与FHIRRESTAPI运营集成 Amazon Comprehend Medical 运营如何整API合到的示例 HealthLake

亚马逊 Comprehend Medical 是如何与之整合的 HealthLake

HealthLake 使用 Amazon Comprehend Medical 推断在DocumentReference资源类型中找到的数据。Amazon Comprehend Medic API al 的DetectEntities-V2运营InferICD10-CM，InferRxNorm并将疾病检测为特征。每项操作都提供了不同的见解。

语言支持

Amazon Comprehend M API edical 的运营仅检测英语文本中的医疗实体。

DetectEntities-V2：检查各种医疗实体的临床文本，并返回有关它们的特定信息，例如实体类别、位置和置信度分数。
推断 ICD1 0-CM：以实体形式检测患者记录中的医疗状况，并将这些实体与经世界卫生组织授权的国家卫生统计中心 ICD -10-CM知识库中的标准化概念标识符关联起来（）。CDC WHO
InferRxNorm: 将药物检测为患者记录中列出的实体，并将其与美国国家医学图书馆 RxNorm 数据库中的标准化概念标识符关联起来。

每个API操作的支持特征是SIGNSYMPTOM、和DIAGNOSIS。如果检测到特征，则会将它们作为FHIR兼容的扩展添加到 HealthLake 数据存储中的不同位置。

添加扩展程序的位置。

DocumentReference：Amazon Comprehend Medic API al 操作的结果将作为extension一个添加到资源类型中的每个文档中。 DocumentReference 扩展的结果分为两组。你可以根据它们在结果中找到它们URL。
- http://healthlake.amazonaws.com/system-generated-resources/
  - 这些是由创建或添加的资源类型 HealthLake。
- http://healthlake.amazonaws.com/aws-cm/
  - 将 Amazon Comprehend Medic API al 操作的原始输出添加到您的数据存储中。 HealthLake
Linkage：此资源类型要么是由于集成而添加的，要么是创建的NLP。对特定项的GET请求Linkage会返回链接资源的列表。要确定是否由添加Linkage了 HealthLake，请查找添加的"tag": [{"display": "SYSTEM_GENERATED"}]键值对。要了解有关 Linkage FHIR 规范的更多信息，请参阅FHIR文档索引中的资源类型：链接。
FHIR由亚马逊 Comprehend Medical 操作生成的资源类型。API
- Observation: 当特征为或时，添加了 Amazon Comprehend M API edical DetectEntities 操作的结果-V2 和 ICD1 Infer 0-CM。SIGN SYMPTOM
- Condition: 有亚马逊 Comprehend Medic API al DetectEntities 运营的结果——V2 和 ICD1 Infer 0-CM 当特征存在时。DIAGNOSIS
- MedicationStatement: 还有亚马逊 Comprehend Medic API al 的运营结果。 InferRxNorm

与FHIRRESTAPI运营集成

默认情况下，Amazon Comprehend Medic API al 操作检测到的特征在提出请求时不会返回。GET

要查看这些资源类型的集成NLP操作的结果，必须指定已知ID。

Linkage
Observation
Condition
MedicationStatement

只有在已知指定ID内容包含 Amazon Comprehend Medical NLP 操作结果的GET请求时，才能获得 DocumentReference 资源类型之外的整合操作结果。API

Amazon Comprehend Medical 运营如何整API合到的示例 HealthLake

示例 1：将患者记录导入 HealthLake 数据存储

以下是基于患者与医疗专业人员的接触的临床记录示例。

合成数据

此示例中的文本是合成内容，不包含个人健康信息 (PHI)。


1991-08-31

# Chief Complaint
- Headache
- Sinus Pain
- Nasal Congestion
- Sore Throat
- Pain with Bright Lights
- Nasal Discharge
- Cough


# History of Present Illness
Jerónimo599
 is a 4 month-old non-hispanic white male.

# Social History
 Patient has never smoked.


Patient comes from a middle socioeconomic background.

Patient currently has Aetna.

# Allergies
No Known Allergies.

# Medications
No Active Medications.

# Assessment and Plan
Patient is presenting with bee venom (substance), mold (organism), house dust mite (organism), animal dander (substance), grass pollen (substance), tree pollen (substance), lisinopril, sulfamethoxazole / trimethoprim, fish (substance). 

