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How to Join

Weekly Squad Call Info: Tuesdays at 3pm UTC | 8:30pm IST | 6pm Nairobi | 5pm Cape Town | 11am Boston | 8am Seattle (GCal link here)

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Talk: FHIR Project

(question) Slack Channel: #fhir

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Expectations for FHIR Squad Notes

The FHIR Squad uses the OpenMRS Wiki - Edit mode for real-time note taking. What does this mean? Everyone attending a meeting monitors and contributes to the note taking. At the start of each squad meeting, we'll ask for (or designate) a volunteer to be the primary note-taker.

Where to Find Work

Sprint Board: 

board FHIR Board

To Address Next Meeting

  • Jose CBS/CBR IG + CBS Updates
  • EMR-LIS QA and IG concept note and update from Piotr
  • Every week: FHIR Board Review
  • Facility Registry Planning

Parking Lot

(lightbulb)Things to discuss on the OpenHIE calls, outside of squad calls(lightbulb)

  • OMRS/OpenCR discussion to review issues in current integration of the 2

(info) About MITRE's SMART Health Card, their SMART Health Card spec, and SMART Health Cards Vaccination & Testing FHIR IG

Grounding Priorities

  • Identifiers (anything to help uniquely i.d. pts in CR & SHR)
  • Facility Registry Workflows: mapping with Intrahealth (OMRS to Facility Registry)
  • Info captured as Obs mapped to meds/med requests because diff OMRS implementations map to data in different ways; need to override to map to way iSantePlus maps to meds, med orders, etc
  • Address FHIR resource gaps i.d.'d for CBS for OHRI (the gaps spreadsheet)
  • Conformance testing to show system specs working with other systems that expect that behavior

  • Finalize PLIR work
  • (more tbc - Facility Registry Workflows?)

  • Support for Patient Lists (blocked?)
  • Use FHIR to generate Patient Alerts/Flags
  • FHIR support for Patient List feature
  • Representing episodes of care (using programs?)
  • tbc


Meeting Notes


Ian, Piotr, Angshu, Suruchi, Steve, Christina, Jan, Grace, Jen, Tendo


  • Bahmni standardized APIs
    • OpenMRS platform 2.1.1 -> 2.4/5 upgrade focus
    • Coarser grain API → FHIR based profiles
    • OMRS Data Model missing the following - means Obs field getting heavily used/abused!
      • Imaging (hacked up through Obs structure)
      • Microbiology (no clear model; things hacked around Obs model. e.g. the culture. Bahmni Microbi/bacteriology so flexible that from one implementation to another, approaches not useable between implementations)
      • Organizations (we have locations but no support for "Organization") FHIR doesn't mix location and organization. Coming up in facility registry workflows. (Problem for both Bahmni and UW/ITECH)
      • Referral modelling: Procedure request, Counselling request - can fit into order model - info like location being referred to. So most OMRS implementations define a form, stored as obs, converted into service request. 
        • Event simple location & referral (reference to provider or location) - can potentially model an org by location.  
  • Suggested OpenMRS FHIR IG to document what we support - use Piotr's testable approach if possible


Jose, Ian, Mozzy, Tendo, Jan, Suruchi, Ken


  • Roadmap & release?
    • Last release - August
    • GSOC work added to module
    • Most helpful - understanding of the needs out there to be met, requirements
      • FR
        • is there something we are fundamentally missing in the OMRS data model? (TAC conversation)
        • ACTION: jan work with grace to set up this conversation
        • need to come to a decision about collaborative working approach here
          • UW leads and just shares knowledge/decisions back with squad
          • UW+squad outlines work in JIRA and completes together
      • MFE support - need analysis, FHIR API v REST API
        • ACTION: jan work with jen/grace to resource this analysis
      • CBS - Ethiopia request for COVID
        • disease specific - COVID, HIV, etc
          • different country to country
        • patient resource - questionnaire - observations → fixed part of your mapping;  then customization per country
          • PATH working on what methods and tools to do the customization part
        • COVID IG - questionnaire, mapping spreadsheet
          • examples of compositions (Jembi might have this)
          • how to transform mappings
          • data elements for case report from UCSF/Jembi
          • WHO guidelines
          • intersect with COVID squad?
        • WHO FHIR IG:
        • ACTION: jan find out where ucsf/jembi are, what we can jumpstart with
        • ACTION: jose share concept note of approaching tooling/methods
      • Immunization - (not concrete ask yet, but coming)
        • digital certificates - do we store these?
        • fhir squad - how do we get these records/events in/out of openmrs
        • NO ACTION: keep conversation on the radar to include in upcoming work/release


  • Need to plan Analytics Engine pipeline vs OMRS EIP pipeline comparison call on Analytics Squad*
  • ITECH updates - review mCSD work in early Septtember
  • ITECH Needs input on how to map Org resource, otherwise would have to make specific table. 

