Tiro.health Implementation Guide
0.1.0 - ci-build
Tiro.health Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.
| Tiro Questionnaire $populate |
Populate a Questionnaire with pre-existing data or AI-extracted values from clinical documents. Extends SDC Questionnaire/$populate with the contextual-populate mode and a provenance output parameter. |
These define collections of interrelated resources that are useful to pass around as a group.
| Patient With Most Recent Report |
Graph to retrieve Patient with most recent Task of type 'complete-questionnaire'. |
| Report Details |
Graph to retrieve Task of type 'complete-questionnaire' with Questionnaire, QuestionnaireResponse |
These define data models that represent the domain covered by this implementation guide in more business-friendly terms than the underlying FHIR resources.
| OMOP Observation |
Model resembling the OMOP-CDM 5.4 Observation table. |
| OMOP Person |
Model resembling the OMOP-CDM 5.4 Person table. |
| OMOP Provider |
Model resembling the OMOP-CDM 5.4 Provider table. |
| OMOP Record |
Base model for a OMOP-CDM 5.4. |
These define constraints on FHIR resources for systems conforming to this implementation guide.
| Form Provenance |
Profile for tracking the origin and method of data entry for form fields to support audit trails and transparency. One FormProvenance resource is created per populated QuestionnaireResponse item. |
| LabMeasurement |
A measurement of a laboratory test. |
| PCaMDT |
Multi-disciplinary team (MDT) meeting for prostate cancer. |
| Quality Indicator |
A Quality Indicator is a measure of the clinical quality of a service or intervention. Typically it is part of the nominator in Value-Based Healthcare model. |
| QuestionTree |
A question tree is a template block that contains a tree of questions. Each question may have one or more answers and may have one or more child questions. |
| Report |
FHIR Document Bundle with a Composition and a list of resources that describe the clinical report. |
| Table |
A table is a template block that contains a repeating set of rows with a uniform set of columns. |
| TemplateBlock |
A template block is a section of a template that defines a block of content that can be included in a document. |
| Tiro Questionnaire |
Profile for a Tiro Questionnaire |
| TumorStaging |
Tumor staging is the process of determining the extent of a cancer's spread from the original site of the tumor to other parts of the body. The staging system used most often in the United States is the TNM system. The T stands for tumor, the N stands for nodes, and the M stands for metastasis. The T describes the size and extent of the primary tumor. The N describes the size and extent of the lymph nodes involved. The M describes whether the cancer has spread to other parts of the body. The TNM system is used to stage many types of cancer, including breast cancer, colon cancer, lung cancer, and prostate cancer. The TNM system is also used to stage other types of cancer, such as melanoma, lymphoma, and leukemia. The TNM system is used to stage many types of cancer, including breast cancer, colon cancer, lung cancer, and prostate cancer. The TNM system is also used to stage other types of cancer, such as melanoma, lymphoma, and leukemia. |
These define constraints on FHIR data types for systems conforming to this implementation guide.
| Answer Comment |
Extension to add a comment to an answer in a QuestionnaireResponse |
| Bookmark |
A bookmark extension |
| Bookmark Launch Context |
List of bookmarks that must be available in the launch context. |
| Enable Suggestions |
Enable suggestions for inline mentions in text fields |
| HTML Element ID |
ID of a labeled HTML element (e.g. a span with a data-label attribute) within a DocumentReference attachment that the AI used as source text when extracting a field value. Multiple occurrences indicate multiple contributing spans. Enables UI source-highlighting. |
| Initial Value Template |
Set of initial values for a questionnaire |
| Input Group Separator |
A separator character for input groups. |
| Item Orientation |
Orientation of the items in the Questionnaire |
| Narrative Alternative Format |
Provides the narrative content in an alternative format such as RTF or plain text. |
| Narrative Generation |
This extension is used to define the narrative generation based on the QuestionnaireResponse. |
| Narrative Template |
FHIR Extension for narrative templates used in Questionnaires. This extension contains a template that is used to dynamically generate the narrative content of a Questionnaire based on provided data. |
| Narrative Template Snippet |
FHIR Extension for narrative snippets used in narrative templates within Questionnaires. These snippets are loaded into the rendering environment and can be referenced by narrative templates or by other snippets to generate dynamic content. |
| Option Restriction |
Conditionally restricts answer options based on FHIRPath expressions that evaluate other answers in the questionnaire. When the expression evaluates to true, the specified option is restricted (hidden or disabled). |
| Pre Expand Flag |
Flag to indicate that the value set has been pre-expanded. |
| Provenance Why (R6 Pre-adopt) |
Pre-adoption of R6 Provenance.why — describes why the event recorded in this provenance occurred in textual form. For AI-populated fields this captures the model's reasoning. Note: the backend currently stores reasoning in activity.text; ProvenanceWhy is the intended field going forward. |
| Questionnaire Item Include In Group Summary |
Indicates whether the question is included in the summary of the parent group. |
| Questionnaire Preset |
Pre-configured questionnaireresponses. |
| Questionnaire answerOption SVG Element |
Reference to an element defined inside the SVG document referenced by the itemMedia extension. |
| Regex |
Regular expression to validate the answer to a question |
| Render Type |
Render Type extension for the FHIR Questionnaire resource which indicates the layout preference for the Questionnaire |
| ValueSet Expansion Match Score |
This extension adds a score to each code in the expansion of a value set. The score is used to sort the codes in the expansion. |
These define sets of codes used by systems conforming to this implementation guide.