## Plan

The patient was prescribed the following medications:
- astemizole 10 mg oral tablet
- nda020800 0.3 ml epinephrine 1 mg/ml auto-injector
The patient was placed on a careplan:
- self-care interventions (procedure)

显示更多

显示更少

提醒一下，这些信息在资源中以 base64 格式编码。 DocumentReference 当本文档被收录 HealthLake 并且 Amazon Comp API rehend Medical 操作完成后，要查看结果，您可以从请求资源类型GET开始。DocumentReference


 GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/DocumentReference

当 Amazon Comprehend Medic API al 操作成功后，请在链接到以下内容的链接中查找这些键值对 extension "url": "http://healthlake.amazonaws.com/aws-cm/"


{
		"url": "http://healthlake.amazonaws.com/aws-cm/status/",
		"valueString": "SUCCESS"
	},
	{
		"url": "http://healthlake.amazonaws.com/aws-cm/message/",
		"valueString": "The Amazon HealthLake integrated medical NLP operation was successful."
	}

以下选项卡显示了如何根据资源类型在 HealthLake 数据存储中报告摄取的医疗记录。

DocumentReference

要查看单个DocumentReference资源类型的结果，请在提供特定资源的地方GET发出请求。id


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed

成功后，您将获得一个200HTTP响应代码和以下响JSON应（为清楚起见，该响应已被截断）。

这是http://healthlake.amazonaws.com/system-generated-resources/部分。你可以看到已经添加Linkage/e366d29f-2c22-4c19-866e-09603937935a了一个新的。您还可以查看在哪些地方向特定Observation和Condition资源类型添加 HealthLake 了基于推断的结果。

要查看这些资源类型是如何修改的，请选择相关选项卡。


{
		"extension": [
			{
				"url": "http://healthlake.amazonaws.com/linkage",
				"valueReference": {
					"reference": "Linkage/e366d29f-2c22-4c19-866e-09603937935a"
				}
			},
			{
				"url": "http://healthlake.amazonaws.com/nlp-entity",
				"valueReference": {
					"reference": "Observation/c6e0a3ff-7a17-4d8b-bfd0-d02d7da090c5"
				}
			},
			{
				"url": "http://healthlake.amazonaws.com/nlp-entity",
				"valueReference": {
					"reference": "Condition/0854e1f3-894d-448e-a8d9-3af5b9902baf"
				}
			}
		],
		"url": "http://healthlake.amazonaws.com/system-generated-resources/"
	}

Linkage

要查看单个Linkage资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/Linkage/e366d29f-2c22-4c19-866e-09603937935a

成功后，你会得到一个200HTTP响应代码，以及以下被截断JSON的响应。

响应包含item元素。其中，键值对"type": "source"表示用于修改的特定DocumentReference条目，Condition并Observations列在"type": "alternate"键值对下。

您还可以看到meta元素和相应的键值对"tag": [{"display": "SYSTEM_GENERATED"}]，表示这些资源是由创建的。 HealthLake


{
		"resourceType": "Linkage",
		"id": "e366d29f-2c22-4c19-866e-09603937935a",
		"active": true,
		"item":
		[
			{
				"type": "alternate",
				"resource": {
					"reference": "Observation/c6e0a3ff-7a17-4d8b-bfd0-d02d7da090c5",
					"type": "Observation"
				}
			},
			{
				"type": "alternate",
				"resource": {
					"reference": "Condition/9d5c1ef6-f822-4faf-b55f-7c70f2a4aa8d",
					"type": "Condition"
				}
			},
			{
				"type": "source",
				"resource": {
					"reference": "DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed",
					"type": "DocumentReference"
				}
			}
		],
		"meta": {
			"lastUpdated": "2022-10-21T19:38:31.327Z",
			"tag": [{
				"display": "SYSTEM_GENERATED"
			}]
		}
	}

Resource type: Observation

要查看单个Observation资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/Observation/e366d29f-2c22-4c19-866e-09603937935a

Amazon Comprehend Medic API al 的运营结果已修改为以下内容：、和。code meta modifierExtension

`code`

类型为的元素CodeableConcept。要了解更多信息，请参阅FHIR文档索引CodeableConcept中的。

HealthLake 附加以下三个键值对。

"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/": 其中URL指的是一项特定的亚马逊 Comprehend Medical 业务。API在本例中，推断 ICD1 0CM。
"code": "A52.06": 标识疾病控制中心知识库中概念的 ICD -10-CM代码在哪里A52.06。
"display": "Other syphilitic heart involvement": 本体中"Other syphilitic heart involvement"对 ICD -10-CM代码的详细描述在哪里。

