SFM Datadeling API Implementation Guide

Indications

Available in SFM version 4

The SFM Indicator API can be used to retrieve a list of patients whose medication lists have been changed locally in SFM since a specified date/time. This is useful, for example, in a nursing home when a doctor updates SFM locally and the nurse needs to be alerted to update the medication list in the administration module before dispensing.

The indicator is primarily intended to ensure that all patients' medication lists are up to date before medication is dispensed. Accordingly, it is expected to be called at medication-dispensing times (e.g., up to six times per day).

Endpoint

The endpoint is accessed via:

GET /fhir/Basic?_tag=indicator

Purpose

The Indicators module is responsible for reacting to relevant domain events and creating audit trail indicators. This is part of the event-driven ecosystem, consuming events published to RabbitMQ via MassTransit from the EventOutboxPublisher and producing a side-effect persisted in the local Indicators database.

An Indicator represents a flag, notification, or reminder that some noteworthy change has occurred to a patient's data—requiring attention, awareness, or review by clinicians or external systems.

Indicators are stored locally in a dedicated Indicators table and exposed via a FHIR-compatible API, allowing for efficient integration with user-facing systems or decision-support tools.

Each Indicator is created when an event occurs and stored with:

OccurredOnUtc – when the event actually happened.
CreatedOnUtc – when the event was saved in the database.
PatientId
EventType - Ex: ReseptRenewal, TreatmentCreated

The API filters Indicators using CreatedOnUtc to make sure no events are missed, even if they were processed later.

Query Parameters

| Parameter | Type | Required | Description | | --- | --- | --- | --- | | _tag=indicator | string | ✅ | Required to specify the resource type. Always set to indicator. | | identifier | string | Optional | Patient identifier(s) in FHIR format (e.g., urn:oid:... | | from| string | Optional | Start date for filtering indicator events (format:yyyy-MM-dd or yyyy-MM-ddTHH:mm:ss). Defaults to *today* if omitted. | | type| string | Optional | One ofSimplified(default) orVerbose`. Dictates the result detail level. |

Profile

sfm-Indicator

SfmIndicator (Basic)

Basic

There are no (further) constraints on this element

Element id

Basic

Short description

Resource for non-supported content

Alternate names

Z-resource, Extension-resource, Custom-resource

Definition

Basic is used for handling concepts not yet defined in FHIR, narrative-only resources that don't map to an existing resource, and custom resources not appropriate for inclusion in the FHIR specification.

Data type

Basic

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.div.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
rim: Act, Entity or Role

0..1

There are no (further) constraints on this element

Element id

Basic.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Meta

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Basic.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Basic.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Basic.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Basic.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings

rim: N/A

extension

0..*

Extension

Element id

Basic.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. 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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Mappings

rim: N/A

patientPid

0..1

Extension

Element id

Basic.extension:patientPid

Short description

Patient identifier with change

Alternate names

extensions, user content

Definition

The patient identifier (PID) for the patient whose medication data has changed.

Comments

Data type

Extension

Extension URL

http://ehelse.no/fhir/StructureDefinition/sfm-indicator-patient-pid-extension

Mappings

rim: N/A

events

0..*

Extension

Element id

Basic.extension:events

Short description

Indicator event types

Alternate names

extensions, user content

Definition

The type(s) of events that triggered this indicator. Multiple events can be associated with a single indicator.

Comments

Data type

Extension

Extension URL

http://ehelse.no/fhir/StructureDefinition/sfm-indicator-events-extension

Mappings

rim: N/A

modifierExtension

0..*

Extension

There are no (further) constraints on this element

Element id

Basic.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

Data type

Extension

Mappings

rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

Basic.identifier

Short description

Business identifier

Definition

Identifier assigned to the resource for business purposes, outside the context of FHIR.

Data type

Identifier

Mappings

w5: FiveWs.identifier
rim: ./identifier

code

S Σ ?!

1..1

CodeableConceptFixed Value

Element id

Basic.code

Short description

Kind of Resource

Definition

Identifies the 'type' of resource - equivalent to the resource name for other resources.

Requirements

Must be able to distinguish different types of Basic resources.

Comments

Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource. Refer to the resource notes section for information on appropriate terminologies for this code.

This element is labeled as a modifier because it defines the meaning of the resource and cannot be ignored.

Data type

CodeableConcept

Binding

Codes for identifying types of resources not yet defined by FHIR.

BasicResourceTypes (example)

Fixed value

{
  "coding": [
    {
      "code": "Indicator"
    }
  ]
}

Mappings

w5: FiveWs.what[x]
rim: ./code

subject

0..1

Reference(Resource)

There are no (further) constraints on this element

Element id

Basic.subject

Short description

Identifies the focus of this resource

Definition

Identifies the patient, practitioner, device or any other resource that is the "focus" of this resource.

Requirements

Needed for partitioning the resource by Patient.

Comments

Optional as not all potential resources will have subjects. Resources associated with multiple subjects can handle this via extension.

Data type

Reference(Resource)

Mappings

w5: FiveWs.subject[x]
rim: ./participation[typeCode='SBJ'] (possibly through a ControlAct and Role)
w5: FiveWs.subject

created

0..1

date

There are no (further) constraints on this element

Element id

Basic.created

Short description

When created

Definition

Identifies when the resource was first created.