| Agent Types ValueSet (Retired) |
Retired. Use ProvenanceAgentTypeVS instead. |
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| Clinical M-Stage Lung Cancer with REO Addendum |
Clinical M-Stage for Lung Cancer with REO Addendum |
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| Clinical MStage Lung Cancer |
AJCC 8th Edition Clinical MStage for Lung Cancer |
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| Clinical NStage Lung Cancer |
AJCC 8th Edition Clinical NStage for Lung Cancer |
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| Clinical TStage Lung Cancer |
AJCC 8th Edition Clinical TStage for Lung Cancer |
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| Detected|Not Detected |
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| Form Activity ValueSet |
Activities that can be performed on form fields |
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| Ja|Nee |
SNOMED-CT codes for 'ja' and 'nee' |
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| KWS Bookmark Value Set |
All available bookmarks for Questionnaire population. |
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| Lung Cancer Diagnosis |
Diagnosis of Lung Cancer |
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| Lung Cancer Location Of Metastasis |
Location of metastasis for Lung Cancer |
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| Narrative Alternative Format MIME Types |
MIME types supported for narrative alternative formats |
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| Positive Negative |
Positive Negative from LOINC Answer List LL360-9 |
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| Provenance Agent Type Value Set |
Standard FHIR agent type codes used in FormProvenance.agent.type. Automated Atticus engines use #assembler; source document authors use #author. |
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| Question Tree Answer Item Code |
The type of an answer in a question tree. |
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| Questionnaire Item Orientation |
Orientation of the items in the Questionnaire |
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| Template Languages |
Available template languages to generate a narrative for a Questionnaire item |
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| Template Status |
Publication statuses for questionnaire templates. |
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| WHO Score |
SNOMED-CT bevindingen functioneringsniveau volgens Wereldgezondheidsorganisatie |
These define new code systems used by systems conforming to this implementation guide.
| Addition codes to be used with the REO Multidisciplinary Discussion at UZ Leuven |
Extra codes for the REO Multidisciplinary Discussion at UZ Leuven |
| Agent Types (Retired) |
Retired. Agent type codes previously used in Provenance.agent.type. Use http://terminology.hl7.org/CodeSystem/provenance-participant-type (code: assembler) instead. |
| Auto Generated Codes |
Tiro.health Auto Generate Codes in case common standard CodeSystems are insufficïent. |
| Example Code |
Example code for use in examples. |
| Form Activity |
Activities that can be performed on form fields and which will be tracked through provenance |
| KWS Bookmark |
A bookmark for KWS resources. |
| KWS Questionnaire Launch Context |
Additional launch context for FHIR Questionnaires launched from KWS. |
| Questionnaire Item Orientation |
Orientation of the items in the Questionnaire |
| Report Sections |
This CodeSystem defines the sections of a report as they are coded in the EHR of ExampleHospital. |
| SNOMED CT |
SNOMED CT |
| Task Input Type |
Supported inputs for Tiro.health tasks. |
| Task Output Type |
Supported outputs for Tiro.health tasks. |
| Task Type |
Supported task types by Tiro.health |
| Template Languages |
Available template languages to generate a narrative for a Questionnaire item |
| Template Status |
Publication status codes for Tiro.health questionnaire templates. |
| Tiro Questionnaire Item Control |
Custom Questionnaire Item Control codes by Tiro Health for rendering FHIR Questionnaire items. |
| UCUM |
UCUM |
These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.
