GP Connect - Investigations

This appears to only be supported by TPP (FHIR DiagnosticOrder). Understand in many cases the Order will be on ICE with the corresponding DiagnosticReport (labsresults) being stored on both the GP system and ICE.

I’m not clinical but would assume the presence of a Report implies an Order. Is it worth including information from Reports?

Afternoon Kevin,

Investigations as an HTML section and concept is the fully reconstituted report including for example, report/test comments and potentially any actions recorded in the primary care system (example). This is typically fed by PMIP/MESH feeds into the GP system (and some are manually typed in) so are available to be populated in response to a request. The order itself though, as you describe, is only in ICE so wouldn’t be something a primary care system could populate in response to request?

I wonder why EMIS say they don’t support? Defence version of EMIS would support the reports/tests results.

I’d got the DiagnosticOrder from this list http://data.developer.nhs.uk/fhir/gpconnect-getrecord-phase3/Profile.GetRecordQueryResponse-Phase-3/Profile.GetRecordQueryResponse-Phase-3.html
Wonder if this should be DiagnosticReport (and matches your link)

As I mentioned it’s from the HTML guidance you’ve read/quoted above. No mention of support for structured DiagnosticOrder or DiagnosticReport (structured/coded) has been published per supplier yet. It’s still in the works!

For info - the profiles in your link have been removed from the latest guidance pack to simplify the technical content of what’s defined as ‘stage 1’. Structured resource should be reintroduced (or references to externally curated profiles if appropriate) in stage 2/3.

Cheers, so investigations section is Diagnostic Reports (or it will be in the structured version).

@richard.pugmire are the json/xml examples you are using for the demonstrator available anywhere (it’s often easier to look at the raw data).

It does look like most suppliers would return investigations. TPP rendering the report (inc observations) and others observations separated by type of report (microbiology, cytology, etc) - similar to MIG v2?

We found out how to access the json files via the demonstrator.

Open up the demonstrator in chrome, switch on Chrome Developer Tools and you see all the calls to GP Connect (call to SMSP FHIR Facade, SDS LDAP FHIR Facade and the actual call to GP Connect).

If your adverse to going through specifications - it’s very useful.

Do the demonstrators return conformance statements from the /fhir/metadata route on the interfaces?

I’ve not seen it. It appears to be a HAPI v1.6 standalone server supplying the mock up’s data.

Fair enough. I’ve written a FHIR facade for SMSP/PDS and it would be useful to see how NHS-Digital were approaching this, but I guess I’ll have to wait and see!

Did you mean this meta section? We’ve been after when a patient was updated as we don’t know which organisation holds the latest address for a patient - it’s not part of SMSP (or we’ve not found it)

{
				"resourceType" : "Patient",
				"id" : "5",
				"meta" : {
					"lastUpdated" : "2016-07-25T12:00:00.000+00:00"
				},
				"identifier" : [{
						"system" : "http://fhir.nhs.net/Id/nhs-number",
						"value" : "9000000041"
					}
				]

For a compliant FHIR server you can go to …/fhir/metadata to retrieve a Conformance resource describing the behaviour of the service i.e. which resources/operations/searches are available.

SMSP returns only one address for the patient, so think it masks this sort of detail.