If your institute has mapped the local Electronic Health Records (EHR) to Castor, you will be able to transfer the data from each EHR to the appropriate Castor record. Castor uses a FHIR importer, which you will need to access regularly to import the data. 

There are several prerequisites for using this functionality:

1. Your institute has enabled linking of the local EHR to Castor
2. Your study has been configured by Castor to allow linking to the local EHR
3. You have mapped the fields in your study forms to the appropriate fields in the EHR
4. You have both View and Edit rights for the appropriate institute

There are two ways to import EHR data, and the method used depends on the specific institute configuration: passive retrieval (example institute: Radboudumc) and active retrieval (example institute: LUMC). There are some minor differences between these methods, which are outlined below.

Steps to import data from EHR to Castor

1. Once per week, Castor checks if there is any new data available in the EHR that hasn't been transferred to Castor for all the records in a study. 

• Passive retrieval: When new data is available, an EHR icon will appear in the 'Records' tab next to the record to which the data belongs. Click on this icon to open the FHIR importer.

Note: This only occurs where new data is detected, not where updates exist for previous data. For previously imported data, you can click on the cogwheel to access the FHIR importer and check for updates in the EHR.

• Active retrieval: In the 'Records' tab, click on the cogwheel next to a record and select 'Import data from EHR'.

2. The FHIR importer will open in a new window.

• Passive retrieval: From the dropdown in the header, select the data set you want to download. Each data set contains all available data from the entire week leading up to the indicated time stamp:

Click on 'Load dataset' to load all available data for the record.

•  Active retrieval: Click on 'Load from EHR':

All available data for the record will be loaded.

3. If the data can be mapped to a phase or report in the study, it will be directly shown under the respective phase or report:

4. If the data can be mapped to multiple phases or reports in Castor, it will be displayed in the left panel under 'Unmapped' and these data points should be manually mapped to the correct phase or report:

You can use the arrowhead next to each data set to expand the view, listing all available results. Each result will have an accompanying date which corresponds to when the value was entered in the EHR:

To map the values from a certain date, enter the specified date in the appropriate phase. In the example below, all laboratory values from 05-08-2018 are to be transferred to the Baseline phase. Once the appropriate date range is selected in the phase 'Baseline', all available values from this date are automatically 'collected' under Baseline:

This is useful where the same measurement type exists in multiple phases or reports, as these can be mapped to different sections of a study based upon the date range.

5. Select the fields and click 'Save data to Castor'. A system message will appear, stating that the data was imported successfully, and the number of datapoints that were imported. This number should correspond to the number of values that were selected:

6. Click 'OK'. The data has now been saved in the record, and you will be returned to the main FHIR importer interface.

•  Passive retrieval: The dataset will now have the suffix (imported) in the 'Select dataset' dropdown. The EHR icon will no longer be present in the record overview.
•  Active retrieval: The data that was imported will no longer be listed when 'Load from EHR' is selected.

7. The FHIR importer may now be closed.