| AI Clipboard Population Provenance |
Provenance for a field extracted by AI from a clinical document (contextual-populate). The entity carries the source DocumentReference and html-element-id extensions identifying the specific labeled spans used for extraction. |
| Abdominal Surgeon |
A practitioner role for an abdominal surgeon |
| Atticus AI Marking Engine |
AI engine that labels and marks clinical document HTML content for extraction. Backend reference: Device/4. |
| Atticus AI Population Engine |
AI engine that extracts answer values from labeled clinical document content (contextual-populate). Backend reference: Device/5. |
| Atticus FHIRPath Engine |
FHIRPath expression evaluation engine. Referenced as Provenance.agent.who when initialExpression or calculatedExpression is evaluated. Backend reference: Device/1. |
| Atticus Population Engine |
Population engine that applies initial values, evaluates definitions, and handles repopulation. Backend reference: Device/2. |
| Atticus Preset Engine |
Preset engine that loads saved preset configurations onto form fields. Backend reference: Device/3. |
| Blood Pressure (formatted input) |
Text field for Blood Pressure which decomposes automatically into Systolic and Diastolic components |
| Blood Pressure (grouped input) |
Blood Pressure with Systolic and Diastolic components |
| Bookmark Snapshot |
A snapshot of KWS bookmarks |
| CM Stage |
CM Stage Observation. |
| CN Stage |
CN Stage Observation. |
| CT Stage |
CT Stage Observation. |
| Calculated BMI |
Example questionnaire demonstrating calculated expressions for automatic BMI computation. |
| Charlson Comorbidity Calculator |
Library to calculate the Charlson Comorbidity Index |
| Clinical TNM Stage |
Clinical TNM Stage |
| Conclusion Questionnaire |
A questionnaire to conclude the report. |
| Contextual Populate Request |
Example contextual-populate request supplying a clinical DocumentReference as AI context. The AI marking pipeline extracts field values and returns one FormProvenance per populated item. |
| Contextual Populate Response |
Example $populate response for contextual-populate mode. Includes the populated QuestionnaireResponse and one FormProvenance entry per populated field. In practice, provenance is repeated once per field. |
| Definition-Based Import Provenance |
Provenance for a field populated by matching Questionnaire.item.definition to a FHIR Observation. The backend sends both #definition and #data-import as tiroActivity codings. |
| Demo Patient |
Patiënt for illustration purposes. |
| Diagnose datum |
Datum waarop de diagnose is gesteld. |
| Dr. Hause |
Example medical doctor specialized in urology/oncology |
| Dr. Pauwels |
A practitioner named Dr. Pauwels |
| Dr. Pneumologist |
Example medical doctor specialized in urology/oncology |
| Dynamic Practitioner Lookup |
Example questionnaire demonstrating dynamic answer options populated from a FHIR server using x-fhir-query. |
| Example Clinical Document |
Stub DocumentReference representing a referral letter, referenced by the AI clipboard provenance example |
| Example Hospital |
This is an example hospital. |
| Example Practitioner |
Stub Practitioner referenced by provenance examples |
| Example QuestionnaireResponse |
Stub QuestionnaireResponse referenced by provenance examples |
| Example Report Template |
Report Template represented as FHIR Questionnaire with references to sub-questionnaires that represent building blocks of the report. |
| Example Table |
An example table. |
| FHIRPath Calculation Provenance |
Provenance for a field computed by the FHIRPath engine from a calculatedExpression |
| FilledReport |
A filled report. |
| Follow-up after TURB |
Percentage of patients with a TURB procedure for bladder cancer who have a MOC or Follow-up containing anatomical pathology report with a diagnosis of bladder cancer within 6 months after the TURB procedure. |
| Initial Report |
An initial report to be filled in. |
| Input Component Library |
Library of reusable input controls and input groups for FHIR Questionnaire items |
| Jan Jansens |
A patient named Jan Jansens |
| Jan Jansens Contact |
An ongoing encounter with Jan Jansens |
| LCaStaging Composition |
Composition containing the Lung Cancer Staging Report. |
| LCaStaging Template |
Questionnaire for Lung Cancer Staging. |
| LCaStagingResponse |
QuestionnaireResponse for Lung Cancer Staging. |
| Lung Cancer Patient |
