如何使用FHIR 表达卫计委发布的卫生信息数据集 数据元目录

[wanghaisheng]

Questionnaires differ from Lists because Lists group existing resources, while Questionnaires group arbitrary questions. In theory, a Questionnaire could be expressed as a List or Composition containing DataElement resources. However, the former would disregard the "wholeness" associated with a questionnaire where questions must generally be maintained as a single structure. The latter would focus on rendering of the data elements rather than organizing the capture of information

[wanghaisheng]

在现有的资源定义中 Questionnaires与structuredefinition是最接近于可以表达dataset卫计委所定义的数据集的资源，而 List or Composition是最接近于表达数据元目录的资源， DataElement用于表达具体的数据元，

[wanghaisheng]

Questionnaire is to both define forms, surveys and other structures that can be filled out. Questionnaire also defines data elements. However, it does so only in the context of a particular questionnaire design. In contrast, DataElement is focused on defining data elements independent of their use in questionnaires and other structures. A single DataElement might be referenced in numerous Questionnaires, or even potentially in multiple places within a single Questionnaire. This reference might either be implicit or may be explicit through an extension. (For implementability reasons, the data constraints should still be explicitly exposed within the Questionnaire rather than being included "by reference" to the DataElement.)

按照目前卫计委的做法，具体的数据集中是对数据元目录中的数据元进行了细化的，比如姓名是一个独立的脱离于应用场景的数据元，而患者本人姓名、医生姓名是复用了姓名这个数据元的，从而成为两个独立的新的数据元，但在数据元目录中并没有收录，于是我们要么维护所有数据集中新衍生出的加上原来数据源目录中的所有数据元，要么舍弃原始的公用的数据元目录，直接从数据集中收集所有特化的衍生的数据元形成新的数据元目录。

[wanghaisheng]

6.20.3.2 Relationship to ISO 11179 One of the sources of the DataElement resource definition was the ISO 11179 Metadata Registries specification. It defines a logical model for the classification, identification, naming and registration of Data Elements, Data Element Concepts and their associated Value and Conceptual Domains.

The DataElement resource can be used to represent both Data_Element and Data_Element_Concept in the ISO logical model. (The ValueSet resource provides the details for Value_Domain and Conceptual_Domain for enumerated elements.) The determination of whether a DataElement resource instance is an ISO 11179 Data_Element or Data_Element_Concept is determined by whether the type property is specified - which corresponds to the ISO property Data_Element.domain.datatype which is required for Data_Elements. I.e. If DataElement.type is present, the instance represents a 11179 data element. If DataElement.type is absent, the instance represents a 11179 data element concept.

Unlike the 11179 logical specification, the DataElement resource does not require a linkage from data element to a distinct data element concept, though this linkage can be established through an extension if desired. The typical means of identification of the data element concept is expected to instead occur through the mapping of the data element to a particular code or reference model that formally defines the concept. It is possible this reference model could be based on ISO's Object_Class and Property mechanism. However, mappings to other reference models are also possible, for example:

HL7's Reference Information Model Open EHR's reference model the BRIDG logical model terminologies such as LOINC or SNOMED In the event of multiple codes and/or mappings, the "authoritative" mapping (the one formally defining the concept) is identified by either setting the "primary" element on the code or by specifying the "primary mapping" ISO 11179 extension.

It is possible to create instances that are "conforming", or even "strictly conforming" to the 11179 specification. However, doing so will require the use of extensions to convey certain properties that are not part of the core resource and data types. An initial starter ISO 11179 profile is included in the FHIR specification. It defines extensions that are relevant to the SDC DataElement profile. If there is sufficient interest, the existing starter set may be enhanced to contain a complete set of extensions and a full 11179 in a future release of the specification.

ISO 11179中有区分数据元概念和数据元本身，例如，患者姓名既是数据元概念(这时候不和具体的表达形式有关，不会说具体的数据类型是string还是text还是二进制流)，又是数据元本身(这时候说的是数据元概念的取值、数据元所携带的信息数据具体是怎么样的，我们要说明其数据类型到底是string还是text 完整的表达应该是患者姓名的数据 简化起见 叫做患者姓名)

[wanghaisheng]

1、现有的DataElement资源中缺少表示该数据元定义参考来源，引用标准的字段，考虑增加扩展来表达 2、发布日期如二〇一一年八月二日
3、启用日期如2012年2月1日起施行