EMIS GP published data transformation and mapping

This article describes the mapping of EMIS published data into the intermediate FHIR store.

Content dependent rules

CareRecord_Observation contains data which is mapped to multiple FHIR resource types. The target resource type is decided by the following rules, using the Read2 code and CodeType from the Coding_ClinicalCode file (looked up using the CodeId from CareRecord_Observation) and the Value field from CareRecord_Observation.

Rule	Target profile
If the Value is empty, and the CodeType is one of (Biochemistry Cyology_Histology, Haematology, Immunology, Microbiology, Radiology, Health_Management)	DiagnosticReport

 

 

 

Test	Action
If the Value is empty, and the CodeType is one of: Biochemistry Cyology_Histology Haematology Immunology Microbiology Radiology Health_Management	Map to DiagnosticReport
If the Value is not empty or the CodeType is one of: Biochemistry Biological_Values Cyology_Histology Haematology Health_Management Immunology Microbiology Radiology Symptoms_Findings Procedure (note, the codes is this category aren't actually "procedures") Adminisation_Documents_Attachments Body_Structure //dental structures Care_Episode_Outcome Dental_Finding Diagnostics Discharged_From_Service EMIS_Qualifier Ethnicity HMP Intervention_Category Intervention_Target KC60 Marital_Status Nationality Nursing_Problem Nursing_Problem_Domain Obsteterics_Birth Person_Health_Social Planned_Dental Problem_Rating_Scale Reason_For_Care Referral_Activity Referral_Rejected Referral_Withdrawn Regiment Religion Trade_Branch Unset	Map to Observation
If the CodeType is Conditions_Operations_Procedures and the Code is in these branches: 6....      Preventive procedures 7....      Operations, procedures, sites 8....      Other therapeutic procedures	Map to Procedure
If the CodeType is Conditions_Operations_Procedures and the Code is in these branches: A....    Infectious and parasitic diseases B....    Neoplasms C....    Endocrine, nutritional, metabolic and immunity disorders D....    Diseases of blood and blood-forming organs E....    Mental disorders F....    Nervous system and sense organ diseases G....    Circulatory system diseases H....    Respiratory system diseases J....    Digestive system diseases K....    Genitourinary system diseases M....    Skin and subcutaneous tissue diseases N....    Musculoskeletal and connective tissue diseases	Map to Condition*
If the CodeType is Conditions_Operations_Procedures	Map to Observation
If the CodeType is any of: Allergy_Adverse_Drug_Reations Allergy_Adverse_Reations	Map to AllergyIntolerance
If the CodeType is any of: Dental_Disorder Dental_Procedure	Map to Condition*
If the CodeTyps is Family_History	Map to FamilyMemberHistory
If the CodeType is Immunisations	Map to Immunization
If the CodeType is Investigation_Requests	Map to DiagnosticOrder
If the CodeType is Pathology_Specimen	Map to Specimen
If the CodeType is Referral	Map to ReferralRequest

 

• If the CareRecord_Observation is linked to by a CareRecord_Problem record, then the Condition resource uses the “problem” profile, otherwise it uses the “condition” profile.

In addition to the above mappings, if the target resource selects is not condition, but the CareRecord_Observation is linked to by a CareRecord_Problem record, then a condition resource will also be created, with the “problem” profile.

 

Prescribing_DrugRecord End Dates

The Prescribing_DrugRecord file contains both a Boolean active indicator (IsActive) and the medication end date (CancellationDate). Within Emis Web, it’s the IsActive indicator that is used to determine whether medication is active or not, the CancellationDate just providing additional information for ended medication. Analysing the received data has highlighted that there are a number of cases where the CancellationDate doesn’t match what the IsActive flag states:

1. IsActive = true but a CancellationDate is present;
2. IsActive = false but a CancellationDate is absent.

From the dates of affected data, these appear to be related to either a service moving to Emis Web from another GP system, and are an artefact of that transfer.

To ensure consistency in the FHIR MedicationStatements created from this file, the Cancellation date will only be carried over if the DrugRecord is non-active. If no cancellation date is present, it will be derived from the medication start and course length (found from the associated Prescribing_IssueRecord file).