Cloud FHIR and Data Harmonization Kalyan Pamarthy, Marianne Slight, and Vivian Neilley, Healthcare

HL7 FHIR DevDays 2020, Virtual Edition US, June 15–18, 2020 | @HL7 @FirelyTeam | #fhirdevdays | www.devdays.com/us

HL7®, FHIR® and the flame Design mark are the registered trademarks of Health Level Seven International and are used with permission. Kalyan Pamarthy Marianne Slight Vivian Neilley Product Manager Product Manager Solutions Engineer FHIR and HL7v2 Healthcare Analytics Healthcare & Life Sciences

2 Topics for today

● G o o g le Clo ud He a lt hc a re API & FHIR c a p a b ilit ie s

● Instructions for Let’s Build

● Google Cloud Healthcare Data Harmonization and De mo Cloud Healthcare API & Data Harmonization Related Presentations

● Let’s Build: Google Cloud FHIR APIs ● Building FHIR - based apps for Cancer Thursday, June 18th, 2:00 pm-2:4 0 p m ET referrals at the University Health Network University Health Network Tuesday, June 16th, 3:30 pm-3:4 5 p m ET ● Building Systems on FHIR with BigQuery and Monday, June 15th, 4:15 pm-4 :30 p m ET ● Building a Real Time Machine Learning System with FHIR and a DICOM VNA Koo Foundation Sun-Yat Sen Cancer Center ● Extend Clinical Workflows using SMART (KFSYSCC) and Stratus Medicine Tuesday, June 16th, 4:45 pm-5:00 pm ET on FHIR Thursday, June 18th 4:00 pm-4 :15 p m ET 1. Google Cloud Healthcare API

5 Cloud Healthcare API Capabilities

Accelerate your healthcare solution development

● Primary API surface for healthcare specific data management in the Google Clo ud Pla t fo rm .

● Fully managed, Standards based serverless, REST APIs ○ FHIR (DSTU2, STU3 a n d R4 ) ○ HL7v2 ○ DIC O M

● Value add capabilities (e.g De-Id, Data Harmonization, NLP) Healthcare API ● St o re s PHI d a t a in c o m p lia nc e wit h re g ula t io ns (e .g HIPAA) ● Integrated with other Google Cloud applications (e.g BigQuery) ● Integrated with Google Cloud components (e.g Cloud PubSub, Cloud Functions)

● Support for Smart on FHIR Apps with API Management Key Managed FHIR Server Capabilities

DSTU2, STU3 & R4 Support FHIR Versions Resource Create/Read/Update/Patch/History/Delete O p e rat io ns

FHIR FHIR Se a r c h Operations Patient $Everything

Execute Bundle (Batch & Transaction)

Cloud Healthcare IG Support & FHIR Pro file Valid at io n FHIR APIs Profiles

Import & HL7v2 and CSV to FHIR transformations Export Import and Export from/to Google

Export to BigQuery - Streaming and Batch Access resources via FHIR Standard REST APIs

Pro je c t Cloud Healthcare API Location Dataset Store (FHIR Datastore)

E.g Get Patient data from a Cloud FHIR Store Le t ’s Build : G o o g le Clo ud FHIR APIs $> curl - X GET https://healthcare.googleapis.com/ v1 /projects/PROJECT_ID/ l ocat i ons/ LOCATION/ dat aset s/ DATASET_ID/ f hi r Thursday, June 18th, 2:00 St or es / FHIR_STORE_ID/Patient/1 pm-2:40 pm - H ' Aut hor i zat i on: Bear er '

https://cloud.google.com/healthcare/docs/how-t o s/fhir Popular Use Cases

● [Cloud Native Health Apps] FHIR Se rve r & APIs as the backend for consumer and enterprise applications. E.g diabetes management, practice management systems

● [Providers] Extracting data out of EMRs and other on-prem systems into the FHIR Server and enable real-time applications and large scale data analytics. Cloud Healthcare E.g patient rounding apps, Sepsis prediction FHIR APIs ● [Payers] Implement Payer Data Access APIs for meeting CMS/ONC mandates

Le t ’s Build : G o o g le Clo ud FHIR APIs Thursday, June 18th, 2:00 pm-2:40 pm cloud.google.com/healthcare

G e ne ra lly Ava ila b le Build this with us on Thursday!

Le t ’s Build : G o o g le Clo ud FHIR APIs Thursday, June 18th, 2:00 pm-2:40 pm

1. Gain Access to the free GCP Lab at: bit.ly/gcpfhir 2. Receive link to the lab

11 2. Google Cloud Data Harmonization

12 Data Harmonization: Clinical Sources

Sources Formats Mapping Ta rg e t transformatio schemas n CSV Fie ld mappings Hist o ric a l data Terminology mappings

Unit s alignment HL7v2

CSV Clinic a l e nt it y extraction St re a m ing data Mapping: Whistle Data Transformation Language

Input JSON Transformatio Output JSON n library

Whis t le mapping config

Whistle is not FHIR Mapping Language - Generic mapping config, supports other schemas - More compact syntax - No forced profile checks - Transpiler for FML Mapping: Whistle Data Transformation Language

{ { "segmentId": "XAD", "use": "Work", "fields": { Transformatio "text": "55 Fruit Street Massachusetts General "1": "55 Fruit Street", Hospital Boston MA 02114 USA", "2": "Massachusetts General Hospital", n library "line": [ "3": "Boston", "55 Fruit Street" "4": "MA", ], "5": "02114", "city": "Boston", "6": "USA", "district": 100, "7": "Work", "state": "MA", "zipCode": "02114", "8": "Other geographic designation", use: XAD.7 "country": "USA", "9": "100" text: " ", XAD.1, XAD.2, XAD.3, XAD.4, "type": "physical" } XAD.5, XAD.6 => _StrJoin } line: XAD.1 => _ListOf } city: XAD.3 district: XAD.9 state: XAD.4 Sample maps: zipCode: XAD.5 - HL7v2 to FHIR for country: XAD.6 Supports repeated and nested structures, type: "physical" ADT_A0 1 a n d O RU_R0 1 terminology mapping, unit harmonization, init ially c linic al e nt it y e xt rac t io n, use r-defined - FHIR to OMOP Whist le m a p p ing c o nfig functions - OMOP to FHIR How To Run A Whistle Mapping Config

Healthcare API Cloud Data Fusion OSS Dataflow

Fully m a na g e d , c lo ud -native data FHIR Im p o rt API Reference Cloud Dataflow int e g rat io n se rvic e fo r b uild ing and (Apache Beam) pipeline to managing ETL and ELT data p ip e line s. convert streaming HL7v2 Cloud Whis t le Cloud to FHIR Storage c o nfig Healthcare With a graphical interface and a resources broad open source library of FHIR Exp o rt API preconfigured connectors and transformations, Cloud Data Fusion shifts an organization’s focus away

Cloud Whis t le from code and integration to BigQuery Healthcare c o nfig insights and action.

HL7v2 → FHIR API

Cloud Whis t le Cloud Healthcare c o nfig Healthcare Show me! 18