CDC Medpmorph

This repository shows reference material related to CDC Electronic Case Reporting (eCR) for cancer registry. The reference material uses Medplum Bots to validate and synchronize the FHIR resource bundles to the registry.

Background and Dataflow

At a high level this integration takes a FHIR Transaction Bundle or FHIR DiagnosticReport resource from an EHR, like Endosoft, and produces a FHIR Message bundle and synchronizes it to the CDC FHIR server.

The workflow corresponds to the Cancer Reporting FHIR Implementation Guide.

Importing eCR Bundles

Sample bundles are available in this repository.

Sending Data to the Registry

The CDC maintains a FHIR server that expects expects bundles with a specific structure. The toolkit demonstrated here shows the process of receiving an FHIR bundle and then validating and reformatting it into the structure required by the Cancer Reporting FHIR Implementation Guide.

This repository also includes a unit test for the conversion, which can be useful as an example.

Message Bundle Structure

The message bundle has the following structure. Here is documentation on bundles and sample bundles. EHRs and other medical systems are typically the source for bundles like these.

├──Message Header

| ├──Collection Bundle

| | ├──Patient

| | ├──Practitioner

| | ├──PractitionerRole

| | ├──DiagnosticReport

| | ├──Observation 1

| | ├──Observation 2

| | ├──Observation *

Transaction Bundle Structure

The message bundle has the following structure. Here is documentation on bundles and sample bundles. This is what the CDC system expects to receive.

├──Transaction Bundle

| ├──Patient

| | ├──Practitioner

| | ├──PractitionerRole

| | ├──DiagnosticReport

| | ├──Observation 1

| | ├──Observation 2

| | ├──Observation 3

Medplum Setup

To set up your bot deployment you will need to do the following:

• Create a Bot on Medplum, call it medmorph-bot and note its id. (All Bots in your account can be found here)
• With the id of the Bot id in hand, add a section to medplum.config.json like so

{
  "name": "medmorph-bot",
  "id": "<bot-id>",
  "source": "src/examples/medmorph-bot.ts",
  "dist": "dist/medmorph-bot.js"
}

• Create an ClientApplication on Medplum. (All ClientApplications in your account can be found here)
• Create a .env file locally by copying .env.example and put the ClientId and ClientSecret from the ClientApplication into the file.
• (Optional) Create an AccessPolicy on Medplum that can only read/write Bots and add it to the Bot in the admin panel.

Create a Subscription on Medplum with criteria "Bundle" and have it trigger the bot you've just created.

Set bot secrets MEDMORPH_DEMO_REPORT_ENDPOINT and MEDMORPH_DEMO_REPORT_ENDPOINT_AUTH to the endpoint that the bot should send the final results to.

Installation

To run and deploy your Bot do the following steps:

Install:

npm i

Build:

npm run build

Test:

npm t

Deploy medmorph bot:

npx medplum deploy-bot medmorph-bot

You will see the following in your command prompt if all goes well:

Update bot code.....
Success! New bot version: 7fcbc375-4192-471c-b874-b3f0d4676226
Deploying bot...
Deploy result: All OK

Related Reading

• MedMorph Data Flow Diagram, this repo represents the Data Health Exchange App
• MedMorph Specification Bundle
• Reference Bot