Bumblebee#
A clinical record for emergency medical teams. It exists to help a volunteer clinician take care of a patient in a disaster — offline, on a cheap phone, with a queue of people waiting.
Bumblebee is at the planning stage. No production code exists yet. What does exist is a design record and the FHIR R4 implementation guide generated from it, which is published here: Bumblebee IG.
What the setting demands#
A team lands in a disaster zone with volunteers who last used the software 12–18 months ago and as little as three hours of pre-deployment training, no internet, intermittent power, cheap Android phones, and a patient every few minutes.
Two measurements from the response to Cyclone Idai in Mozambique in 2019 — 13 teams over 110 days — govern what the record is optimised for:
- Of 13,738 health events, 56.5% had no more specific description than "other". Major head and spine, torso and extremity injuries together were 0.5%.
- 84.7% of health events had nothing to do with the disaster, rising to 94.5% by the end of the response, because a team in the acute phase substitutes for health facilities that are not working.
So the clinical surface has to be excellent at ordinary illness seen once in a tent. Disaster trauma is the rare case.
What is in the guide#
32 profiles · 8 extensions · 4 value sets · 3 code systems, all on FHIR R4, covering one contact between a patient and a team — registration, triage, diagnosis, observations, medicines, procedures, and everything that happens at the end of a visit — plus the standing facts about a person that outlive any one visit.
The guide carries its own narrative: what the record holds, how to read the profiles, the terminology, the design rationale behind each profile, the graded evidence the design rests on, how it relates to published national guides, and what is still open.
Where it sits in the family#
Bumblebee builds on the rest of the FHIR-FLI packages — fhir_r4 and
fhir_r4_db for the model and the encrypted local store, fhirant
as the site
server, katydid for questionnaires, and fhir_path and cql
for computable
logic.
Status#
Draft, version 0.1.0. The profiles are proposed rather than agreed, several rest on decisions taken provisionally for a partner to confirm, and there are no examples yet. Nothing in the guide has been used to record the care of a real patient. The project's design record — the decision log, the graded source library and the review questions — is not published alongside it.