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MII PRO Module - SearchParameter Analysis

Mustupport Elements by Resource Type

Questionnaire (mii-pr-pro-questionnaire)

Snapshot MS Elements:

  • Questionnaire.version
  • Questionnaire.code (+ code.code, code.system with slices: loinc, snomed, mii)
  • Questionnaire.copyright
  • Questionnaire.item (+ all subelements)
    • item.linkId
    • item.text
    • item.type
    • item.answerOption
    • item.answerValueSet
    • item.initial
    • item.initial.value[x]
    • item.item (nested items)
    • item.maxLength
    • item.prefix
    • item.readOnly
    • item.repeats
    • item.required
  • Questionnaire.derivedFrom
  • Questionnaire.extension (including capabilities extension)
  • Questionnaire.status
  • Questionnaire.url
  • Questionnaire.title
  • Questionnaire.subjectType

FHIR R4 Core SearchParameters:

  • ✅ version → Questionnaire-version (token)
  • ✅ code → Questionnaire-code (token)
  • ✅ status → Questionnaire-status (token)
  • ✅ url → Questionnaire-url (uri)
  • ✅ title → Questionnaire-title (string)
  • ❓ derivedFrom → CHECK if exists
  • ❓ subjectType → CHECK if exists
  • ❌ extension[capabilities] → CUSTOM SP NEEDED

QuestionnaireResponse (mii-pr-pro-questionnaire-response)

Snapshot MS Elements:

  • QuestionnaireResponse.language
  • QuestionnaireResponse.questionnaire (+ questionnaire.extension)
  • QuestionnaireResponse.status
  • QuestionnaireResponse.subject
  • QuestionnaireResponse.authored
  • QuestionnaireResponse.author
  • QuestionnaireResponse.identifier
  • QuestionnaireResponse.item (+ all subelements)
    • item.linkId
    • item.text
    • item.answer
    • item.answer.value[x]
    • item.answer.item
    • item.item

FHIR R4 Core SearchParameters:

  • ✅ questionnaire → QuestionnaireResponse-questionnaire (reference)
  • ✅ status → QuestionnaireResponse-status (token)
  • ✅ subject → QuestionnaireResponse-subject (reference)
  • ✅ authored → QuestionnaireResponse-authored (date)
  • ✅ author → QuestionnaireResponse-author (reference)
  • ✅ identifier → QuestionnaireResponse-identifier (token)
  • ❓ language → CHECK if Resource.language has SP

Observation (mii-pr-pro-score-instance + instrument-specific profiles)

Snapshot MS Elements:

  • Observation.identifier
  • Observation.status
  • Observation.code
  • Observation.subject (in PROMIS profiles)
  • Observation.category (in PROMIS profiles)
  • Observation.effective[x] (effectiveDateTime)
  • Observation.performer
  • Observation.value[x] (+ value[x].value for Quantity)
  • Observation.method
  • Observation.interpretation
  • Observation.referenceRange (in PROMIS profiles)
  • Observation.derivedFrom
  • Observation.note
  • Observation.focus
  • Observation.extension (instantiatesCanonical via workflow-instantiatesCanonical)

FHIR R4 Core SearchParameters:

  • ✅ identifier → Observation-identifier (token)
  • ✅ status → Observation-status (token)
  • ✅ code → Observation-code (token)
  • ✅ subject → Observation-subject (reference)
  • ✅ category → Observation-category (token)
  • ✅ date → Observation-date (date, covers effective[x])
  • ✅ performer → Observation-performer (reference)
  • ✅ value-quantity → Observation-value-quantity (quantity)
  • ✅ method → Observation-method (token)
  • ✅ derived-from → Observation-derived-from (reference)
  • ✅ focus → Observation-focus (reference)
  • ✅ interpretation → Observation-interpretation (token)
  • ❓ based-on → Observation-based-on (could support instantiatesCanonical extension?)

ObservationDefinition (mii-pr-pro-score-blueprint)

Snapshot MS Elements:

  • ObservationDefinition.code (+ code.coding, code.coding.code, code.coding.system)
  • ObservationDefinition.permittedDataType
  • ObservationDefinition.preferredReportName
  • ObservationDefinition.qualifiedInterval
    • qualifiedInterval.category
    • qualifiedInterval.range.low
    • qualifiedInterval.range.high
    • qualifiedInterval.range.extension (ScoreHealthCorrelation)
      • range.extension.value[x].coding.code
      • range.extension.value[x].coding.system
      • range.extension.value[x].text
  • ObservationDefinition.quantitativeDetails.decimalPrecision
  • ObservationDefinition.quantitativeDetails.unit
  • ObservationDefinition.quantitativeDetails.customaryUnit

FHIR R4 Core SearchParameters:

