Hacker News Reader

Hi, is your CDR storing clinical data as FHIR objects natively?

Yes it is! As we’ve worked with users, we’ve been continually impressed by how the FHIR spec handles complex real-world use cases. Because of this flexibility, we made the decision to store FHIR natively, rather than roll a custom schema under the hood and convert to FHIR on the fly.

> we’ve been continually impressed by how the FHIR spec handles complex real-world use cases

what's an example?

One of the most complex Medplum projects is a large multi-party lab integration. We followed the US Core Lab Profile (https://hl7.org/fhir/us/core/StructureDefinition-us-core-obs...). We not only represented the labs results in FHIR (ServiceRequest, Observation, DiagnosticReport), we also represented the full lab catalog (ObservationDefinition, ActivityDefinition, PlanDefinition).

Time after time, stakeholders would raise new requirements -- how do we model pregnancy status? how do we model multi-step lab tests? how do we model contextualized reference ranges? Time after time, the FHIR schema had a clear answer.

That goes a long way to simplifying and streamlining multi-party integrations, and cuts out a lot of wasted time trying to reinvent everything from scratch.

Reply on news.ycombinator.com