Example patient that is diagnosed with lung cancer. |
| Lung Cancer Staging |
Lung Cancer Staging Condition. |
| Lung Cancer Staging Encounter |
Example encounter where a patient has a lung cancer level. |
| Lung Cancer Staging Report |
Bundle containing the Lung Cancer Staging Report including the QuestionnaireResponse and related resources. |
| Metastasis |
Metastasis Observation. |
| Multiple Choice Example |
Questionnaire demonstrating the use of multiple choice questions defined as seperate items. |
| Multiple Choice Response Example |
Questionnaire response demonstrating the use of multiple choice questions defined as seperate items. |
| Nested Answer Horizontal |
This is an example of a nested answer horizontal question. |
| PCA PSA |
PSA Measurement observation |
| PCA PSA |
PSA Measurement observation |
| PCa EAU Risk Group |
EAU Risk Group observation of the prostate tumor. |
| PCa Gleason Score |
Gleason Score observatoin |
| PCa T Stage |
Clinical T Stage observation of the prostate tumor. |
| PD-L1 Expression |
PD-L1 Expression Observation. |
| PSA |
PSA is a measurement of the prostate specific antigen in a blood sample. |
| Patient Identifier |
A system for identifying patients in the ReportServer. |
| Population Request (pre-populate) |
Example pre-populate request: evaluates initialExpression and item.initial at form launch. |
| Pre-populated Patient Demographics |
Example questionnaire demonstrating pre-population of patient data using FHIRPath expressions and variables. |
| Preset Population Provenance |
Provenance for fields populated from a saved preset configuration. The backend sends both #preset and #static as tiroActivity codings. |
| Prostate Cancer |
Patient is diagnosed with prostate cancer. |
| Prostate Cancer MDT |
Defines the set of resources to created during the MDT Prostate Cancer. |
| Prostate Cancer Patient |
Example patient that is diagnosed with prostate cancer. |
| Prostate Cancer Staging Composition |
Example of a Composition from a Prostate Cancer Staging report. |
| Prostate Cancer Staging Report |
FHIR Document containing all resources related to the Prostate Cancer diagnosis for PCaPatient by Dr. Hause. |
| QuestionnaireWithBookmarks |
A basic questionnaire with launch context referring to bookmarks. |
| REO Previous Problem |
Previous problems overview for REO Multidisplincary Discussion |
| REO Previous Therapies |
Previous therapies overview for REO Multidisplincary Discussion |
| Raised PSA Encounter |
Example encounter where a patient has a raised PSA level. |
| Raised PSA diagnosis |
Patient is diagnosed with raised PSA. |
| Report Population Bundle |
A bundle containing a resources to populate the report. |
| Response |
A response to the questionnaire. |
| SACQ |
Self Administered Comorbidty Questionnaire |
| Session |
A session to launch a questionnaire. |
| Smoking Status |
Smoking Status |
| Subcribe to All Reports |
This subscription triggers an event when a report is updated and the extraction of FHIR resources has completed. |
| Subcribe to Single Report |
This subscription triggers an event when a specific report is updated and the extraction of FHIR resources has completed. |
| TNM Stage Group |
TNM Stage Group Observation. |
| Table Layout Renderer |
Render library to render a FHIR Questionnaire in a table layout |
| Tree Layout Renderer (Version 3) |
Render library to render a FHIR Questionnaire in a tree like question-answer layout |
| URS because of TCC |
Ureterenoscopie because of a TCC |
| URS because of TCC |
Ureterenoscopie because of a TCC |
| URS because of TCC |
Uretorenoscopy because of a TCC |
| URS because of TCC |
Uretorenoscopy because of a TCC |
| User Input Provenance |
Provenance for a field manually entered by the treating clinician |
| Validated Measurement Input |
Example questionnaire demonstrating validation extensions: entryFormat, minValue, maxValue, maxDecimalPlaces, and regex. |
| Value Set With Expansion Score |
This value set has an expansion with scores for each code. |
| Value Set With Pre Expand Flag |
This value set has a flag to indicate that it has been pre-expanded. |
| WHO Score |
Functioneringsniveau volgens Wereldgezondheidsorganisatie |
These are resources that are used within this implementation guide that do not fit into one of the other categories.
| Report updates |
This topic triggers an event when a report is updated and the extraction of FHIR resources has completed. |