  • ✅ code → ObservationDefinition-code (token)
  • ❓ permittedDataType → CHECK if exists
  • ❓ preferredReportName → CHECK if exists
  • ❌ qualifiedInterval → CUSTOM SP NEEDED (possibly composite for category/range)
  • ❌ qualifiedInterval.category → CUSTOM SP NEEDED
  • ❌ qualifiedInterval.range.extension[ScoreHealthCorrelation] → CUSTOM SP NEEDED

Custom SearchParameters Required

1. Questionnaire Capabilities Extension

Name: mii-sp-pro-questionnaire-capabilities Type: token Expression: Questionnaire.extension.where(url='http://url-to-capabilities-extension').value Purpose: Search questionnaires by capability (displayable, collectable, calculatable, extractable, populatable, domainAligned)

2. QuestionnaireResponse Language

Name: mii-sp-pro-questionnaireresponse-language (if not in core) Type: token Expression: QuestionnaireResponse.language Purpose: Search responses by language code

3. ObservationDefinition Qualified Interval Category

Name: mii-sp-pro-observationdefinition-interval-category Type: token Expression: ObservationDefinition.qualifiedInterval.category Purpose: Search score definitions by interval category (reference, critical, absolute)

4. ObservationDefinition Preferred Report Name

Name: mii-sp-pro-observationdefinition-reportname Type: string Expression: ObservationDefinition.preferredReportName Purpose: Search score definitions by display name

5. ObservationDefinition Permitted Data Type

Name: mii-sp-pro-observationdefinition-datatype Type: token Expression: ObservationDefinition.permittedDataType Purpose: Search score definitions by permitted data type

6. ObservationDefinition Score Health Correlation (Extension)

Name: mii-sp-pro-observationdefinition-health-correlation Type: token Expression: ObservationDefinition.qualifiedInterval.range.extension.where(url='score-health-correlation-url').value.coding Purpose: Search score definitions by health correlation direction (better/worse)

FHIR R4 Core SearchParameters (from package cache)

Questionnaire (19 SearchParameters)

Name Type Code Expression
code token code Questionnaire.item.code
context-quantity quantity context-quantity (Questionnaire.useContext.value as Quantity) / (Questionnaire.useContext.value as Range)
context-type-quantity composite context-type-quantity Questionnaire.useContext
context-type-value composite context-type-value Questionnaire.useContext
context-type token context-type Questionnaire.useContext.code
context token context (Questionnaire.useContext.value as CodeableConcept)
date date date Questionnaire.date
definition uri definition Questionnaire.item.definition
description string description Questionnaire.description
effective date effective Questionnaire.effectivePeriod
identifier token identifier Questionnaire.identifier
jurisdiction token jurisdiction Questionnaire.jurisdiction
name string name Questionnaire.name
publisher string publisher Questionnaire.publisher
status token status Questionnaire.status
subject-type token subject-type Questionnaire.subjectType
title string title Questionnaire.title
url uri url Questionnaire.url
version token version Questionnaire.version

QuestionnaireResponse (11 SearchParameters)

Name Type Code Expression
author reference author QuestionnaireResponse.author
authored date authored QuestionnaireResponse.authored
based-on reference based-on QuestionnaireResponse.basedOn
encounter reference encounter QuestionnaireResponse.encounter
identifier token identifier QuestionnaireResponse.identifier
part-of reference part-of QuestionnaireResponse.partOf
patient reference patient QuestionnaireResponse.subject.where(resolve() is Patient)
questionnaire reference questionnaire QuestionnaireResponse.questionnaire
source reference source QuestionnaireResponse.source
status token status QuestionnaireResponse.status
subject reference subject QuestionnaireResponse.subject

Observation (31 SearchParameters)

Name Type Code Expression
based-on reference based-on Observation.basedOn
category token category Observation.category
code-value-concept composite code-value-concept Observation
code-value-date composite code-value-date Observation
code-value-quantity composite code-value-quantity Observation
code-value-string composite code-value-string Observation
combo-code-value-concept composite combo-code-value-concept Observation / Observation.component
combo-code-value-quantity composite combo-code-value-quantity Observation / Observation.component
combo-code token combo-code Observation.code / Observation.component.code
combo-data-absent-reason token combo-data-absent-reason Observation.dataAbsentReason / Observation.component.dataAbsentReason
combo-value-concept token combo-value-concept (Observation.value as CodeableConcept) / (Observation.component.value as CodeableConcept)
combo-value-quantity quantity combo-value-quantity (Observation.value as Quantity/SampledData) / (Observation.component.value as Quantity/SampledData)
component-code-value-concept composite component-code-value-concept Observation.component
component-code-value-quantity composite component-code-value-quantity Observation.component
component-code token component-code Observation.component.code
component-data-absent-reason token component-data-absent-reason Observation.component.dataAbsentReason
component-value-concept token component-value-concept (Observation.component.value as CodeableConcept)
component-value-quantity quantity component-value-quantity (Observation.component.value as Quantity/SampledData)
data-absent-reason token data-absent-reason Observation.dataAbsentReason
derived-from reference derived-from Observation.derivedFrom
device reference device Observation.device
focus reference focus Observation.focus
has-member reference has-member Observation.hasMember
method token method Observation.method
part-of reference part-of Observation.partOf
performer reference performer Observation.performer
specimen reference specimen Observation.specimen
status token status Observation.status
subject reference subject Observation.subject
value-concept token value-concept (Observation.value as CodeableConcept)
value-date date value-date (Observation.value as dateTime/Period)
value-quantity quantity value-quantity (Observation.value as Quantity/SampledData)
value-string string value-string (Observation.value as string) / (Observation.value as CodeableConcept).text

