "id": "f005",
            "text": {
                "status": "generated",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: f005</p><p><b>identifier</b>: 6327 (OFFICIAL)</p><p><b>status</b>: final</p><p><b>code</b>: Hemoglobin [Mass/volume] in Blood <span>(Details : {LOINC code '718-7' = 'Hemoglobin [Mass/volume] in Blood', given as 'Hemoglobin [Mass/volume] in Blood'})</span></p><p><b>subject</b>: <a>P. van de Heuvel</a></p><p><b>effective</b>: 05/04/2013 10:30:10 AM --&gt; 05/04/2013 10:30:10 AM</p><p><b>issued</b>: 05/04/2013 3:30:10 PM</p><p><b>performer</b>: <a>A. Langeveld</a></p><p><b>value</b>: 7.2 g/dl<span> (Details: UCUM code g/dL = 'g/dL')</span></p><p><b>interpretation</b>: Low <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation code 'L' = 'Low', given as 'Low'})</span></p><h3>ReferenceRanges</h3><table><tr><td>-</td><td><b>Low</b></td><td><b>High</b></td></tr><tr><td>*</td><td>7.5 g/dl<span> (Details: UCUM code g/dL = 'g/dL')</span></td><td>10 g/dl<span> (Details: UCUM code g/dL = 'g/dL')</span></td></tr></table></div>"
            },
            "identifier": [
                {
                    "use": "official",
                    "system": 	"http://www.bmc.nl/zorgportal/identifiers/observations",
                    "value": "6327"
                }
            ],
            "status": "final",
            "code": {
                "coding": [
                    {
                        "system": "http://loinc.org",
                        "code": "718-7",
                        "display": "Hemoglobin [Mass/volume] in Blood"
                    }
                ]
            },
            "subject": {
                "reference": "9a106b7f-2fa1-4b54-b3cb-c29cbfebe2ee",
                "display": "P. van de Heuvel"
            },
            "effectivePeriod": {
                "start": "2013-04-05T10:30:10+01:00",
                "end": "2013-04-05T10:30:10+01:00"
            },
            "issued": "2013-04-05T15:30:10+01:00",
            "performer": [
                {
                    "reference": "Practitioner/f005",
                    "display": "A. Langeveld"
                }
            ],
            "valueQuantity": {
                "value": 7.2,
                "unit": "g/dl",
                "system": "http://unitsofmeasure.org",
                "code": "g/dL"
            },
            "interpretation": [
                {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                            "code": "L",
                            "display": "Low"
                        }
                    ]
                }
            ],
            "referenceRange": [
                {
                    "low": {
                        "value": 7.5,
                        "unit": "g/dl",
                        "system": "http://unitsofmeasure.org",
                        "code": "g/dL"
                    },
                    "high": {
                        "value": 10,
                        "unit": "g/dl",
                        "system": "http://unitsofmeasure.org",
                        "code": "g/dL"
                    }
                }
            ],
            "valueCodeableConcept": {
                "coding": [{
                    "system": "CD-ITEM",
                    "code": "adr",
                    "version": "1"
                }],
                "id": "CD-ITEM|adr|1"
            }
        }
    }]
}

let createdBundle = await fetch(`${host}/rest/fhir/r4`, {
    method: 'POST',
    headers: {
        'Content-Type': 'application/json',
        'Accept': 'application/json',
        'Authorization': `Basic ${credentials}`
    },
    body: JSON.stringify(bundleToCreate)
})
    .then(response => response.json());

console.log(`Created FHIR Bundle : ${JSON.stringify(createdBundle, null, ' ')}`)

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