National Electronic Health Record Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Overview

This guide represents the National Electronic Health Record (or NEHR) for Sri Lanka. The API for inbound and outbound interactions are defined within.

Use Cases

The NEHR satisfies several different use cases.

• clinical repository (encounter, discharge, patient and all supporting resources)
• eReferral workflow (task, service requests)

Electronic Referrals has it's own guide and is anticipated to share a repository and profiles with the NEHR.

Encounter Summary

Some FHIR Resource instances will be submitted to the NEHR throughout an encounter. For example, lab reports, will be submitted when they are produced. The Encounter Summary (LKEncounterSummary) is designed as a Composition and includes References to all artifacts of the encounter. This design requires connecting hospital or clinic systems to either

• update a LKEncounterSummary instance (adding new Resource References) every time a new Resource instance is submitted or changed
• or track all the Resource instances and submit the summary at the end of the encounter.

Consideration 🔎 An alternate approach is to use meta.tag to associate all Resource instances related to a single encounter. This may be done in addition to using Encounter Summary if it helps a system to relate all the Resource instances or make searching simpler.

Consideration 🔎 FHIR Compartments are similar to the Encounter Summary. However the definition of a Encounter Compartment includes all Resources that refer to the Patient referenced by the Encounter. This approach may be feasible if all Resources included in the Encoutner Summary (as defined in this guide) are also included in the Encounter Compartment and each Encounter has a new Patient resource.

Discharge Summary

This structure is a FHIR Document. It consists of a LKDischargeSummaryBundle Bundle and LKDischargeSummary Composition. This is different from the Encounter Summary and requires that instances of Resources are included as entries in the Bundle.