FHIR R4, R5 and emerging R6 considerations
DigiDOT is an FHIR R4 package. R5 and R6 elements are not added to R4 resources through DigiDOT-specific extensions. Future exchange with another FHIR version requires an explicit mapping. R6 is still under development; its continuous-integration build may change and must not be treated as an adopted implementation target.
Procedure, Condition and Observation changes
| Area | R4 | Later FHIR | DigiDOT approach |
|---|---|---|---|
| Procedure time | Procedure.performed[x] |
R5 and the current R6 build use Procedure.occurrence[x] |
Map directly during version conversion. |
| Clinical reason | Procedure.reasonReference to Condition; reasonCode is not used |
R5 and the current R6 build use Procedure.reason as CodeableReference |
Map the Condition reference to reason.reference. Reassess a coded reason only if DigiDOT later defines its terminology. |
| Used material or product | Not in the current Procedure scope | R5 and the current R6 build use Procedure.used as CodeableReference |
No mapping is defined until DigiDOT agrees a material and product-traceability model. |
| Dental anatomy | Condition.bodySite and Procedure.bodySite with DigiDOT tooth and surface slices |
R5 retains bodySite. The current R6 build removes bodySite and uses bodyStructure as CodeableReference(BodyStructure). |
Keep the R4 body-site pattern. When an adopted later-version target is agreed, define and test a migration mapping with dental examples. |
| Observation anatomy | Observation.bodySite with DigiDOT tooth and surface slices |
R5 adds Observation.bodyStructure and does not permit it together with bodySite. The current R6 build deprecates bodySite and makes bodyStructure repeatable CodeableReference(BodyStructure). |
Keep the R4 body-site pattern. Do not use focus as a BodyStructure substitute. Define and test a migration mapping only when a later-version anatomy model is agreed. |
Anatomy and BodyStructure
In R4, DigiDOT records coded tooth and surface information in Condition.bodySite, Observation.bodySite and Procedure.bodySite. No active clinical profile uses a BodyStructure extension or Observation.focus as a BodyStructure substitute.
R5 preserves the Condition and Procedure bodySite pattern and adds an Observation bodyStructure reference that is mutually exclusive with Observation.bodySite. The current R6 continuous-integration build replaces or deprecates these body-site patterns in favour of bodyStructure as a CodeableReference(BodyStructure). This is not a direct replacement for the current R4 model and can still change before a future release is adopted. DigiDOT should keep the R4 model for this draft and test concrete Condition, Observation and Procedure anatomy mappings only when a later FHIR version is selected.
EHDS note
EHDS does not currently require a specific FHIR R5 or R6 Procedure profile. The relevant direction is structured exchange using agreed datasets, coding systems, technical specifications and profiles. DigiDOT therefore keeps a valid R4 representation, constrained profiles and versioned SNOMED CT expressions while the EEHRxF requirements mature.
References: FHIR R5 Condition, FHIR R5 Observation, FHIR R5 Procedure, current FHIR R6 Condition build, current FHIR R6 Observation build, current FHIR R6 Procedure build, EHDS EHR certification.