Narrative

$10 / year

Any resource that is a domain resource may include a human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. If narrative is present, it will reflect all content needed for a human to understand the essential clinical and business information otherwise encoded within the resource. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Complexity

The narrative for a resource is allowed to contain additional information that is not in the structured data, including human-edited content. Such additional information shall be in the scope of the definition of the resource, though it is common for the narrative to include additional descriptional information extracted from other referenced resources. Narrative for a resource should include summary information about any referenced resources that would be required for a consumer of the resource to be able to understand the key, essential information about a resource without retrieving any additional resources. For example, the narrative for a MedicationOrder might include brief summary information about the referenced patient, prescriber and medication. Some resources (e.g. List, Composition) may provide specific rules about what content must (or must not) be included in the resource narrative. Consideration should be given to the fact that referenced resources may be updated without updating referencing resources, so the proportion of content of a referenced resource included in a referencing resource should be limited. Systems may choose how narrative is generated, including how much de-referencing to perform, but should not assume that the resource is rendered in any particular context when generating narrative, since resources will be used in multiple contexts.

Resources should always contain narrative to support human-consumption as a fallback. Structured data should not generally contain information of importance to human readers that is omitted from the narrative. Creators of FHIR resources should not assume that systems will render (or that humans will see) data that is not in the narrative. However, in strictly managed trading systems where all systems share a common data model and additional text is unnecessary or even a clinical safety risk, the narrative may be omitted. Implementers should give careful consideration before doing this, as it will mean that such resources can only be understood in the limited trading environment. Closed trading partner environments are very likely to open up during the lifetime of the resources they define. Also, many workflow steps involving finding and aggregating resources are much more difficult or tedious if the resources involved do not have their own text.

Fast Healthcare Interoperability Resources (FHIR) is a draft standard describing data formats and elements (known as “resources”) and an application programming interface (API) for exchanging electronic health records. The standard was created by the Health Level Seven International (HL7) health-care standards organization.

Its goal is to facilitate interoperation between legacy healthcare systems, to make it easy to provide healthcare information to healthcare providers and individuals on a wide variety of devices from computers to tablets to cell phones, and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.

FHIR provides an alternative to document-centric approaches by directly exposing discrete data elements as services. For example, basic elements of healthcare like patients, admissions, diagnostic reports and medications can each be retrieved and manipulated via their own resource URLs (Uniform Resource Locators). FHIR was supported at an American Medical Informatics Association meeting by many EHR (Electronic Health Record) vendors which value its open and extensible nature.

Date Created

2018-09-20

Last Modified

2018-01-01

Version

4.0.1

Update Frequency

Annual

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs; Health Level Seven International;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

FHIR, HL7, Medical Terminology, Processes Data, Processes Information, Processes Documentation, Health Information Exchange, Electronic Health Records, FHIR Smart, Smart on FHIR

Other Titles

FHIR Narrative Resource, Electronic Health Records Exchange Through FHIR

NameDescriptionTypeConstraints
Concept_NameName of the concept in the FHIR structurestringrequired : 1
Computer_Ready_NameA Computer-ready name (e.g. a token) that identifies the structure - suitable for code generation. Note that this name (and other names relevant for code generation, including element & slice names, codes etc) may collide with reserved words in the relevant target language, and code generators will need to handle this.string-
TypeThe type the structure describes.string-
Dollar_RefThe Dollar_Ref ($ref) string value contains a Uniform Resource Identifier (URI) which identifies the location of the JSON (JavaScript Object Notation) value being referenced.string-
DescriptionA free text natural language description of the structure and its usestring-
ItemsThe value of the keyword should be an object or an array of objects. If the keyword value is an object, then for the data array to be valid each item of the array should be valid according to the schema in this value.string-
EnumThe enum is used to restrict a value to a fixed set of values. It must be an array with at least one element, where each element is unique.string-
RequiredThe value of the keyword should be an array of unique strings. The data object to be valid should contain all properties with names equal to the elements in the keyword value.string-
Concept NameComputer Ready NameTypeDollar RefDescriptionItemsEnumRequired
Narrativeid#/definitions/stringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
NarrativeextensionarrayMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension there is a set of requirements that SHALL be met as part of the definition of the extension.{'$ref': '#/definitions/Extension'}
NarrativestatusThe status of the narrative - whether it's entirely generated (from just the defined data or the extensions too) or whether a human authored it and it may contain additional data.['generated' 'extensions'
Narrative_status#/definitions/ElementExtensions for status
Narrativediv#/definitions/xhtmlThe actual narrative content a stripped down version of XHTML.
Narrative['div']
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