Requirements

Allows ordering resource instances by time.

Data type

date

Mappings

w5: FiveWs.recorded
rim: ./participation[typeCode='AUT']/time (possibly through a ControlAct and Role)

author

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)

There are no (further) constraints on this element

Element id

Basic.author

Short description

Who created

Definition

Indicates who was responsible for creating the resource instance.

Requirements

Needed for partitioning the resource.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Organization)

Mappings

w5: FiveWs.author
rim: ./participation[typeCode='SUB'] (possibly through a ControlAct and Role)

Retrieval on Datashare

The actual retrieval of indicator data is performed using a named query on Basic. Parameters may include patient identifiers and a date filter:

GET [base]/Basic?_tag=indicator&from=2024-01-01
POST [base]/Basic/_search
_query=Indicator&type=Simplified&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509

Note that SFM will return all matching entries based on the given parameters, and the number of items may grow during a typical session.

Example Request

Simplified View

Note that the use of _search is allowed so patient identifiers are not logged anywhere.

Example 1 – Multiple Patients

POST Command 'host' could not render: There is no placeholder called 'host'/Basic/_search
Authorization: Bearer Command 'token' could not render: There is no placeholder called 'token'
Content-Type: application/x-www-form-urlencoded
_query=Indicator&type=Simplified&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509,urn:oid:2.16.578.1.12.4.1.4.2|58129218310

Fetches simplified indicators for patients 31126711509 and 58129218310 from 2024-01-01 onward.

Example 2 – Single Patient

POST Command 'host' could not render: There is no placeholder called 'host'/Basic/_search
Authorization: Bearer Command 'token' could not render: There is no placeholder called 'token'
Content-Type: application/x-www-form-urlencoded
_query=Indicator&type=Simplified&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509

Fetches simplified indicators for patient 31126711509 starting from 2024-01-01.

Verbose View

Example 1 – Multiple Patients

POST Command 'host' could not render: There is no placeholder called 'host'/Basic/_search
Authorization: Bearer Command 'token' could not render: There is no placeholder called 'token'
Content-Type: application/x-www-form-urlencoded
_query=Indicator&type=Verbose&from=2023-11-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509,urn:oid:2.16.578.1.12.4.1.4.2|58129218310

Returns detailed (verbose) indicator data for the listed patients since 2023-11-01.

Example 2 – Single Patient

POST Command 'host' could not render: There is no placeholder called 'host'/Basic/_search
Authorization: Bearer Command 'token' could not render: There is no placeholder called 'token'
Content-Type: application/x-www-form-urlencoded
_query=Indicator&type=Verbose&from=2023-11-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509

Returns detailed indicator data for patient 31126711509 since 2023-11-01.

Supported Identifiers

You can use the following identifier formats:

| Identifier Type | Example | | --- | --- | | FNR | urn:oid:2.16.578.1.12.4.1.4.1 | | **DNR** | urn:oid:2.16.578.1.12.4.1.4.2 | | XXXID | `urn:oid:2.16.578.1.12.4.1.4.14 |

Multiple identifiers can be sent:

identifier=urn:oid:...|12345678901,urn:oid:...|98765432109

Example Response

{
  "resourceType": "Bundle",
  "id": "41b9819f-9444-40f1-8d02-e5f2d011dcd6",
  "meta": {
    "lastUpdated": "2025-06-02T17:40:07.5973486+00:00"
  },
  "type": "searchset",
  "total": 1,
  "entry": [
    {
      "fullUrl": "http://datashare.dev1.forskrivning.no/Basic/ec38e3ab-bfd8-4ca5-87bf-5a93f5f07985",
      "resource": {
        "resourceType": "Basic",
        "id": "a224eff3-94ac-462c-bcf8-f54293386c74",
        "meta": {
          "profile": [
            "http://ehelse.no/fhir/StructureDefinition/sfm-indicator"
          ]
        },
        "extension": [
          {
            "url": "http://ehelse.no/fhir/StructureDefinition/sfm-indicator-patient-pid-extension",
            "valueString": "31126711509"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "Indicator"
            }
          ]
        },
        "created": "2025-06-02"
      }
    }
  ]
}

Usage Examples

Search by Date Only

POST /fhir/Basic/_search
_query=Indicator&type=Simplified&from=2024-01-01

Search by Single Patient Identifier

POST /fhir/Basic/_search
_query=Indicator&type=Simplified&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509

Search by Multiple Patient Identifiers

POST /fhir/Basic/_search
_query=Indicator&type=Simplified&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509,urn:oid:2.16.578.1.12.4.1.4.2|58129218310

Search with Verbose View

POST /fhir/Basic/_search
_query=Indicator&type=Verbose&from=2024-01-01&identifier=urn:oid:2.16.578.1.12.4.1.4.1|31126711509

All requests require appropriate authorization headers:

Host: (host)
Content-Type: application/x-www-form-urlencoded
Accept: application/json
Authorization: Bearer (token)

Behavior Notes

If no identifier is provided → all indicator records are returned.
If identifiers don't match any patients → response is 404 Not Found.
If from is missing or invalid → defaults to today's date.
If type is not Verbose → default is Simplified.
Filtering always uses CreatedOnUtc to ensure no delayed events are missed.

EPJ could make use of the lastUpdate datetime to make the next request so that no event is lost. Or, they can simply save the request time from their side.