以下被截断的JSON响应仅包含元素。code


"code": {
		"coding":
		[
		  {
			"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/",
			"code": "A52.06",
			"display": "Other syphilitic heart involvement"
		  }
		],
		"text": "Other syphilitic heart involvement"
	}

要了解模型对分配的 ICD -10-CM 代码正确性的置信度，请使用元素。modifierExtension

`meta`

该meta元素包含的元数据表明该code元素是否包含由 Amazon Comprehend Medical 操作添加的详细信息。API

以下被截断的JSON响应仅包含元素。meta


"meta": {
		"lastUpdated": "2022-10-21T19:38:30.879Z",
		"tag": [{
			"display": "SYSTEM_GENERATED"
		}]
	}

`modifierExtension`

该modifierExtension元素包含有关code元素中已分配代码的可信度等级的更多详细信息。它还具有键值对，这些键值对提供了指向 DocumentReference 用于生成结果的原始值和相关的 Linkage 资源类型的链接。

对于添加的每个coding元素，您都会看到一个entity-score和一个entity-Concept-Score被添加到中modifierExtension。对于键值对中的每个值，您会看到一个分数。因为entity-score，该分数是 Amazon Comprehend Medical 对检测准确性的可信度。因为entity-Concept-Score，该分数是Amazon Comprehend Medical对该实体与-10厘米概念准确关联的信心程度。ICD

以下被截断的JSON响应仅包含元素。modifierExtension


"modifierExtension": [{
			"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-score",
			"valueDecimal": 0.45005733
		},
		{
			"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-Concept-Score",
			"valueDecimal": 0.1111792
		},
		{
			"url": "http://healthlake.amazonaws.com/system-generated-linkage",
			"valueReference": {
				"reference": "Linkage/e366d29f-2c22-4c19-866e-09603937935a"
			}
		},
		{
			"url": "http://healthlake.amazonaws.com/source-document-reference",
			"valueReference": {
				"reference": "DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed"
			}
		}
	]

完整JSON回应


{
		"subject": {
			"reference": "Patient/0679b7b7-937d-488a-b48d-6315b8e7003b"
		},
		"resourceType": "Observation",
		"status": "unknown",
		"code": {
			"coding": [{
				"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/",
				"code": "A52.06",
				"display": "Other syphilitic heart involvement"
			}],
			"text": "Other syphilitic heart involvement"
		},
		"meta": {
			"lastUpdated": "2022-10-21T19:38:30.879Z",
			"tag": [{
				"display": "SYSTEM_GENERATED"
			}]
		},
		"modifierExtension": [{
				"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-score",
				"valueDecimal": 0.45005733
			},
			{
				"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-Concept-Score",
				"valueDecimal": 0.1111792
			},
			{
				"url": "http://healthlake.amazonaws.com/system-generated-linkage",
				"valueReference": {
					"reference": "Linkage/e366d29f-2c22-4c19-866e-09603937935a"
				}
			},
			{
				"url": "http://healthlake.amazonaws.com/source-document-reference",
				"valueReference": {
					"reference": "DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed"
				}
			}
		],
		"id": "7e88c7c5-21a5-4dd7-8fc2-a02474fba583"
	}

Condition

要查看单个Condition资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/Condition/b06d343d-ddb8-4f36-82cb-853fcd434dfd

Amazon Comprehend Medic API al 的运营结果已修改为以下内容：、和。code meta modifierExtension

`code`

类型为的元素CodeableConcept。要了解更多信息，请参阅FHIR文档索引CodeableConcept中的。

HealthLake 附加以下三个键值对。

"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/": 其中URL指的是一项特定的亚马逊 Comprehend Medical 业务。API在本例中，推断 ICD1 0CM。
"code": "I70.0": 标识疾病控制中心知识库中概念的 ICD -10-CM代码在哪里A52.06。
"display": "Atherosclerosis of aorta": 本体中"Other syphilitic heart involvement"对 ICD -10-CM代码的详细描述在哪里。

以下被截断的JSON响应仅包含元素。code


"code": {
		"coding":
		[
		  {
			"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/",
			"code": "I70.0",
			"display": "Atherosclerosis of aorta"
		  }
		],
		"text": "Atherosclerosis of aorta"
	}

要了解模型对分配的 ICD -10-CM 代码正确性的置信度，请使用元素。modifierExtension

`meta`

该meta元素包含的元数据表明该code元素是否包含由 Amazon Comprehend Medical 操作添加的详细信息。API

以下被截断的JSON响应仅包含元素。meta


"meta": {
		"lastUpdated": "2022-10-21T19:38:30.877Z",
		"tag": [{
			"display": "SYSTEM_GENERATED"
		}]
	}

