Azure FHIR Service unable to recognize derived extensions and generates a warning

Question

I created a FHIR Patient profile, which is based on FHIR US Core 6.1.0.The profile is created with FHIR ShortHand, and converted to FHIR json format with "sushi" with inclusion of a snapshot:sushi build -s .After publishing the profile to Azure Health Data FHIR Service, I'm trying to validate a Patient resource based on the created profile.However, Azure FHIR Service generates a warning that the service is unable to derived extension from the US Core Patient profile:

curl -X post --header "Content-type: application/json" --header "Authorization: Bearer ${azFhirToken}" --data "@fsh-generated/resources/PatientUS.json" 'https://abc-fhir001.fhir.azurehealthcareapis.com/Patient/$validate' | jq  
                                                                        
% Total    % Received % Xferd  Average Speed   Time    Time     Time  Current                                 Dload  Upload   Total   Spent    Left  Speed100  6523    0   605  100  5918    354   3466  0:00:01  0:00:01 --:--:--  3834

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "warning",
      "code": "business-rule",
      "details": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/dotnet-api-operation-outcome",
            "code": "2012"
          }
        ],
        "text": "Cannot walk into unknown StructureDefinition with canonical 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race' at 'https://abc-fhir001.fhir.azurehealthcareapis.com/StructureDefinition/patient-us#Patient.extension (Patient.extension:race)'"
      },
      "location": [
        "Patient // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression"
      ],
      "expression": [
        "Patient"
      ]
    }
  ]
}

My question in general - how can I overcome this warning? Is there a way to make Azure FHIR Service to retrieve and analyze extensions (race, etnicity, etc) from http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient ? Probably there is some trick to include race/enticity/etc US Core extensions into my Patient profile before publishing it? In worst case, can I suppress the warning?

Thank you for any advise!

Answer 1

@Olex Thanks for reaching out. Based on the information you provided, it seems that the issue may be related to the StructureDefinition for the US Core race extension not being loaded into the Azure Health Data FHIR Service.

please verify the following steps:

1. Query the FHIR service at <hostname&gt>/StructureDefinition to confirm that the proper StructureDefinition for the US Core race extension was loaded into the Azure Health Data FHIR Service, and that it has the matching URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race.
2. It looks like you may have created a StructureDefinition of your own with URL https://abc-fhir001.fhir.azurehealthcareapis.com/StructureDefinition/patient-us#Patient.extension (Patient.extension:race) and your own StructureDefinition refers to the us-core-race StructureDefinition, which may not be loaded into the FHIR server.
3. Once the US Core race extension StructureDefinition is loaded into the Azure Health Data FHIR Service, you can try validating the Patient resource again to see if the warning message is resolved.

Also note, it can take a few minutes after loading a StructureDefinition before it is available to the validator logic.

let me know incase of further queries, I would be happy to assist you.