You can suggest for example a new resource type or a new profile to the data content or a change to the existing data content. You don’t have to have a complete profile / suggestion to get feedback.
The submitted proposals are discussed and reviewed by HL7 PH SIG group and Kela in PH SIG online meetings (Skype for Business) arranged monthly. In these online meetings, you can also ask for help and get advices how to use HL7 FHIR based national data content in your integration. A timetable for the meetings is available below and at PH SIG Kanta PHR -webpages (only in Finnish). You can sign up for the meetings by emailing Janne Aaltonen, email@example.com.
The review focuses on the feasibility of the development proposal to the Kanta PHR data content, including the following criteria:
- feasibility from the perspective of FHIR standard
- feasibility from the perspective of the promotion of welfare
- overlaps with existing data content
- other actors that are interested
- national integrity of proposed value sets and code systems
- possible change requirements in the national Kanta PHR platform maintained by Kela.
The Finnish PHR profiling guidelines describe the profiling guidelines for Kanta PHR. Profile drafts and profiles supported in the national Kanta PHR data content are published in the Simplifier profile registry, in the Finnish PHR project. There you can also find the Implementation guide that describes the use of the published profiles.
New profiles can be created for example by using a profile authoring tool. HL7 International has published a list of currently available tools. Forge is a good freeware option. If you suggest new profiles or profile changes, you should also produce new or updated descriptions for the implementation guide as well. NB! If you want to add a new Vital signs related profile, you can deliver just the loinc code of the observation and the unit of measure, and Kela will produce the profile based on the Finnish PHR Vital Signs profile for you.
Also, remember that you can test your application and new profiles in the Kanta PHR Sandbox environments before, during and after this process. NB! If your development proposal is a bigger one that requires changes in the PHR platform itself (for example a new resource type), sandbox environments probably doesn’t support all functionalities of your application yet. Meaning you have to wait until Kela has developed and implemented the necessary changes in sandbox environments (during step C of the process, see process flow below).
The picture below shows the flow of the development process.
How to submit your proposal (step A)
You should submit your proposal for discussion and reviewing two weeks before the scheduled PH SIG online meeting.
To submit your proposal for reviewing:
Describe your development proposal using this proposal form (also available in Finnish and Swedish) and send it to firstname.lastname@example.org and email@example.com. If your proposal includes a new profile, CodeSystem, ValueSet, Questionnaire, etc. (or a change to an existing one), please include them as attachments in the email as well. Prepare to present your development proposal in the next PH SIG online meeting (unless informed otherwise before the meeting). Also, you may be asked to give more information about your development proposal before the online meeting.
NB! If you want to add a new profile under the Vital Signs category and haven’t produced the profile yet, you can skip submitting the profile, and just deliver the loinc code and the unit of measure (include them in your description of your proposal when submitting your proposal. Kela will produce the profile based on the Finnish PHR Vital Signs profile for you.
Reviewing in online meetings (step B)
After applying for reviewing, the next step is to present your development proposal in the (usually next) PH SIG online meeting. Reviewers and participants in the meeting may ask some questions to get sufficient information to be able to comment or conduct the review.
Some feedback may be given already in the first online meeting, but it is possible that the reviewers will need more time to give comprehensive feedback on the proposal and to be able to officially accept the proposal. Thus, it is possible that the review will last over multiple online meetings. Also, the commenting and feedback in the online meetings won’t focus on any technical issues in the profile (for example incorrect valueset bindings or binding strengths, typos in the json form etc.). Feedback on those will be given outside the meetings by email.
During the review process, the development proposal and the submitted profile(s) may be asked to be modified to ensure feasibility to the Kanta PHR data content. After making the modifications, HL7 PH SIG group and Kela should be informed by email. The changes will be reviewed in the next scheduled PH SIG online meeting, if submitted two weeks before the meeting.
As a final result of the official reviewing, the development proposal will be accepted or rejected. Kela will also assess whether the development proposal requires changes developed and implemented by Kela in the PHR platform itself. An estimate of the schedule of implementing those changes will be delivered as well. Kela’s assessment may take some time, so the final result is not always ready in the PH SIG meeting but will be informed by email after it.
At this point, you should produce new or updated descriptions for the Kanta PHR implementation guide, if you haven’t produced them earlier (Tip! Check the existing profile descriptions in the implementation guide what’s been written about the existing profiles.)
In addition, please be aware that the profile that has been accepted may still change as a result of the joint testing of application.
What’s next after your proposal has been accepted (steps C, D, E)
If changes are required in the PHR platform itself (step C)
If the development proposal requires changes in the PHR platform itself, Kela has to develop and implement those changes in the joint testing environment, before joint testing can begin. Kela will inform about the progress of implementing said changes.
Joint testing process (step D) and production deployment (E)
Joint testing of application is a separate process that an application supplier has to go through before being able to connect their application to the Kanta PHR platform in testing (or production use). The joint testing process and related instructions will be published later.
After a successfully completed joint testing process, the changes (FHIR profiles and possible changes to the PHR platform itself) will be delivered to the production environment by Kela. Instructions for deployment in the production environment will be published later.
Some additional special notes on the development process and development proposals
The duration of the process (from submission of the proposal to deployment in production) varies across different types of proposals. Smaller proposals (for example a new profile based on a national profile or a new extension to an existing profile) typically don’t require changes in the PHR platform itself, thus enabling faster deployment.
Bigger development proposals (for example a new resource type or a new profile that required new processing logic), on the other hand, do require changes in the PHR platform itself (which are developed and implemented by Kela), and therefore take a longer time to be implemented in joint testing or production environments.
The development proposal will be accepted only if the existing data content doesn’t cater for the need behind the proposal. Overlapping data elements that, for example, differ only in the name of the element, won’t be accepted.
Not all data should to be stored in the national Kanta PHR platform. For example, data that isn’t related to the citizen’s health or wellbeing.