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The Clinical Data Model and FHIR
The clinical data model is built to align with the Fast Healthcare Interoperability Resources (FHIR) specification, which is an open API standard for the exchange of healthcare information. The FHIR standard is defined by Health Level 7 (HL7), the organization that also defined the HL7 messaging standard.
Required Editions
Available in: Lightning Experience Available in: Enterprise and Unlimited Editions with Health Cloud |
The standard objects in the clinical data model store all sorts of clinical data, including conditions, medications, encounters, immunizations, procedures, and so on. To use the FHIR-aligned clinical data model, you must have Health Cloud. The Health Cloud implementation of FHIR aligns with FHIR v4.0.1.
To verify the FHIR (Fast Healthcare Interoperability Resources) R4-aligned clinical data model for Health Cloud is enabled in your org, search for and then select FHIR R4 Support Settings under Health Cloud in Setup. If the FHIR-Aligned Data Model setting is not enabled for your org, enable it now.
From the FHIR R4 Support Settings page, you can also enable Adverse Events to give users access to the Adverse Events features and objects. Adverse Events helps you to manage and document any unfavorable or unintended signs, symptoms, or diseases that occur as a result of an intervention, such as medical care or research, that impacts a patient or group of patients or participants. These events can include a wide range of physical or psychological effects that vary from mild discomfort to serious health complications.
The FHIR-Aligned Clinical Data Model
Health Cloud’s clinical data model maps closely to the FHIR R4 specification, but with a few minor differences.
- The clinical data model supports most of the FHIR R4 attributes, except certain instances that aren’t relevant for the typical Health Cloud user.
- Entities like Identifier and Code Set have more attributes than their FHIR R4 counterparts. These extra fields increase data usability across the Salesforce platform and support specific needs of certain features in Health Cloud.
- FHIR R4 typically defines zero-to-one, zero-to-many, one-to-one, or one-to-many values for each attribute. However, the Salesforce platform doesn’t support one-to-many and zero-to-many values for a field, except in multi-select picklists. Instead, Salesforce uses child objects that can create multiple records that all reference the same parent record to achieve this type of logical zero/one-to-many values. For instance, an encounter can have multiple providers participating in it. To support this scenario, Salesforce has the Clinical Encounter Provider child object. This child object has records representing each provider in an encounter, and each of these records reference the record of the encounter that these providers were a part of.
