How to model Patient flowsheet in HL7 FHIR

1. Overview

Recently I am working on the HL7 FHIR information model to represent patient flowsheet for the purpose of integration with one EMR vendor product, the EMR vendor also does not have information and model to represent patient flowsheet, though the reading is represented using Observation resource.

I searched FHIR chat group, there is also no specific implementation guideline on patient flowsheet, thus I have proposed the following design, I welcome comment and discussion on this topic.

1) Use PlanDefinition resource to represent the flowsheet

2) Use CarePlan resource to represent the association of the selected flowsheet to the patient

3) For the Observation resource, use "basedOn" attribute to specify the specific patient flowsheet for the reading submission

Below diagram illustrates the model and relationship between the three resources

2. CarePlan resource

CarePlan resource to represent the specific flowsheet selected for the patient, the "category" attribute will be used to specify this care plan is patient flowsheet.

3. PlanDefinition resource for the flowsheet which can be selected and assigned to the patient

4. Observation resource for the patient flowsheet reading, use "basedOn" to associate wth the patient flowsheet

5. Revised Design after consultation within FHIR community

After discussion within FHIR community, the consensus is that we should use Questionnaire to represent the Flowsheet template.

Below please find the overview of the revised model (Click on the image to Zoom In)