Access FHIR reports

NilRead can be configured to access FHIR® diagnostic reports on a FHIR resource server. FHIR (Fast Healthcare Interoperability Resources) is a next generation standards framework created by HL7. FHIR reports can be accessed the same way as other reports in NilRead (on the patient timeline and in the Patient Directory).

NilRead FHIR report configuration requires the following steps.

1. Enable FHIR reports for the site.
2. (Optional) Modify the FHIR report templates for the site.
3. Complete the following steps for each FHIR service you want to use to access diagnostic reports.
   1. Register with the FHIR service.
   2. Add an endpoint for the FHIR service. This allows NilRead to access the FHIR resource server.
   3. Add a diagnostic report for the FHIR service. This is required to load FHIR reports from the service.

Enable FHIR reports for the site

Use the Timeline Reports settings to enable FHIR reports for the site.

1. Select Settings. Under System, select Timeline Reports.
2. Enter the following information.

   Enable reports access  Select this option to enable FHIR reports for the site.

   Report search adapters  Select Fhir in the Excluded list, then select Add. Fhir is moved to the Included list.

3. Select Save.

Modify FHIR report templates

NilRead uses XSL transformation (XSLT) templates to render FIHR reports. You can change the appearance of FHIR reports for your site by modifying these templates. For example, you could add a logo to the reports.

The FHIR report templates are located in the App_Data/DicomSRTemplates folder within your NilRead site folder (for example: C:\inetpub\wwwroot\Nil\Nil-4.3.22.95194-Site\App_Data\DicomSRTemplates). This folder contains two XSLT templates you can modify: FhirReportNarrativeTemplate and FhirReportTemplate.

Some FHIR reports have a built-in narrative. To render FHIR reports with the built-in narrative (when available), add the following parameter to the configs/Nil.config file within your NilRead site folder. Set the value to False to use the NilRead report templates. Set the value to True to use the built-in narrative (the NilRead report templates will be used if a built-in narrative is not available).

<setting name="FhirDiagnosticReportShowNarrative" serializeAs="String">

   <value>True</value>

</setting>

Register with a FHIR service

Register with each FHIR service you want to use. See the FHIR service web site for details on registering and creating an app to use with NilRead.

Add an endpoint

Add an endpoint for the FHIR service resource server. The endpoint configuration is based on the SMART on FHIR open specifications.

1. Select Settings. Under Devices, select FHIR.
2. In the FHIR Endpoints area, select Create.
3. Enter the FHIR endpoint information. This information will depend on the service you registered with. For example, the service will require you to use a specific authorization grant type. The required endpoint fields will change based on the authorization grant type you select.

   The NilRead Authorization Code Flow redirection URL is [base url]/FhirRedirect.aspx.

4. Select Verify to test the configuration settings.
5. Select Save.

Add a diagnostic report resource

Add a diagnostic report resource for the FHIR endpoint you want to use for reports.

1. Select Settings. Under Devices, select FHIR.
2. In the Resources area, select Create.
3. Enter the following information.
   • Name  Name to identify the diagnostic report.
   • Endpoint  Endpoint to use with the diagnostic report.
   • Resource Type  Type of resource to retrieve. Select DiagnosticReport.
   • Filter, Patient Identifier Filter  Search filters to use when querying the FHIR service. Use the format {DicomTagName} to specify the query values NilRead should use. For example, NilRead will replace {AccessionNumber} with the accession number from the study when submitting the query.
4. Select Enabled to allow NilRead to query the FHIR service and retrieve information.
5. Select Verify to test the configuration settings.
6. Select Save.

Edit or delete an endpoint or resource

1. Select an endpoint or resource.
   
2. Select Edit. Modify the details, then select Save.
   or
   Select Delete.

Check the status of a FHIR endpoint

You can check if NilRead is currently authorized to access a FHIR endpoint. You may need to refresh the FHIR endpoint connection periodically if the authorization period has expired. Depending on the authorization type, you may be prompted to log into the FHIR service in order to access the endpoint.

The message “Check FHIR endpoint status” will appear on a FHIR report if NilRead is not able to access the FHIR endpoint. This message will also appear in the image viewing area if the study contains an FHIR report and NilRead is not able to access the FHIR endpoint.

1. Select Settings. Under Devices, select FHIR. In the Remote FHIR Resources section, select Remote FHIR endpoint status.

   or

   Click (or tap) the “Check FHIR endpoint status” message in a report or the image viewing area.

2. The FHIR Endpoint Status window appears. Endpoints that NilRead is currently authorized to access are shown in green.
3. To refresh all endpoints, select Refresh. To refresh a specific endpoint, select beside the endpoint.
4. If prompted, log into the FHIR service.
5. Select Close.