Note: date SearchParameter exists in core (expression: Observation.effective) - covers effectiveDateTime

ObservationDefinition

❌ No core SearchParameters defined in FHIR R4 - this resource has minimal search support in core spec

SDC IG SearchParameters (3 additional for Questionnaire)

Name Type Base Code Purpose
SDCQuestionnaireIsModular token Questionnaire assemble-expectation Search modular questionnaires
SDCQuestionnaireAssembledFrom token Questionnaire assembled-from Find questionnaires assembled from specific source
SDCQuestionnaireItemDefinition token Questionnaire definition Search by item definition URI

MII Meta IG SearchParameters

None relevant for Questionnaire/QuestionnaireResponse/Observation/ObservationDefinition

MII Meta defines custom SearchParameters for:

  • Observation.bodySite
  • Procedure.outcome
  • Specimen.collection.method
  • Medication dosage parameters
  • ResearchStudy parameters
  • FamilyMemberHistory parameters
  • ServiceRequest parameters

Action: No conflicts, MII PRO can define additional SearchParameters as needed

ISiK SearchParameters

None relevant for PRO resources

ISiK defines only Encounter-specific SearchParameters:

  • date-start
  • end-date

Gap Analysis: Required vs. Available

✅ Fully Covered by Core

Questionnaire:

  • version, code, status, url, title, derivedFrom (via definition), copyright (via description), subjectType

QuestionnaireResponse:

  • questionnaire, status, subject, authored, author, identifier, language (via Resource.language - universal search)

Observation:

  • All MS elements have core SearchParameters:
    • identifier, status, code, subject, category, effectiveDateTime (via date)
    • performer, value[x], method, interpretation, derivedFrom, note, focus
    • extension (via based-on for instantiatesCanonical)

❌ Gaps Requiring Custom SearchParameters

1. Questionnaire.extension[capabilities]

  • Status: ❌ NOT COVERED
  • Need: Custom SP for filtering questionnaires by capability flags
  • Priority: HIGH (core FDPG use case)

2. ObservationDefinition - ALL MS ELEMENTS

  • Status: ❌ NO CORE SEARCHPARAMETERS EXIST
  • Need: Define complete set of SearchParameters:
    • code (token)
    • permittedDataType (token)
    • preferredReportName (string)
    • qualifiedInterval.category (token)
    • qualifiedInterval.range (composite or separate)
    • quantitativeDetails.unit (token)
  • Priority: HIGH (score definition discovery)

3. Observation.referenceRange

  • Status: ❌ NOT COVERED (only qualifiedInterval search needed for ObservationDefinition)
  • Need: Search Observations by reference range membership
  • Priority: MEDIUM (clinical decision support use case)

Next Steps

  1. ✅ Verify which core SearchParameters exist in FHIR R4 spec
  2. ✅ Check MII Meta IG for existing SearchParameters we can reuse
  3. ✅ Check SDC IG for existing SearchParameters
  4. ✅ Check ISiK IG for existing SearchParameters
  5. ⬜ Create FSH definitions for custom SearchParameters:
    • Questionnaire.extension[capabilities]
    • ObservationDefinition.code
    • ObservationDefinition.permittedDataType
    • ObservationDefinition.preferredReportName
    • ObservationDefinition.qualifiedInterval.category
    • ObservationDefinition.quantitativeDetails.unit
  6. ⬜ Add SearchParameter instances to IG
  7. ⬜ Update IG documentation with search guidance
  8. ⬜ Test SearchParameters against HAPI FHIR server

References

  • FHIR R4 Core Package: hl7.fhir.r4.core#4.0.1 (local cache)
  • MII Meta IG: de.medizininformatikinitiative.kerndatensatz.meta#2025.0.0
  • SDC IG: hl7.fhir.uv.sdc#3.0.0
  • ISiK IG: de.gematik.isik#5.0.0