2021-08-17: Facility Registry Implementation Guide

Attendees: Grace, Piotr, Christina, Daniel, Mozzy, Tendo

(Draft) Concept Note - Facility Registry IG

  • Goals
    • Develop an OpenHIE-specific Implementation Guide (IG) for FHIR-based implementation of the OpenHIE Facility Registry (FR) workflows.
    • Base the specifications on the IHE mCSD (mobile Care Services Discovery) Profile, as outlined in the following IG: (
    • Add test artifacts (acceptance criteria, test scripts, test data) to IG that can validate conformance with the outlined specifications.
    • Add facility workflow support in OpenELIS and OpenMRS, using OpenHIM and GoFR
    • Incorporate testable IG artifacts in OpenELIS and OpenMRS Quality Assurance Pipelines
    • Deploy developments as Instant OpenHIE laboratory package
  • A lot of mCSD approach to queries isn't supported in many LMIC contexts - idea is to focus on master facility list 
  • Need to do work on FHIR module side to support needed resources, esp. Organizations; missing mapping for Org resource in FHIR module
    • Need input on how to map them, otherwise would have to make specific table. Are there places where this is already stored, or do we need a new table to natively store the FHIR Org resource (that can support both the vanilla Org and the Facility-specific Org)
      • Next Step: Mozzy & Piotr to look into it in more detail
    • Additional work beyond the FHIR module needed: orchestration of communication transactions to go from OMRS to GoFR (Facility Registry) to OELIS
      • Would OMRS-EIP work? Maybe, but more likely to use Analytics Engine approach with Debezium since want a FHIR-based approach and use Debezium (although OMRS EIP is also based on Debezium and Mekom looking at FHIR-izing it). Also doesn't leverage OpenHIE framework/standards - does Sync between two systems directly; good if you want integration btwn 2 systems directly.
      • Next Step: Piotr & Mozzy to raise question about EIP vs AES model with Analytics Engine squad this week
  • Practitioner & Location: Practitioner done, May have to update Location resource
  • Service: not really looking at these workflows
  • Mobile Care Services Discovery (mCSD)
  • Mobile Care Services Discovery (mCSD Profile)


Attendees: Grace, Ian, Jen, Mozzy, Christina 

1 or 2 small and not so small use cases that need to be optimized, but other than that not sure what else needs to be done

review of the usage of the fhir api in 3.0 - did we make progress? No - This would be a good project for a student. Grace and Ian to meet on this. 


Attendees: Grace, Jose, Piotr, Mozzy, Jan, Ken, Steve, Christine


Debriefed Gazelle Deep Dive with IHE Services on Friday. (Recording of Gazelle Deep Dive on 7/30)

Our impression: Gazelle is more for test Management and Traceability. User builds test scripts themselves. There’s support for native fhir testing but unclear if it’s really mature enough. Currently missing Gherkin/syntax/BDD approach to setting up tests. 

IHE is looking for input to improve Gazelle. We should explore what the gaps are that we think are needed in order to meet our needs. IHE may have resources and could improve the tool.

Q: Are they providing services for pay?

IHE: Capabilities need to have test script, criteria, narrative (can be in Gherkin). Tools to execute the tests. 

Support for Analytics Engine Squad/Jembi/DISI


Attendees:Alexander Berler, Ankit, Christine Gichuki, Didi Davis, Ian, Jen, John Moehrke, Jose, Medhavi, Joseph, Moses, Piotr, Dylan, Ken, Steve

  • IHE Services introductions
  • Piotr gave a re-cap of current work on testing approach
    • John has been thinking of making this a complement IG
    • Country-specific needs, mappings may also drive/extend general test scripts
      • Do this in a way that ministries/governments can lead this
    • How do you summarize complex results so they are understandable?
      • How do you convey, communicate what we mean by quality?
    • Those writing the scripts also have a responsibility in defining what is minimally acceptable and/or expected
    • John shared test plan:
    • Next steps
      • Get something working (focusing on one part of the workflow)
      • Piotr is setting up a reference environment to run tests against, involving OpenMRS, OpenELIS, HAPI FHIR Server & OpenHIM
      • Working on a collection of postman tests on the OpenELIS side to send out to SHR
      • Moses is looking at expressing this scenario in Gherkin
      • InstandHIE has a Cucumber based test framework that they use
      • Jose offered to help look at the translation TestScript-Postman
    • Alexander brought up IHE environment already set up for OpenMRS-OpenELIS, Gazelle
      • Dylan: Doesn't currently support Gherkin scripting, don't use Postman right now
      • Action item: Set up a time to go over Gazelle and look at supporting Gherkin, how IHE does test design, planning
      • Friday, July 30th at 4pm EAT | 9am ET | 6am PT
  • FHIR Board Review
  • Squad Showcase Prep/Check In