`modifierExtension`

以下被截断的JSON响应仅包含元素。modifierExtension


"modifierExtension": [{
			"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-score",
			"valueDecimal": 0.94417894
		},
		{
			"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-Concept-Score",
			"valueDecimal": 0.8458298
		},
		{
			"url": "http://healthlake.amazonaws.com/system-generated-linkage",
			"valueReference": {
				"reference": "Linkage/e366d29f-2c22-4c19-866e-09603937935a"
			}
		},
		{
			"url": "http://healthlake.amazonaws.com/source-document-reference",
			"valueReference": {
				"reference": "DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed"
			}
		}
	]

完整JSON回应


{
		"subject": {
			"reference": "Patient/0679b7b7-937d-488a-b48d-6315b8e7003b"
		},
		"resourceType": "Condition",
		"code": {
			"coding": [{
				"system": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/",
				"code": "I70.0",
				"display": "Atherosclerosis of aorta"
			}],
			"text": "Atherosclerosis of aorta"
		},
		"meta": {
			"lastUpdated": "2022-10-21T19:38:30.877Z",
			"tag": [{
				"display": "SYSTEM_GENERATED"
			}]
		},
		"modifierExtension": [{
				"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-score",
				"valueDecimal": 0.94417894
			},
			{
				"url": "http://healthlake.amazonaws.com/aws-cm/infer-icd10/aws-cm-icd10-entity-Concept-Score",
				"valueDecimal": 0.8458298
			},
			{
				"url": "http://healthlake.amazonaws.com/system-generated-linkage",
				"valueReference": {
					"reference": "Linkage/e366d29f-2c22-4c19-866e-09603937935a"
				}
			},
			{
				"url": "http://healthlake.amazonaws.com/source-document-reference",
				"valueReference": {
					"reference": "DocumentReference/0e938f03-da7f-4178-acd8-eea9586c46ed"
				}
			}
		],
		"id": "b06d343d-ddb8-4f36-82cb-853fcd434dfd"
	}

示例 2：DocumentReference包含 MedicationStatement 资源类型的 A

以下是根据患者与医疗专业人员的接触而编写的临床记录示例。

合成数据

此示例中的文本是合成内容，不包含个人健康信息 (PHI)。


Tom is not prescribed Advil

以下选项卡显示了如何根据资源类型在 HealthLake 数据存储中报告摄取的医疗记录。

DocumentReference

要查看单个DocumentReference资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/DocumentReference/c549125d-a218-421f-b8bf-23614c5e796c

成功后，您将获得200HTTP响应代码和以下截断JSON的响应。

键值对表示其中的资源类型是由 Amazon Comprehen extension d Medical API 操作添加的。"url": "http://healthlake.amazonaws.com/system-generated-resources/"您可以看到新的Linkage资源类型和多个MedicationStatement资源。


"extension": [{
			"extension": [{
					"url": "http://healthlake.amazonaws.com/linkage",
					"valueReference": {
						"reference": "Linkage/394bb244-177b-4409-8657-26b20ed56dd7"
					}
				},
				{
					"url": "http://healthlake.amazonaws.com/nlp-entity",
					"valueReference": {
						"reference": "MedicationStatement/cbf6af10-b0b9-451c-bdde-99611e3498a8"
					}
				},
				{
					"url": "http://healthlake.amazonaws.com/nlp-entity",
					"valueReference": {
						"reference": "MedicationStatement/9a89b0d3-6681-45ca-9926-27951edce5c7"
					}
				},
				{
					"url": "http://healthlake.amazonaws.com/nlp-entity",
					"valueReference": {
						"reference": "MedicationStatement/4a01f6c8-5f3a-4122-80ab-405312f96aa2"
					}
				},
				{
					"url": "http://healthlake.amazonaws.com/nlp-entity",
					"valueReference": {
						"reference": "MedicationStatement/fbfb77d8-70cf-4579-b4c0-d6fe3c01656b"
					}
				},
				{
					"url": "http://healthlake.amazonaws.com/nlp-entity",
					"valueReference": {
						"reference": "MedicationStatement/1340c9ce-9c48-4bf9-9b2f-d0ab027f5e0b"
					}
				}
			],
			"url": "http://healthlake.amazonaws.com/system-generated-resources/"
		}

Linkage

要查看单个Linkage资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/Linkage/394bb244-177b-4409-8657-26b20ed56dd7

