Official URL: http://iehr.ai/fhir/ie/core/ImplementationGuide/iehr.fhir.ie.core				Version: 2.0.0
IG Standards status: Trial-use			Maturity Level: 3	Computable Name: IECore
Other Identifiers:
Copyright/Legal: iEHR.ai, all rights reserved Creative Commons License

Where possible, new and updated pre-publishing content is highlighted with green text and background- This highlighting will be removed prior to publication.

Key updates and detailed changes between this and prior versions are available on the IE Core Change Log and Changes Between Versions pages.

Introduction

This guide and the IE Core profiles have become the foundation for Irish FHIR implementation guides. This annual release reflects changes to iEHR IE Core Data for Interoperability (IECDI), and The National General Practice Information Technology (ICGP-GPIT) Group Software Management Systems Requirements, comments and requests from the Irish FHIR community. (The Future of IE Core page outlines this approach to yearly updates.) IE Core has benefitted from testing and guidance by the Argonaut Project Team. Their feedback continues to lay the groundwork for documenting the IE Core Profile design, interactions, requirements, and guidelines for patient data access and ICGP-GPIT Certification testing. Under the guidance of HL7 and the iEHR.ai Ireland Steering Committee, the content will expand in future versions to meet the needs specific to the Irish.

The IE Core Implementation Guide is based on FHIR Version R4. It defines the minimum constraints on the FHIR resources to create the IE Core Profiles. The elements, extensions, vocabularies, and value sets that SHALL be present are identified, and how they are used is defined. It also documents the minimum FHIR RESTful interactions for each IE Core Profiles to access patient data. Establishing the "floor" of standards to promote interoperability and adoption through common implementation allows for further standards development evolution for specific use cases. There are two different ways to implement IE Core:

1. Profile Only Support: Systems may support only the IE Core Profiles to represent clinical information.
2. Profile Support + Interaction Support: Systems may support both the IE Core Profile content structure and the RESTful interactions defined for a resource.

For a detailed description of these different usages of IE Core, see the Conformance Requirements page.

How To Read This Guide

This Guide is divided into several pages, which are listed at the top of each page in the menu bar.

• Home: The home page provides the introduction and background for IE Core.
• Conformance: These pages describe the set of rules to claim conformance to this guide
  • General Requirements: This page defines requirements common to all actors and profiles used in this guide, including how CapabilityStatements are used to claim conformance.
  • Must Support: This page defines the expectations for mandatory and Must Support elements in the IE Core Profiles.
• Guidance: The Guidance pages document best practices and how to use the profiles and transactions defined in this guide.
  • IECDI: This page maps the IE Core Profiles to the (IECDI) data classes and data elements.
  • General Guidance: This page provides guidance, definitions, and requirements common to all actors and profiles used in this guide.
  • Clinical Notes: This page provides guidance on the interactions between Consumers and Producers of clinical notes.
  • Medication List: This page provides guidance on how a patient or provider can access a patient's medications.
  • Basic Provenance: This page provides implementers with important definitions to create and share the Provenance Resource.
  • Screening and Assessments: This page documents how IE Core Profiles are used to represent screenings and assessments for patient health status
  • Changes Between Versions: This page considers the user and developer experience when transitioning between versions of IE Core and documents the changes between versions.
  • Future of IE Core: This page outlines the approach to adding new content to IE Core.
• FHIR Artifacts: These pages provide detailed descriptions and formal definitions for all the FHIR objects defined in this guide.
  • Profiles and Extensions: This page lists the IE Core Profiles and Extensions defined in this guide to exchange quality data.
    • Each IE Core Profile page includes a narrative description that lists all the Mandatory and Must Support data elements, profile-specific implementation guidance, and formal definitions. A "Quick Start" guide summarizes the supported search transactions for each profile. Although the guidance typically focuses on the profiled elements, it also may cover un-profiled elements to aid with implementation and certification.
  • Search Parameters and Operations: This page lists the defined IE Core Operations and Search Parameters used in IE Core transactions.
  • Terminology: This page lists the IE Core ValueSets, and CodeSystems defined for the profiles.
  • Capability Statements: These pages define the expected FHIR capabilities of the IE Core Servers and Clients.
• Security: This page documents the general security requirements and recommendations for actors.
• Examples: This page lists all the examples used in this guide. These examples show what data produced and consumed by systems conforming with this implementation guide might look like. Every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification, nor fully representative of real-world examples.
• ​Downloads: This page provides links to downloadable artifacts.
• Change Log: This page documents the changes across the versions of IE Core

IE Core Actors

The following actors are part of the IE Core IG:

IE Core Requestor

A IE Core Requester is an application that initiates a data access request to retrieve patient data. The IE Core Requestor is the client in a client-server interaction. The terms "IE Core Requestor" and "Client" are used interchangeably throughout this guide and are not meant to limit this actor to only patient and provider apps. For example, payers and other users can use the same technology. These terms are a short-hand notation for "user application".