Attendees: Ian, Piotr, Jan, Mozzy, Medhavi, Jose, Christine, Grace, Tendo, Daniel, Jen, Ken

  • EMR-LIS QA and IG concept note and update from Piotr
    • @Piotr Mankowski will be talking about testing approaches between components at the next OpenHIE DevOps call on July 12. To add this to your calendar, please click on this link and add your email as a guest.
    • Piotr, Jose, and Mozzy met last week to work on the concept note. Piotr will be working to create some tests for the workflow and see how they can be stored as test scripts, how we can represent that scenario as Gherkin scenario
    • Goal is to be consistaent with OpenHIE guidance/standards (section 4.6 of the OpenHIE Architecture) as well as OpenMRS, OpenELIS community standards
    • Take the guidance and test an Order Laboratory Test workflow - show that the approach is feasible and can be used for testing
    • Each individual transaction that relate to each service/system will need to be tested
      • OpenMRS responsible for testing transactions specific to OpenMRS, same with OpenELIS.
        • Creating a lab order in OpenMRS is not one thing
      • OpenHIE is the glue that brings the QA done by GG actors - defines actors & transactions, makes them available via the IG. Specify the resources to be used.
    • Work backwards to define what is piloted
    • Feedback on concept note, work being done is welcome.
    • Piotr will provide updates
    • Ian: not possible to go directly from a test script to Gherkin. Will need to figure out how to express this in Gherkin.
  • Jose CBS/CBR IG + CBS Updates
  • Every week: FHIR Board Review
  • Next week's squad showcase
  • FHIR2 Module roadmap


Attendees: Piotr, Jen, Ankit, Ian, Cliff, Daniel, Grace, Lars, Suruchi, Medhavi, Moses, Christina, Maurya, Mr. Brian

  • PLIR TX_CURR POC demo from Cliff
  • PLIR non-technical documentation
    • How does this actually solve problems on the ground.
    • Cliff to have draft ready for review by the end of this week, finalized by next FHIR Squad meeting
  • Every week: FHIR Board Review
    • FM2-347 more work to be done on comments for review
    • FM2-367 on hold 
    • FM202- on hold
    • FM-195 - held up for FM 202
  • There is a whole epic that is not included - the work Medhavi is doing - Ian will get those epics on the board 


Attendees: Piotr, Ankit, Daniel, Jan, Medhavi, Moses, Suruchi, Jose, Lars, Cliff, Tendo, Maurya, Steve, Ken

  • FHIR Board Review
    • Botswana EMR-LIS IG
  • PLIR status check in
    • Cliff has been working on TX_CURR and is putting together a video. He'll demo this next week.
    • Cliff and Moses are working on non-technical + technical documentation. Aim is to share draft by next Tuesday. See Talk discussion for details.
  • Testing Approach
    • Outline of workflow
    • Questions:
      • How do we integrate a standard representation of test batteries with actual testing tools like cucumber studio / postman / etc.?
      • How do we differentiate between generic tests that can be stored as part of the IG and system-specific tests? Should IG testing only focus on system-system aspects, like between an EMR and LIS? EMR and SHR/MPI?
      • Can we create tests in a generic way so that they can be run with multiple testing tools?
    • Test data: Jose shared points from discussion about synthetic data
      • Use the IG to trigger Synthea
      • Jose will follow up with Carl about timelines for similar work (possibly under TAP)
    • Practical outline of an idealized testing workflow using an IG


Translate priorities into Epics; Assign tech lead to each 

Attendees: Christina, Piotr, Ian, Jennifer, Daniel, Grace, Joseph, David, Suruchi, Tendo

  • JIRA board review (
    • FM-367 is being de-prioritized - moving from using the base openmrs cohort to a module that uses cohort 
    • Lab Workflow
      • Lots of work on Botswana side, but enhancements need to be pulled back in
      • Profiles derive from IPS profiles
      • Talk more about it next week
    • FM-323 - DONE - ticket canceled (PLIR project finishing
    • SMART on FHIR tickets - GSOC project 
    • FM2-375 - Close ticket (OpenCR-specific)
    • TX_CURR sprint started by Cliff (PLIR-TX_CURR Epic)
    • Facility Registry Workflow- no tickets added yet, just a placeholder
    • Updated to HAPI FHIR 5.4.0
  • PLIR
    • Work coming to an end this month
    • Jen working on draft for final report (due 23 June)
  • IHE Europe Connectathon
    • Happening next week
  • Monthly OpenHIE DevOps call on 7 June