成功后，您将获得200HTTP响应代码和以下JSON响应。

响应包含item元素。其中，键值对"type": "source"表示用于修改MedicationStatement资源DocumentReference类型的特定条目。

您还可以看到meta元素和相应的键值对"tag": [{"display": "SYSTEM_GENERATED"}]，表示这些资源是由创建的。 HealthLake


{
		"resourceType": "Linkage",
		"id": "394bb244-177b-4409-8657-26b20ed56dd7",
		"active": true,
		"item": [{
				"type": "alternate",
				"resource": {
					"reference": "MedicationStatement/cbf6af10-b0b9-451c-bdde-99611e3498a8",
					"type": "MedicationStatement"
				}
			},
			{
				"type": "alternate",
				"resource": {
					"reference": "MedicationStatement/9a89b0d3-6681-45ca-9926-27951edce5c7",
					"type": "MedicationStatement"
				}
			},
			{
				"type": "alternate",
				"resource": {
					"reference": "MedicationStatement/4a01f6c8-5f3a-4122-80ab-405312f96aa2",
					"type": "MedicationStatement"
				}
			},
			{
				"type": "alternate",
				"resource": {
					"reference": "MedicationStatement/fbfb77d8-70cf-4579-b4c0-d6fe3c01656b",
					"type": "MedicationStatement"
				}
			},
			{
				"type": "alternate",
				"resource": {
					"reference": "MedicationStatement/1340c9ce-9c48-4bf9-9b2f-d0ab027f5e0b",
					"type": "MedicationStatement"
				}
			},
			{
				"type": "source",
				"resource": {
					"reference": "DocumentReference/c549125d-a218-421f-b8bf-23614c5e796c",
					"type": "DocumentReference"
				}
			}
		],
		"meta": {
			"lastUpdated": "2022-10-24T20:05:03.501Z",
			"tag": [{
				"display": "SYSTEM_GENERATED"
			}]
		}
	}

MedicationStatement

要查看单个MedicationStatement资源类型的结果，请在提供特定资源的地方GET发出请求。ID


GET https://https://healthlake.your-region.amazonaws.com/datastore/your-datastore-id/r4/eeb8005725ae22b35b4edbdc68cf2dfd/r4/MedicationStatement/9a89b0d3-6681-45ca-9926-27951edce5c7

MedicationStatement 资源类型是查找 Amazon Comprehend Medical 操作 InferRxNorm API结果的地方。将结果修改为以下要素：medicationCodeableConceptmeta、和modifierExtension。

medicationCodeableConcept

类型为的元素CodeableConcept。要了解更多信息，请参阅FHIR文档索引CodeableConcept中的。

HealthLake 附加以下三个键值对。

"system": ""http://healthlake.amazonaws.com/aws-cm/infer-rxnorm/: 其中URL指的是一项特定的亚马逊 Comprehend Medical 业务。API在这种情况下， InferRxNorm.
"code": "731533": 概 RxNorm 念 ID 在731533哪里，也称为 Rx CUI。
"display": "ibuprofen 200 MG Oral Capsule [Advil]": RxNorm 概念ibuprofen 200 MG Oral Capsule [Advil]的描述在哪里。

以下被截断的JSON响应仅包含元素。MedicationStatement


"medicationCodeableConcept": {
		"coding": [
			{
				"system": "http://healthlake.amazonaws.com/aws-cm/infer-rxnorm/",
				"code": "731533",
				"display": "ibuprofen 200 MG Oral Capsule [Advil]"
			}
		]
	}

`meta`

该meta元素包含的元数据表明该code元素是否包含由 Amazon Comprehend Medical 操作添加的详细信息。API

以下被截断的JSON响应仅包含元素。meta


"meta": {
		"lastUpdated": "2022-10-24T20:05:02.800Z",
		"tag": [
			{
				"display": "SYSTEM_GENERATED"
			}
		]
	}

`modifierExtension`

该modifierExtension元素包含键值对，这些键值对提供了指向 DocumentReference 用于生成结果的原始元素的链接以及相关的 Linkage 资源类型。


"modifierExtension": [
			{
				"url": "http://healthlake.amazonaws.com/system-generated-linkage",
				"valueReference": {
					"reference": "Linkage/394bb244-177b-4409-8657-26b20ed56dd7"
				}
			},
			{
				"url": "http://healthlake.amazonaws.com/source-document-reference",
				"valueReference": {
					"reference": "DocumentReference/c549125d-a218-421f-b8bf-23614c5e796c"
				}
			}
	]

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