clinical-data-patternslisted

# Clinical Data Patterns > One-line mission: every clinical fact (vital, observation, > medication, allergy, condition, encounter, lab result, image) > moves through the system in a standards-compliant, version- > aware, terminology-coded shape that an EHR, a payer, a patient > app, and a regulator can all consume without translation > work. ## Purpose Principal-level engineering guidance for building clinical data interoperability into health-tech systems. Covers FHIR R5 + R4 (still the production majority through 2026-2027), HL7 v2 (the workhorse of US EHRs since 1989), CDA / CCDA documents, SMART on FHIR launch flows, USCDI v4 (the US federal data floor as of 2024), DICOM imaging, clinical terminologies (ICD-10-CM / ICD-10-PCS / SNOMED-CT / LOINC / RxNorm / CPT / HCPCS), telehealth + mHealth platforms (Apple HealthKit, Google Health Connect), and the ONC information-blocking + Cures Act API mandates. **Out of scope (deliberate)**: - HIPAA regulation + BAAs + breach + audit — covered by `hipaa-compliance` - Generic security baseline — covered by `security` + `owasp-asvs` - FDA SaMD device classification — separate domain - Clinical decision support algorithms — separate scope (this skill covers the data shapes; algorithm validation is its own discipline) - Medical billing claims (837/835) — separate revenue-cycle scope ## Standards Cited - **HL7 FHIR R5** — published 2023-03-26 (current normative release) - **HL7 FHIR R4** — published 2019-10-30 (production m