Attendees: Christina, Piotr, Ian, Jan, Ankit, Medhavi, Lars, Suruchi, Mozzy, JJ, Grace, Kaweesi



  • JIRA board update (
  • Grounding Priorities
    • Review of current list of grounding priorities: Grounding Priorities
    • AMPATH priorities
    • UCSF priorities
  • Discussion about JIRA Epics and Release Schedule
    • How should we manage the work on each Epic?
    • Distributed model: Should a certain person and group be responsible for a given Epic? (TPM plays part in coordinating)
      • In MF Squad, feature epics are usually owned by the lead dev, that names the Epic and creates the tickets required to complete it.
    • Centralized model: Should we instead have a single lead person or set of people who would manage Epics for the squad? Responsibilities: pulling out what is required, bringing discussions to the squad, and managing the required resources to be able to do the actual work.  (a more active TPM/PM )
    • Hybrid approach: Depending on the scope of the Epic, it might make more sense to use one model or the other, or some hybrid of both.
    • Overall, we're basically trying to document what our workflow has been like in the FHIR2 squad
  • Review of Epic board to confirm technical ownership
  • Testing


Attendees: Christina, Piotr, Jose, Mozzy, Cliff, Bett, Daniel, Esther, Grace, Ian, Kaweesi, Lars, David, Stanlaus, Tendo


  • Announcements:
    • Digital Square FHIR® Profiling & Documentation Webinar (Jose is presenting!)

      May 26, 2021 | 8-10 am ET/ 2-4 pm SAST/ 9-10 pm SGT Register here

  • Jose CBS/CBR IG + CBS Updates
    • Discussions with Jembi on HIV, no updates on CBS
  • Testing:
    • Jose is pursuing the technical implementation of this. Discussed with Lloyd
    • Missing link: linking test script to the artifacts, nothing conceptually new - need examples
    • Piotr talked to OpenHIE about their approach to testing, overlap with Jose's ideas
    • Jose has also spoken with John at IHE
    • Work more on concrete examples
      • Test driven development/specifications
    • TODO: Piotr will present this at next week's call
  • Review of HL7 Belgium Way of Working
  • LIS EHR FHIR Implementation Guide updates from Piotr
    • Walkthrough of LIS-EMR FHIR IG for Botswana, based on previous LIS-EMR guide, OpenHIE guide
  • Updates: Grounding Priorities
    • Intellisoft Priorities
    • UCSF Priorities
  • FHIR Board Review


Attendees: Ian, Jen, Grace P, Ankit, Cliff, Bett, Daniel, Esther, Ian, Jan, Joseph K, Medhavi, Stanslaus (PATH), Piotr, Suruchi, Tendo

  • Reviewed grounding priorities of Implementers in squad
  • Created OpenHIE Topics Parking Lot (top of the meeting notes page)
  • Welcome:
    • Stanslaus from PATH
    • Ankit & Medhavi: Selected as GSOC students for FHIR-related projects!
  • TODO: Next week: Updates on Intellisoft & PATH fhir-related priorities to come next week. 
  • TODO: Next week: LMIS EHR FHIR Implementation Guide updates from Piotr
  • FHIR Board Review
    • Ian working on Immunization Resource this week → unblocks next FHIR release soon (smile) 
    • FHIR Client Support completed


Attendees: Christina, Jen, Ankit, Bashir, Daniel, Esther, Medhavi, Tendo, Moses, Kaweesi, Brian, Patric, Suruchi


Dev Updates

  • 365: Ankit: This can be closed
  • 373 & 362: Medhavi: both have been completed and closed.
  • 347: Moses reviewed this with Cliff. Still in progress.
  • Mozzy: has been working on a testing approach for PLIR and spinning up a Dockerized instance of PLIR.


Attendees: Christina, Ian, Jen, Ankit, Bashir, Daniel, Esther, Grace Bish, Medhavi, Patric, Maurya, Tendo, Jan, Moses, Kaweesi, Lars


  • Board Review (and Epic Name updates)
    • Update Epic name to reflect problem. Aim: communicate what the epic is trying to solve
    • 347: Cliff is still working on this
    • 356: Still in progress
    • 365: Ankit waiting on Ian's reply
    • Sprint
  • Jose CBS/CBR IG + CBS Updates
    • Sent a draft for making IGs testable
  • Discussions for General Module 2 Improvements
    • FHIR module is slow in some cases (esp with high volume of data). This is killing the patient list feature.
    • Ian proposed cacheing idea
  • FHIR Pipeline discussion (PLIR - CBS - Analytics-Musoke OHRI request harmonization)
  • System field for identifiers discussion
    • Problem: Make sure we can differentiate between patient identifiers. How do we get the URL information into the system?
    • Possible approach is similar to cases (concepts) where we need FHIR specific table
    • Separate from global property setting
    • Timeline dependant on having someone who can take this on
  • FHIR Module vision / priorities on the wiki
  • Cool kids update for testing approach
  • Schedule for Lab FHIR IG overview - no updates this week



