Please note: This is the old version of the Estonian Base Implementation Guide. The new version can be found HERE.


Introduction

The EEBase Implementation Guide covers a set of national base profiles, terminology components and guiding principles based on FHIR®© version R4. The switch from document-based data exchange to a more granular one will be realized as a transitional process. The development of this Implementation Guide should be considered the first step in helping event-based health data exchange to become a real-life scenario in Estonia.

This guide serves the purpose of simplifying the process of implementing FHIR and thus increasing interoperability and clinical data quality in the Estonian context by including the following components:

  • FHIR resources tailored for local use, e.g. base profiles, whereas conformance requirements must support flags and binding strengths have been held to as minimum as possible to support open-world modeling;
  • Ready-to-use CodeSystems and ValueSets developed for Estonian healthcare data exchange specifically;
  • Implementation and profiling guidance to support a smooth transition from other standards to FHIR.
Even though the initial draft of the EEBase Implementation Guide was developed in March-October 2022 as part of project "Estonian National Health Information System support for event-based data exchange", it should be regarded as the intellectual property of a community of contributors and reviewers who have provided valuable input during the validation process of this guide.

Audience

This document aims to provide standardized clinical data components and instructional materials to both implementation guide author communities and vendor communities. Users of this guide are expected to be familiar with FHIR, at least to some degree, to find additional information from the official specification page if needed. Implementation of, testing and offering feedback on this specification is highly encouraged. Readers of this guide are welcome to find the appropriate e-mail address on the Contact Us page in case of questions, suggestions, information requests, or collaboration offers.


Scope

From the perspective of future and current implementers, it is most logical to divide the content of the EEBase Implementation Guide into three parts by the function they serve:

  • FHIR profiles and extensions suitable for use in the Estonian healthcare domain specifically. Each profile has its dedicated page for details on example use cases, usage instructions and descriptions of data items. For a general overview of all profiles and extensions in this guide, it is suggested to look at the Profiles Index page, where one can find profiling guidelines developed and followed in the profiling process of EEBase. The profiling guidelines offer insight into the principles and best practices, which are especially valuable in the early stage of building profiles based on one's use cases. Please note that EEBase profiles are intended as a starting point for utilizing the possibilities offered by FHIR for specific use cases, projects and/or services. The profiles provided should not be considered suitable for use straight out of the box but must be used as a base profile to derive additional profiles from;
  • CodeSystems and ValueSets specially developed for EEBase (this means that CodeSystems and ValueSets developed by HL7 are not included in this IG even when bound with data elements in EEBase profiles, as the latest documentation of these artefacts could be found on FHIR’s webpage). ConceptMaps from custom value sets developed for EEBase to HL7’s ’default’ value sets are also provided in case of implementers decide on using the ones provided by HL7. For maximum interoperability, it is encouraged to use stable identifiers (either a URI or OID) in profiles. For that purpose, the authors of this implementation guide have utilized the NamingSystem resources. For more information on using terminology, see the Profiling Guidelines section on the Profiles Index page and pages under the Terminology tab;
  • Policy from general compliance principles to FHIR operations to be followed when implementing FHIR within your jurisdiction. For more information, see the Policy Index page.

How to Read This Guide

This Guide is divided into several pages, which are listed at the top of each page in the menu bar.