IE Core Responder

A IE Core Responder is a system that responds to the data access request providing patient data. The IE Core responder is the server in a client-server interaction. The terms "IE Core Responder", "Server", and "EHR" are used interchangeably throughout this guide and are not meant to limit this actor to electronic health record systems. For example, HIEs, care coordination platforms, population health systems, etc., can use the same technology. These terms are a short-hand notation for "interoperable healthcare platform".

IE Core Profiles

Below is the list of IE Core Profiles. Each profile identifies which core elements, extensions, vocabularies, and ValueSets SHALL be present in the resource when using this profile. Together, they promote interoperability and adoption through common implementation and provide the floor for standards development for specific use cases. See the IECDI page, for a mapping to the iEHR IE Core Data for Interoperability (IECDI).

A simple narrative summary gives each profile's requirements and guidance. A formal hierarchical table presents a logical view of the content in both a differential and snapshot view, and provides references to appropriate terminologies and examples.

AllergyIntolerance

• IE Core AllergyIntolerance Profile

CarePlan

• IE Core CarePlan Profile

CareTeam

• IE Core CareTeam Profile

Condition

• IE Core Condition Encounter Diagnosis Profile
• IE Core Condition Problems and Health Concerns Profile

Coverage

• IE Core Coverage Profile

Device

• IE Core Implantable Device Profile

DiagnosticReport

• IE Core DiagnosticReport Profile for Laboratory Results Reporting
• IE Core DiagnosticReport Profile for Report and Note Exchange

DocumentReference

• IE Core ADI DocumentReference Profile
• IE Core DocumentReference Profile

Encounter

• IE Core Encounter Profile

Goal

• IE Core Goal Profile

Identifier

• IE Core Company Registration Number
• IE IHI
• IE Insurance Member Number
• IE Medical Record Number

Immunization

• IE Core Immunization Profile

Location

• IE Core Location Profile

Medication

• IE Core Medication Profile

MedicationDispense

• IE Core MedicationDispense Profile

MedicationRequest

• IE Core MedicationRequest Profile

Observation

• IE Core Average Blood Pressure Profile
• IE Core Care Experience Preference Profile
• IE Core Observation ADI Documentation Profile
• IE Core Observation Clinical Result Profile
  • IE Core Laboratory Result Observation Profile
• IE Core Observation Occupation Profile
• IE Core Observation Pregnancy Intent Profile
• IE Core Observation Pregnancy Status Profile
• IE Core Observation Screening Assessment Profile
• IE Core Observation Sexual Orientation Profile
• IE Core Simple Observation Profile
• IE Core Smoking Status Observation Profile
• IE Core Treatment Intervention Preference Profile
• IE Core Vital Signs Profile
  • IE Core Pediatric Head Occipital Frontal Circumference Percentile Profile
  • IE Core Blood Pressure Profile
  • IE Core BMI Profile
  • IE Core Body Height Profile
  • IE Core Body Temperature Profile
  • IE Core Body Weight Profile
  • IE Core Head Circumference Profile
  • IE Core Heart Rate Profile
  • IE Core Pulse Oximetry Profile
  • IE Core Respiratory Rate Profile
  • IE Core Pediatric BMI for Age Observation Profile
  • IE Core Pediatric Weight for Height Observation Profile

Organization

• IE Core Organization Profile

Patient

• IE Core Patient Profile

Practitioner

• IE Core Practitioner Profile

PractitionerRole

• IE Core PractitionerRole Profile

Procedure

• IE Core Procedure Profile

Provenance

• IE Core Provenance Profile

QuestionnaireResponse

• IE Core QuestionnaireResponse Profile

RelatedPerson

• IE Core RelatedPerson Profile

ServiceRequest

• IE Core ServiceRequest Profile

Specimen

• IE Core Specimen Profile

IE Core FHIR RESTful interactions

For systems that support the IE Core Profile content structure and the RESTful interactions defined for a resource, the requirements are formally defined in the IE Core CapabilityStatements. In addition, each profile page has a Quick Start Section that documents the required FHIR RESTful search and read operations. These sections demonstrate how to access a patient's clinical and administrative data:

See the FHIR specification for details on FHIR RESTful Search API and the SMART App Launch for how an application gets access to a patient record.