Attendees: Christina, Lars, Jose, Mozzy, Ian, Jen, Ankit, Tendo, Jan, Daniel, Bett, Piotr, Medhavi, Bashir, Cliff, Grace


  • Mozzy dockerization demo - PLIR updates
    • openmrs - openhim - hapi fhir as SHR
    • PLIR widget for visualizing the fhir measure resource (rather than using postman)
    • Add patient to openmrs -< resource exported to HAPI - query to show patient record → widget shows 0 for indicator b/c no observations; go back and add obs → now indicator is 1
      • now add pt with suppressed VL value, see a change in the denominator 
      • is there a way to add a "description/def" to the result page of the widget (for those viewing the demo to understand what the indicator is)?
      • automated testing / validation
    • Next steps:  most of the deliverables are completed, need to work more closely with analytics
      • OHRI data load into another HAPI FHIR instance - can we align with OHRI?
        • A good point of the idea behind the PLIR POC was to also develop a model for loading data into a HAPI server.
        • Bashir - 
      • recent update in HAPI → point to IG?
        • we would need to standardize our efforts and work off an IG (shall contain X,Y etc)
        • config file in HAPI before deploying you change the yaml file to point to package ID of IG, operation defs and structure defs and mappings in IG will be contained in HAPI
  • New member to the squad - Lars from UCSF
  • Board Review
    • Patient Lists (Bett) - unable to make progress due to an upgrade, coming week will be working on a few issues - will be creating more tickets and working on them
    • Creating Encounters (Medhavi and Piotr) - work is pushed today and needs someone to review (Ian)
    • MFE (Cliff and Ian) - in code review, incorporating feedback from Ian
    • MFE API review (Christina and Jan) - need help
    • Lab IG (Piotr) - ongoing with Botswana project, havent done much directly recently
      • ACTION: schedule for overview on FHIR squad call in 2-3 weeks
    • FHIR Clients (Ian) - pending, no update
    • SoF (Ankit) - ready for Ian's review
    • General - still on hold, need feedback, add to agenda items for next week
  • DELAY - System field for identifiers discussion
  • DELAY - FHIR Module vision / priorities on the wiki
  • DELAY - CBS updates (next week Jose IG overview)
  • DELAY - Cool kids update for testing approach


Attendees: Christina, Jan, Ian, Bashir, Ankit, Matthew Dickie (JEMBI), Piotr, Tendo, Daniel, Jose, Cliff, Medhavi, Grace P

Regrets: Jen on leave

  • Introduction of new member: Matthew Dickie - JEMBI Dev/BA
  • Dev board review
    • Patient Lists - Bett
    • Encounters - Piotr + Medhavi
      • Ian made the fixes, merged
    • MFE
      • Ian - Immunization resource still in progress, PR documenting progress 
        • History - Dimitri committed a version that works maybe, but might have some gaps
        • Integration tests - simulates sending a request to FHIR2 module, then running it through to the db, translating to FHIR resources, verifying/validating
        • Jose - are we looking at registration event, or is it more like "read" for smart vaccine cert
          • working with IHE Pharm WG - implementing profile for immunization reg event (there's a Belgian model that Jose is comparing it with, no draft yet)
          • IHE not working on the passport/cert - includes QR codes, etc (Carli at PATH working on those)
    • Lab IG - Piotr, no progress
    • FHIR client - no updates, Dickinson college project (small request at times in the community, but not high priority)
    • SoF - Ankit waiting on Ian's reply on github
    • General
      • FM2-163 support for FHIR resources (really keep the FHIR2 module from halting when loading new modules into OpenMRS)
        • move back to in progress, still looking for solution (priority: nice to have)
        • problem: if you load new module while running, fhir2 module will stop working
        • effects MFE specifically
        • reassigned to Daniel with Ian+ Piotr assisting
      • FM2-373 system field for identifiers - Piotr
        • stalled on iSantePlus side b/c using slightly modified version of FHIR2 module
        • ACTION: Needs discussion about how to set the system field (where do we fit this in?)
    • Board Issues
      • No way for folks outside of the squad to know what the priorities
      • ACTION: Talk with Grace - can take a look at how to set up a "product vision" on the wiki for folks to be able to view
  • DELAY - Demo of pre-configured dockerized setup (Mozzy)
    • delay until next week to view something that he's working on this week (per Ian)
  • CBS for OHRI
    • Minimum data set completed by UCSF
    • Jembi mapped MDS to FHIR resources needed
    • Ian+Grace mapped to what the FHIR2 module currently supports+needs more discussion/assigned
    • Mapping & Comments Spreadsheet:
      • Items for discussion before slating the work
        • "needs curation" - needs discussion about how to support the structure in OHRI
        • marital status - recorded as obs, so needs custom work to map into attribute on patient record, could use SNOMED codes
        • ward/div/commune - no FHIR mapping available
        • - have a way to specify relationships in openmrs, but its free text - hard to convert to coded relationship to convert to FHIR; often captured as obs
      • Jose - mapping is really important here
        • formal mapping - jSON file of FHIR concept mapping
          • Piotr - and they should be computable
          • Jose - FHIR analyzer, mandatory fields with how they should be filled in
          • Matthew - set up template on how to map things, 
            • some of these things may map neatly, others need a bit of transformation, may need a prefix/suffix/dateformat changes - template should reflect those
        • ACTION: need a field for OpenMRS data elements (Ian, Jan, Grace discuss approach to this)
        • ACTION: need to hone in on discuss and needs curation (Ian, Jan, Grace discuss approach to this)
        • ACTION: Matthew to check on his time to start working on the initial ideas for doing the formal mapping
  • DELAY - Testing against standards re:cool kids update (mozzy, jose, piotr) 
    • continue focus on this


