Inera Core Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Change Log
Change Log
All notable changes to the Inera Core Implementation Guide will be documented in this file.
[0.2.0] - 2025-12-15 (Current CI Build)
Added - 2025-12-12
Guidance Documentation
- TGP Guidance (Tjänstebaserade Gemensamma Principer): Comprehensive guide for service-based common principles in Swedish healthcare IT, covering service contracts, technical specifications, and implementation patterns
- TKB Header Mapping: Detailed mapping of TKB header elements to FHIR Provenance and meta elements, covering source system identification, authorship, consent references, and organizational hierarchy
- DocBook to FHIR Narrative Transformation:
- ConceptMap with 40+ element mappings from Inera's DocBook format (used in 1177 Inkorg) to FHIR Narrative XHTML
- Comprehensive transformation guide with patient administrative examples (screening invitations, appointment bookings) and clinical documentation patterns
- Discussion on emphasis mapping strategies: direct XHTML formatting vs semantic section codes
- Section semantic type CodeSystem and ValueSet (information, warning, notice, supplementary)
- Presentation style extension for rendering hints (info-box, warning-box, framed-box, collapsible)
Added
Base Profiles
- PatientBaseInera: Swedish patient profile with personnummer, samordningsnummer, and reservnummer support
- PractitionerBaseInera: Healthcare professional profile with HSA-ID
- PractitionerRoleBaseInera: Links practitioners to organizations with Swedish role codes
- OrganizationBaseInera: Care provider and care unit profiles with HSA-ID
- ProvenanceBaseInera: TKB header metadata tracking with authorship and organizational context
Clinical Profiles
- ConditionBaseInera: Base condition profile extending IPA
- ConditionDiagnosisInera: Diagnosis-specific profile with ICD-10-SE and SNOMED CT SE bindings
- EncounterBaseInera: Swedish encounter (vårdkontakt) profile
- ProcedureBaseInera: Surgical procedures, examinations, interventions with KVÅ codes
ConceptMaps (TKB → FHIR)
- GetActivities → Procedure: 29 element mappings for activities/procedures service
- GetAlertInformation → AllergyIntolerance/Flag: 19 AllergyIntolerance mappings + 5 Flag mappings
- GetDiagnosis → Condition: 7 key element mappings for diagnosis service
- GetLaboratoryOrderOutcome → Observation/DiagnosticReport: 29 Observation + 6 DiagnosticReport mappings
- GetMedicationHistory → MedicationStatement/MedicationRequest: 24 MedicationStatement + 8 MedicationRequest mappings
Terminology
- Swedish Identity Type CodeSystem: Personnummer, samordningsnummer, reservnummer
- Organization Type SE CodeSystem: Vårdgivare, vårdenhet classification
- ICD-10-SE ValueSet: Swedish diagnosis codes (preferred binding)
- SNOMED CT SE ValueSet: Swedish SNOMED CT edition bindings
Documentation
- Introduction: IG purpose, scope, design principles
- Mapping Strategy: TKB to FHIR transformation patterns
- TKB Header Mapping: Detailed metadata handling (authorship, provenance, consent, signatures)
- Migration Guide: Phased migration strategies, ETL patterns, rollback procedures
- Security and Privacy: PDL/GDPR compliance, OAuth 2.0, consent (spärr), audit logging
Changed
- Upgraded to IPA 1.1.0 dependency (from no base)
- Added US Core 7.0.0 dependency for metadata patterns
- Updated sushi-config.yaml with complete menu structure and pages configuration
Dependencies
- hl7.fhir.uv.ipa: 1.1.0
- hl7.fhir.us.core: 7.0.0
[0.1.0] - 2025-11-10 (Initial Draft)
Added
Initial Setup
- Created IG structure following SUSHI conventions
- Basic sushi-config.yaml with Swedish jurisdiction
- Initial package.json for NPM publishing
First Profiles
- ConditionBaseInera (simplified version): Initial draft with basic ICD-10 binding
- Patient profile stub (not yet fully specified)
Planning Materials
- Comprehensive 12-month implementation plan in
/temp
- README with deliverables structure
- ConceptMap templates for all priority TKB services
Known Issues
- Missing base profiles (Patient, Practitioner, Organization)
- No provenance tracking
- Limited terminology bindings
- No examples
Versioning Strategy
This IG follows Semantic Versioning (semver):
- MAJOR version: Incompatible API changes
- MINOR version: Backwards-compatible functionality additions
- PATCH version: Backwards-compatible bug fixes
Release Cadence
- CI Builds: Continuous (every commit to
main)
- Minor Releases: Quarterly (Q1, Q2, Q3, Q4)
- Major Releases: Annually (planned for Q4 2026)
Ballot and Normative Status
| Version |
Status |
Ballot Period |
Notes |
| 0.x.x |
Draft |
N/A |
Development, breaking changes expected |
| 1.0.0-ballot |
STU Ballot |
Q2 2026 (planned) |
Community review |
| 1.0.0 |
STU 1 |
Q4 2026 (planned) |
First stable release |
| 2.0.0 |
Normative (planned) |
Q4 2027 (planned) |
Production-ready |
Upcoming in 0.3.0 (Planned: 2025-12-15)
Planned Additions
- Examples: Condition, Patient, AllergyIntolerance, MedicationStatement examples
- Observation Profiles: ObservationLaboratoryBaseInera, ObservationVitalSignsInera
- Medication Profiles: MedicationStatementBaseInera, MedicationRequestBaseInera
- AllergyIntolerance Profile: AllergyIntoleranceBaseInera with Swedish hypersensitivity patterns
- Consent Profile: ConsentBaseInera for spärr (inner/outer blocks)
- Additional ConceptMaps: GetCareDocumentation, GetFunctionalStatus
Planned Improvements
- Enhanced search parameters documentation
- CapabilityStatement for reference server implementation
- Validation rules (FHIRPath invariants) for Swedish-specific constraints
- Narrative generation templates
Migration Notes
Upgrading from 0.1.0 to 0.2.0
Breaking Changes: None (additive release)
New Features:
- Base profiles are now available; update your Patient/Practitioner references to use Swedish profiles
- Use ConceptMaps for TKB service migrations
- Apply Provenance pattern for TKB header metadata
Action Required:
- Review new ConceptMaps if implementing TKB replacement
- Consider adding Provenance resources for full metadata tracking
- Update terminology bindings to use ICD-10-SE/SNOMED CT SE
Deprecation Policy
Elements marked as deprecated will:
- Be marked in documentation (0.x.0 release)
- Generate warnings in validators (next minor release)
- Be removed (next major release)
Minimum Deprecation Period: 6 months
Feedback and Contributions
We welcome feedback on this implementation guide:
Contributing
To contribute:
- Fork the repository
- Create a feature branch (
git checkout -b feature/my-improvement)
- Write FSH profiles/examples
- Submit pull request with description
Companion IGs
- Inera Medications IG: TBD (Q1 2026)
- Inera Laboratory IG: TBD (Q2 2026)
- Inera Imaging IG: TBD (Q3 2026)
Regional Implementations
- Region Västra Götaland IG: Uses Inera Core 0.2.0 as base
- Region Stockholm IG: In planning
Historical Context
This implementation guide represents Sweden's transition from document-oriented healthcare IT (RIVTA/TKB with Green CDA) to resource-oriented FHIR APIs. The phased approach ensures compatibility with existing infrastructure while enabling modern integration patterns.
TKB Baseline: 120+ services across 15 clinical domains
FHIR Target: RESTful APIs with Swedish national profiles
Timeline: 2025-2027 (3-year transformation)