Bericht aus Subsystemen (Composition / Document Bundle)

What it is

Hospitals run many specialized subsystems: laboratory software, radiology tools, cardiology equipment, and others. Their findings and reports need to make it back into the main hospital information system so clinicians can actually see them, alongside the rest of a patient's record. This data object, "report from subsystems," is how ISiK standardizes that hand-off.

Why it matters

Today, results from these subsystems are frequently sent back only as flat PDFs, or not sent back in any structured way at all, simply because the sending and receiving systems don't share a common format. ISiK addresses this by requiring subsystems to send their reports back as structured "documents" that always include a human-readable version, so results show up where clinicians are already working instead of living only in a separate system.

At this stage of ISiK, what's required is the document's metadata (its type, date, and source) plus a human-readable view. Deeper structured content within a report, such as diagnoses or procedures embedded in a lab or radiology finding, is planned for a future stage of the standard, and for now it's up to each vendor whether that structured content is imported automatically or only when a user chooses to.

How ISiK treats this differently from a typical FHIR exchange

Most FHIR data is created or updated resource by resource. This one isn't: ISiK requires the whole report to arrive as a single self-contained package called a document Bundle, submitted in one request rather than built up piece by piece. That's a deliberate choice, since a clinical report only makes sense as a complete, signed-off whole, not as a set of fragments that might be sent separately and arrive out of order.

How Kodjin supports it

The Kodjin FHIR Server has built specific support for receiving these document bundles, including validating that the patient and visit referenced in the report already exist, extracting the human-readable content and storing it as a linked file, and returning a clear error if a bundle can't be matched to an existing patient or visit. The technical details of how Kodjin processes these bundles, including how to enable this feature, are covered in the Document Bundle reference page.