Attendees: Christina, Jan, Grace, Jen, Ankit, Jose, Maurya, Piotr, Bett, Bashir, Tendo, Mozzy, Medhavi, Cliff, Joshua, Ken

  • JIRA Board → 
    •  Sprint got accidentally closed?
    • Dev Updates 
      • Encounters
        • Piotr has 2 PRs to complete addressing reviewer comments (one encounters - period and type additions)
        • Medhavi has the day/time field missing for 352 to be completed
        • What happens now?
          • Does it get released?  What is our release process/plan for when we decide to do it?
            • Ian planning to include this and bug fixes soon
            • Historically ended up in the main branch that weren't ready, b/c folks write unit tests but don't do integration tests
            • Release candidate:  
          • What is the QA process around this?
            • Ian currently releases when he "feels confident" that everything is ready and works....
            • Integration testing - CI testing/automated
            • How do we align/leverage the QA team guidelines/direction?
              • Mozzy - scripting technologies around testing
              • Ian - we are doing something like this with OCL
              • Piotr - structured testing packages with specifications, based on conversation with Jose
              • Jose - some testing guidance/scripts should/might be included in the IGs - specifcially referring to the CBS/CBR work
            • ACTION: over the next couple of week sub-group (aka "cool kids") will work on a proposal of a more structured systematic approach to testing against standards, etc 
              • Mozzy, Jose, and Piotr
          • Who is the target driver of this priority epic - and can we have them do acceptance testing on this?
            • AMPATH + Analytics engine squad, but mostly generalizable
            • don't necessarily need the acceptance testing for this epic
      • PLIR (Cliff)
        • update - setting up dockerized instance for test
        • Mozzy looking at frameworks for PLIR testing
        • Is there a reason we don't have tickets for this work?  Currently in the infra board, not sure why some of the tickets don't appear in the FHIR board (Grace: add to the PLIR epic)
      • Smart on FHIR GSOC (Ankit)
        • 365 still in progress, Ian just reviewed PRs and Ankit now needs to address the comments
      • FHIR Client Service
        • 357 is a team of 3 people who are writing some tests for it
      • Patient Lists (Bett) - no progress this week, update next week
      • MFE support
        • Cliff - did some mappings for 347 and waiting for review from Ian
        • Immunizations - Ian - working on integration tests and re-fixing all the code, not ready for code review
      • LIS-EMR FHIR IG (Piotr) - still in progress
      • General
        • System Identifiers
          • ACTION: make this an agenda item for next week so we can assign it
          • important for the HT work, but others expressed interest - Piotr assigned himself to it
          • increase priority ticket to "must", and explanation that this is for a real implementation (re: acceptance testing!)
          • 163 (Ian) no progress
          • 375 (?) should this even live in the FHIR module? 
            • forcing name to be official is in the FHIR spec, but important for the exchange with MPI - so might need to live in MPI Client Module
            • incorporate legal name flag into core?
            • ACTION: add this to agenda - demo solution in MPI module
  • CBS/CBR FHIR IG update from Jose
    • still adding resources, testing approach to the IG - not much progress this week from last week
  • PLIR / DASH connect the dots
    • Demo for preconfigured Dockerized instance of PLIR -
    • ACTION: Mozzy will do next week


Attendees: Christina, Jan, Jen, Daniel, Domou, Mozzy, Jose, Tendo, Medhavi, Bashir, Ankit, Kenneth, Steve, Cliff, Ian, Grace, Ankit

