FHIR Patient Generator

A tool for generating eCQM-specific patient data using Synthea™

Table of Contents

• Prerequisites
• Developer Quickstart
  • Installation
  • Usage
  • Examples
• Generation and Calculation
• Existing Patient Data
• Pre-loading a Docker Image

Prerequisites

• Node.js >=10.15.1
• Docker
• fhir-bundle-calculator command line utility

Developer Quickstart

NOTE: This tool is only compatible with fhir-bundle-calculator version 4.0.0 or higher:

npm install -g fhir-bundle-calculator
calculate-bundles --version
# should ouput 4.x.x

Installation

git clone https://github.com/projecttacoma/fhir-patient-generator
cd fhir-patient-generator

Usage

As a CI tool in the connectathon repository

make MEAUSRE_DIR/path/to/measure/dir CI_TOOL=true

Running Standalone

make MEASURE_DIR=/path/to/measure/dir CALC_TYPE=<fqm|http> PATIENT_COUNT=10

MEASURE_DIR is the relative path to the directory in fhir-patient-generator for the desired measure. Currently supported measures:

• EXM_104
• EXM_105
• EXM_124
• EXM_125
• EXM_130

CALC_TYPE tells fhir-bundle-calculator which engine to use for measure calculation. The default is fqm-execution, which is also what will be used if CALC_TYPE=fqm is specified. To use cqf-ruler instead, specify CALC_TYPE=http after the make command.

PATIENT_COUNT specifies the number of (live) Synthea patients to generate for each measure. Actual patient counts will vary because Synthea doesn't count dead patients during generation.

Examples

# Generate R4 patient data for EXM130
make MEASURE_DIR=EXM_130

Generation and Calculation

The Makefile in fhir-patient-generator consolidates the following dependencies and links them together to eventually output patient data along with calculation statistics.

• Abacus Synthea Fork: Used for generating measure-specific patient data
• cqf-ruler: Used for running calculation and getting MeasureReport resources
• Connectathon repository: Used for loading cqf-ruler with needed ValueSet, Library, and Measure resources
• fhir-bundle-calculator: Command line utility for requesting and interpreting calculation results
• fqm-execution: Command line utility/Typescript library for calculating FHIR-based eCQMs against FHIR-based patients

The following diagram depicts the operations that each utility is responsible for and the order in which they are executed:

Existing Patient Data

We have published patient data for all supported measures in both R4 and STU3, which can be found in the <measure-directory>/patients-r4 and <measure-directory>/patients-stu3 for all supported measures.

Pre-loading a Docker Image

fhir-patient-generator also supports loading and tagging a Docker image with patient data for a specific measure, not including ValueSets. This image will be published to the Tacoma Docker organization

make MEASURE_DIR=/path/to/measure/dir VERSION=x.y.z preload

This command will tag and push tacoma/cqf-ruler-preloaded:x.y.z to Dockerhub.

Examples

# Publish preloaded image with EXM130 R4 data under tag 1.0.0
make MEASURE_DIR=EXM_130 VERSION=1.0.0 preload