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Implementation of IPS FHIR IG on Aidbox FHIR platform

Demo | Inferno International Patient Summary Test Kit

This repository contains pre-configured Aidbox instance and implementation of $summary operation defined by IPS.

About IPS (International Patient Summary)

The IPS is intended to support the provision of essential healthcare information for a patient, regardless of where they are receiving care. It includes critical information such as allergies, medications, past surgeries, and other significant medical history details. See IPS Specification

Prerequisites

STEP 1: Environment and Aidbox license

Copy .env.tpl file into .env file:

cp .env.tpl .env

If you are hosting Aidbox on your local computer, obtain the self-hosted license as described in the documentation.

Add the license (AIDBOX_LICENSE) int the .env file.

STEP 2: Run aidbox and node-app in Docker

docker compose up --build

On start, the node-app will upload a sample FHIR Bundle with patient data.

Step 3: Open and log in into Aidbox instance

Open in browser http://localhost:8888

And log in witn username: admin and password: password

Step 4: Request $summary using REST Console

In the Aidbox admin window, navigate to the APIs section and choose REST Console.

The $summary operation requires either the logical ID (Patient.id) or a business identifier (Patient.identifier) of the patient. You can use the following request to view all available patients:

GET /fhir/Patient?_elements=id,identifier

To request the IPS "document" Bundle for a specific patient using the REST Console, you can use the following request:

GET /fhir/Patient/[id]/$summary

Replace [id] with the logical ID of the patient you want to retrieve the IPS document for.

For example:

GET /fhir/Patient/2b90dd2b-2dab-4c75-9bb9-a355e07401e8/$summary

Or you can use request with identifier search parameter:

GET /fhir/Patient/$summary?identifier=<patient-identifier>

For example:

GET /fhir/Patient/$summary?identifier=574687583

Step 5: Request $summary using HTTP Client

If you're starting the Aidbox FHIR server for the first time, the initial step involves creating a Client resource with an ID and secret. Since the newly created client does not have default permissions to access the Aidbox REST API, the next step is to configure access policies. Refer to the documentation: Create and test access control

The easiest way to achieve this is by navigating to Auth > Sandbox in the Aidbox Web Admin UI and performing REST queries to create the 'basic' client and assign the AccessPolicy.

Once the client is created, you can perform the $summary operation using an HTTP tool, similar to the following example:

curl --location 'http://localhost:8888/fhir/Patient?_elements=id%2Cidentifier' \
--header 'Content-Type: application/json' \
--header 'Authorization: Basic YmFzaWM6c2VjcmV0' \
--data ''

Deploy

This application works with aidbox running under the following settings (envs):

AIDBOX_FHIR_VERSION=4.0.1
AIDBOX_FHIR_SCHEMA_VALIDATION=true
AIDBOX_FHIR_PACKAGES=hl7.fhir.r4.core#4.0.1:hl7.fhir.uv.ips#1.1.0
AIDBOX_VALIDATE_BINDING_URL="https://r4.ontoserver.csiro.au/fhir/ValueSet/\$validate-code"

It is possible to deploy Aidbox with Helm charts. To do so, follow the steps outlined below:

1. Add aidbox helm repo

helm repo add aidbox https://aidbox.github.io/helm-charts

2. Prepare database config

config: |-
  listen_addresses = '*'
  shared_buffers = '2GB'
  max_wal_size = '4GB'
  pg_stat_statements.max = 500
  pg_stat_statements.save = false
  pg_stat_statements.track = top
  pg_stat_statements.track_utility = true
  shared_preload_libraries = 'pg_stat_statements'
  track_io_timing = on
  wal_level = logical
  wal_log_hints = on
  archive_command = 'wal-g wal-push %p'
  restore_command = 'wal-g wal-fetch %f %p'

env:
  PGDATA: /data/pg
  POSTGRES_DB: postgres
  POSTGRES_PASSWORD: <your-postgres-password>

image.repository: healthsamurai/aidboxdb
image.tag: "16.1"
storage:
  size: "10Gi"
  className: <your-storage-className>

and apply it

helm upgrade --install aidboxdb aidbox/aidboxdb \
  --namespace ips --create-namespace \
  --values /path/to/db-config.yaml

3. Prepare Aidbox config

host: <your-aidbox-host>
protocol: https

config:
  PGHOST: aidboxdb.ips.svc.cluster.local
  PGDATABASE: postgres
  PGUSER: postgres
  PGPASSWORD: <your-postgres-password>
  AIDBOX_CLIENT_ID: <your-aidbox-client-id>
  AIDBOX_CLIENT_SECRET: <your-aidbox-client-password>
  AIDBOX_ADMIN_ID: <your-aidbox-admin-id>
  AIDBOX_ADMIN_PASSWORD: <your-aidbox-admin-password>
  AIDBOX_LICENSE: <aidbox-license>
  AIDBOX_DEV_MODE: true
  AIDBOX_FHIR_VERSION: 4.0.1
  AIDBOX_FHIR_SCHEMA_VALIDATION: true
  AIDBOX_FHIR_PACKAGES: hl7.fhir.r4.core#4.0.1:hl7.fhir.uv.ips#1.1.0
  AIDBOX_VALIDATE_BINDING_URL: "https://r4.ontoserver.csiro.au/fhir/ValueSet/$validate-code"
  AIDBOX_BASE_URL: <your-base-url>
  AIDBOX_PORT: 8888
  AIDBOX_COMPLIANCE: enabled

ingress:
  annotations:
    acme.cert-manager.io/http01-ingress-class: nginx
    cert-manager.io/cluster-issuer: letsencrypt
    kubernetes.io/ingress.class: nginx

and apply it

helm upgrade --install aidbox aidbox/aidbox \
  --namespace ips --create-namespace \
  --values /path/to/aidbox-config.yaml

To deploy the application use prepared k8s config. Additionally, you have to add to the config resource Secret:

apiVersion: v1
kind: Secret
metadata:
  name: ips-app
  namespace: ips
stringData:
  AIDBOX_CLIENT_ID: <your_aidbox_client_id>
  AIDBOX_CLIENT_SECRET: <your_aidbox_client_secret>
  APP_SECRET: <your_app_secret> # allows aidbox safely communicate with this app

Run Inferno IPS tests

To run Inferno IPS tests against this implementation:

  1. Copy the prepared configuration for the test suite.
  2. Create a test session on the Inferno website.
  3. Click on the "RUN ALL TESTS" button.
  4. Paste the copied configuration into the JSON field and submit.