  • JIRA Board → 
    • Encounters
      • Medhavi - in code review stage but for one issue
      • FM2-352 blocked: day/time field causing error when creating encounter - need 366 (Piotr) to be merged in order to proceed on 352
    • General Issues (Ian)
      • FM2-163 FHIR module causing errors on MFE (need label to be added to board)
      • How-to add label to issue in JIRA → Edit issue, select Sprint (it will show you which projects hold which sprints)
      • PR reviews
    • Tendo
      • FM2-130 Mapping - Ian will review PR today
    • PLIR (Mozzy)
      • Automating more tasks for the docker set up to integrate into the automated framework,
      • Preparing PLIR demo for squad showcase
    • Cliff
      • FM2-347: implementing a search parameter for servicerequest and observation resources - waiting for PR review
    • Ankit
      • FM2-371 and 365: Smart on FHIR module, started encounter support 
    • Christina and Piotr
      • No support for systems within identifiers - outside of use category there is no way to select an identifier
      • Not sure if Piotr created a ticket for it - he updated to include support for system within each identifier
      • Ian: sending identifiers w/o system b/c there is no way to systematically determine URL without user inputting something
      • Ian: Need an implementation identifier, because IDs are relative to implementation or a national standard - context specific
      • Ian: instance of implementation ID in OpenMRS, but it's not normally filled out
      • Jose: wanted a map to see who is implementing what, needed a system identifier (this is related)
        • could this be a FHIR resource (yes)
        • device resource → can we utilize this? placeholder for application ID
          • christina: how is this populated when FHIR module loaded in implementation?
          • capabilities statement if published?
    • CBS updates (Jose)
      • case reporting IG is up, still adding features:
      • Want multi language content
      • to-do: e2e sample - custom format mapping to q-r, q-r extraction to FHIR resources, structure and definition, measures
      • Future discussion/CBR Overview (preferably with Jembi):
        • share case reporting background, IG model/map,
        • highlight where OpenMRS fits in
          • PLIR work - possibly a foundation?
      • Jose to provide update next Tuesday, presentation+discussion the following week or scheduling as he is ready - should probably include JEMBI as they are also part of this work
    • How do folks get access to JIRA board? 
      • Need OMRS Jira account (who do they contact to get that?)
        • Request an account at OpenMRS helpdesk.
        • In the Summary text box, state that you would like to have edit access to wiki and JIRA.
        • Submit the helpdesk request.
  • Squad Showcase Presentation
    • Grace: FHIR first messaging
      • Decision to start a new FHIR2 module - story of evolution
        • What does it mean to get to FHIR first?
          • House a FHIR data model? Dynamically map to FHIR?
        • why fhir-first model?
          • export from OMRS that can be used directly by other systems
          • clear guidance on kinds of entities and objects in health data in your EMR (not making it up - using external expertise to guide our model)
          • reduce mental burden by providing basic building blocks
            • re-usable pieces 
          • fhir provides a search API - easier in FHIR, much harder in the current OMRS API
          • jose: not so ambitious to have everythign based on fhir, but whatever we do from now on, the first thing we look towards is 'can it be done in fhir'.... rather than meaning all is on fhir, just that our roadmap is on fhir
        • where do people go to take a look at things? when do we recommend each of the following?
          • FHIR API wiki page
            • not just theory - using this for MFE
            • call out work on OpenELIS integration, SHR, OpenCR
          • FHIR module code repo - shouldn't need to touch this, unless they need to change the way we are mapping to FHIR, should just need to install mostly
  •  Documentation



Attendees: Christina, Ian, Jan, Jen, Grace, Bashir, Kaweesi, Cliff, Bett, Piotr, Patric, Tendo, Medhavi, Jose, Domou, Daniel, Ankit


  • Agenda:
    • Community meeting and squad showcase
    • PLIR Update
    • Updates on patient lists and flags
    • Case based reporting needs
  • Community Meeting and Squad Showcase
  • PLIR update
    • Finalizing the libraries 
    • currently working on a testing framework that can validate the data extracted into FHIR
      • looking at scripts like being used in the analytics engine
      • also looking at testing frameworks that support HIE
    • Atom feed and debezium for Bahmni
      • which path will be used? currently  atomfeed client within bahmni
    • Can Mozzy do a PLIR presentation for the community meeting?
  • Updates on patient lists and flags
    • there is an implementation for the flag resource - almost complete
    • support for flag resource and those that depend on the implementation will be separate
  • Case based reporting needs 
    • UCSF has min data set and curating terminology standards - such as in the CIEL dictionary
    • This is driven by OHRI (OpenMRS HIV Reference Implementation)
    • Will be in a pipeline with the DISI (data integration strategy) workstream being led by JEMBI
    • FHIR questionnaire/response approach? - to go to SHR
    • Jose: Case reporting FHIR IG
      • Key features, longitudinal wide but not heavy
      • Translation of questionnaire
      • Transformations out of a bundle
      • Measures for indicators
      • Maybe DQ, provenance, etc
      • Includes testing, semantics, consistency in use of resources
    • What about timelines for FHIR2 updates needed to feed into OHRI to be in compliance with FHIR IG


