Using different FHIR profiles from US Core

[andyol74]

Hello All,
I'm trying to understand if it's possible to use FHIR profiles other than US Core to export resources that have, in example, specific extensions.
If it's not supported, how can the existing export be modified?

Thanks in advance for your support!

[dehall]

There's no built-in support for any profiles other than US Core, and no ability for Synthea to load arbitrary IGs and create relevant data for them. What we do have though which hopefully addresses your needs is the "Flexporter". The basic idea is that you can define a mapping file that transforms the output from Synthea in common ways, such as creating new resource types or adding new fields to existing resources. See more about the flexporter here: https://github.com/synthetichealth/synthea/wiki/Flexporter and feel free to ask if you have further questions on how to use it. It's still experimental so certain things you want to do may be tricky, but when people actually use it then we do what we can to improve it.

If that doesn't cover your needs, modifying the existing exporter can theoretically be done if you're willing to make changes to the java code, but I would save that for a last resort.

[andyol74]

Thank you! Very interesting... I was already working to understand how to adapt the Java class :).
In the next few days, I will do some test with "flexporter" and I'll let you know. At first glance, it seems to me that there is no option to add extensions to FHIR resources, did I miss something? It would be a functionality that, in my opinion, would be very useful.

[dehall]

It's not only for extensions, but what you probably want is either the set_values action to add fields to an existing resource, or the create_resource action to create new resources.

Here's an example mapping file with two actions to add extensions to existing resources:

---
name: Extensions

applicability: true

actions:
 - name: Set QI Core Procedure Recorded
   set_values:
     - applicability: Procedure.performed.ofType(Period)
       fields:
         - location: Procedure.extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded').valueDateTime
           value: $getField([Procedure.performed.start])
     - applicability: Procedure.performed.ofType(dateTime)
       fields:
         - location: Procedure.extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded').valueDateTime
           value: $getField([Procedure.performed])

 - name: Set Patient birthdate.extension
   set_values:
     - applicability: Patient
       fields:
         - location: Patient.birthDate.extension.where(url='http://hl7.org/fhir/StructureDefinition/patient-birthTime').valueDateTime
           value: $getField([Patient.birthDate])
           transform: toDateTime

The syntax is admittedly a little awkward for the extensions in these examples but hopefully it's clear enough what's happening. Please let us know if you run into any issues.

[jagandecapri]

Hi @dehall ,

I have similar use case to generate synthetic data based on non-US FHIR profiles. I just want to check if it is still the case that only Flexporter is the way to go?

Thank you.

[dehall]

Hi @jagandecapri , it depends on the specifics of your profiles, but most likely yes the flexporter is the way to go. The idea of the flexporter is that you want to use Synthea data, it's very close to meeting your data needs, but there are just a few things missing, like a couple fields or a resource type or two. So the flexporter allows you to fill in those few details.
If you need data that is very different from what synthea offers though, you might be better off post-processing the data with custom tools you write yourself; the flexporter is fairly limited.

[jagandecapri]

Hi @dehall , thank you for your response. It's very helpful!