How a Referral Letter is Structured in FHIR: Electronic Health Record Sharing and Med-Well

Details

This technical article by Common Creation Corporation, which provides the hospital LINE window system "Med-Well," delves into the data structure of electronic referral letters (eReferrals) for the Electronic Health Record Information Sharing Service. It first establishes FHIR fundamentals: 'Resource' (the smallest unit), 'Bundle' (the transmission package), and 'Composition' (the document index). Using the referral letter as a case study, it explains how physical sections map to specific FHIR Resources, detailing that the Bundle uses Composition to organize references to resources like Patient, Practitioner, and Organization. A key focus is the Japanese context. The article highlights JP-CLINS, an implementation guide that adds Japan-specific constraints to the international FHIR standard. This ensures strict rules for code systems (e.g., using specific codes for diseases or medical institutions). Finally, it discusses how Med-Well's existing reservation and questionnaire data could be mapped onto this structured FHIR format to generate a 'draft,' suggesting future integration possibilities.