Attendees: Ian, Bashir, Joachim, Ankit, Christina, Daniel, Grace Nakiguli, Grace Potma, Jan, Jen, Jessie Anker, Bett, Joseph Kaweesi, Medhavi Srivastava, Moses, Patric, Piotr, Sri Maurya, Tendo


What we want out of this call:

  • Review the FHIR Board (
  • Begin discussions around support for CBS/Case Reporting

FHIR Board Review

  • Use epics to track larger pieces of work, documentation
  • Current Priorities:
    • Patient Lists for OpenMRS - by Bett from AMPATH
    • Support creating Encounters - by Medhavi 
      • Allows to create Encounters via the FHIR API. So FHIR Encounters are mapped to OMRS Encounters; adding in bit of metadata to differentiate them. Close to being merged. 
    • Microfrontend Support - by Christina & Ian
      • Christina to go through 3.0 Demo to i.d. where REST API is being relied on instead of the FHIR API; log those gaps as tickets and begin work on those.
    • Lab Workflow - documentation ongoing by Piotr from ITECH
    • Support for FHIR Clients - 
    • FHIR2 Module Improvements
  • Christine will add tickets/address gaps
  • Process: managing prioritization, assignments, documentation
    • Prioritization
      • Will have overlapping work/complex dependencies across epics
      • Linking tickets - something to try
      • Talk through dependencies
      • Look at short list every week - this should reflect current priorities
    • Delegate assignments on each call
    • Documentation:

2021-03-16 Squad Call

  • What we want out of this call:
    • Clarity on FHIR Squad roadmap
    • Explore using FHIR IGs to capture FHIR module capabilities
  • Squad note-taking conventions
    • Take the notes in real-time on the OpenMRS Wiki
    • Bold key points, action items, key decisions
    • Note taker: start each call by asking for a note taker. No volunteers = someone is voluntold
  • Roadmap
    • New FHIR module release
      • Subscriptions will not be in the next release
      • Need to be able to create resources for lab orders, med orders, encounters, visits
      • FHIR-based patient lists
    • Role of FHIR module vis a vis FHIR Squad
      • FHIR module is the basis for supporting FHIR, provides infrastructure
      • FHIR module is not the home for everything FHIR-related
        • Request, sending is part of the FHIR module
        • Collecting, storing data is with a particular/relevant module
        • FHIR module should not depend on anything else besides the OpenMRS platform
      • Actual workflow does not belong in the FHIR module, but is the responsibility of OpenMRS platform or other modules that rely upon the FHIR module for the infrastructure to support FHIR bundles/pathways
      • Work to integrate CR, MPI belongs in the FHIR module
  • FHIR IGs
    • How to translate the conceptual requirements into a format that we can use to describe capabilities and test them (long term - conformance testing) +1
    • Write an “OpenMRS FHIR IG” to use for our base requirements/boundaries for FHIR module and other modules?
    • Be sure that we’re actually documenting what we’re implementing
      • IGs help others reproduce this
      • Document specific choices we’ve made for LIS
    • Define the boundaries of the FHIR module
    • OHRI + integration with other systems
    • Current FHIR IG
    • Need to document capabilities and boundaries as SOP for developing on the FHIR module
  • JIRA
    • Lots of issues/tickets created - some too general
    • Epics created to group tickets - good!
    • Can we tie epics to documentation of requirements on the Wiki?  So that folks like Patric and Jan could review and make sure the requirements are representative of what is needed for an implementation.  Then look at epics+tickets to see if the work is assigned, etc.
    • Sprints: use it to double check being on track - have mini-backlogs - board view could see which epic are getting attention.
    •  Use Jira board to help gain clarity on priorities
  • QA
    • Acceptance testing still lies with the team creating the work (fhir squad), wont be shifting testing to an outside team - but…
      • May create a ticket in JIRA for QA support on a specific “thing” to be tested outside of the team (such as those participating on the QA team)
      • “Edit issue -> “Components” change to “QA” -- this will make this issue show up for the QA team to address, or have a QA automation engineer to work on automating a test for this (Such as Kawees
  • Action items
    •  Grace Potma Ian Bacher to meet today to set up a sprint model that reflects current priorities
    • Others to give feedback on Jira board by the end of the week
  • Recordings

2021 FHIR Squad Meeting Notes (January 1 - March 9)

2019-2020 FHIR Squad Meeting Notes