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MedMij:Vissue-MM-3961/FHIR BGZ 2017

2022-11-18T10:52:25Z

Terrence Young:

{{IssuePaginaWaarschuwing|MM-3961|MedMij:V2020.01/FHIR_BGZ_2017}}
__NOINDEX__
__NUMBEREDHEADINGS__
{{DISPLAYTITLE:MedMij FHIR Implementation Guide: BgZ {{VersieInfo|BgZ}}}}
{{MedMij:Vprepub-2020.01/Issuebox_FHIR_IG}}

[[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]]
[[Bestand:BGZ_icoon.png |link=|links|90px|Use case BgZ 2017|Patient Summary (BgZ)]]
<imagemap>Bestand:Leeswijzer-technisch-banner 03 white.png|center|400px|alt=Afspraken-Functioneel-Technisch
circle 241 216 211 [https://www.medmij.nl/afsprakenstelsel Afsprakenstelsel]
circle 1013 224 212 [[MedMij:Vprepub-2020.01/OntwerpBGZ_2017|Functioneel]]
circle 1787 230 212 [[MedMij:Vprepub-2020.01/FHIR_IG|Technisch]]
desc none
</imagemap>

__TOC__

==Introduction==
[[Bestand:Functioneel-02.png|link=MedMij:Vprepub-2020.01/Ontwerpen |100px|rechts|Functional design|Go to functional design]]

The program ‘Registratie aan de bron’ (Clinical documentation at the point of care) has defined Health and Care Information models ([https://zibs.nl/wiki/HCIM_Mainpage HCIMs] (English) or [https://zibs.nl/wiki/ZIB_Hoofdpagina zibs] (Dutch)) for The Netherlands. Next to these HCIMs, the program ‘Registratie aan de bron’ also made a selection of these HCIMs into the so-called ‘Basisgegevensset Zorg’ (Common Clinical Dataset, a Dutch version of a ‘patient summary’, further referred to as ‘BgZ’). The BgZ serves as a minimal healthcare dataset that is always appropriate for caregivers in order to provide continuity of care for a patient and can be seen as a representation of a patient summary.

A subselection of the published [https://zibs.nl/wiki/HCIM_Release_2017(EN) HCIMs release 2017] constitute the [https://www.registratieaandebron.nl/pdf/BgZ_specificatie_obv_zibs_2017_v1.1.pdf BgZ 2017]. The BgZ makes a subselection of the information concepts within the HCIMs or restricts the HCIMs to a certain category. For example, only include the general practitioner of the patient or only the last known value of 'X'. MedMij created FHIR profiles that represent these HCIMs completely if no existing and usable profiles were available. The profiles represent their entire respective HCIM, to make them applicable in a broader context than a patient summary or even the MedMij context. An overview of the profiles can be found at the [[MedMij:Vprepub-2020.01/FHIR_BGZ_2017#List_of_profiles|list of profiles]].

The patient journey of [https://www.nictiz.nl/ehealth/MedMij Thomas van Beek], provides a patients context for exchanging a patient summary from a healthcare provider's system (XIS) to a personal health record (PHR). MedMij created a [[MedMij:Vprepub-2020.01/Ontwerpen|functional design]] of the BgZ use case. This use case consists of enabling a patient to view his own BgZ in a PHR. This page will elaborate further on the HL7 FHIR details needed to exchange the BgZ information using FHIR.

'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:Vprepub-2020.01/FHIR_IG#Use case overarching principles|use case overarching principles]].

==Actors involved==
{| class="wikitable"
! colspan="2" style="text-align:left;" | Actors
! colspan="2" style="text-align:left;" | Systems
! colspan="2" style="text-align:left;" | FHIR Capability Statements
|-
! style="text-align:left;" |Name
! style="text-align:left;" |Description
! style="text-align:left;" |Name
! style="text-align:left;" |Description
! style="text-align:left;" |Name
! style="text-align:left;" |Description
|-
| Patient
| The user of a personal healthcare environment.
| PHR
| Personal health record
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-clientcapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Client}}
| FHIR Client requirements
|-
| Healthcare professional
| The user of a XIS
| XIS
| Healthcare information system
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-servercapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Server}}
| FHIR Server requirements
|}

==Boundaries and Relationships==
The BgZ 2017 v1.1 use case follows the BgZ v1.0 use case. The difference between the two is the underlying HCIMs, which have been upgraded from release 2015 to release 2017. The changes are documented in a [https://github.com/Nictiz/Nictiz-STU3-Zib2017/raw/master/ReleaseNotes%20FHIR%20profielen%20ZIB2017.pdf release notes] document.

The BgZ use case has similarities and differences with other use cases such as Medication Process, Vital Signs and Lab Results. These use cases use the same HCIM based FHIR profiles for exchanging information. The BgZ use case covers practically all profiles included in the other use cases. However, the BgZ differs in the scope of the actual health information content that should be exchanged. For example, the BgZ conveys only the last known lab result of each type while the Lab Results use case may cover all known information.

==Use Case: Retrieve BGZ information==
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to MedMij Afsprakenstelsel]]

{{FHIR-IG-Afsprakenstelsel-Note}}

===PHR: request message===
The PHR system requests the BgZ using individual [https://www.hl7.org/fhir/stu3/search.html search] interactions. The BgZ consists of multiple FHIR resources with certain constraints. To obtain the patient's BgZ, the client can use multiple individual search operations based on specified search queries. The interactions are performed by an HTTP GET as shown:

<code>GET [base]/[type]{?[parameters]}</code>

The table below shows in the first four columns the BgZ sections, the HCIMs that constitute those sections and the specific content of the BgZ. The last column shows the FHIR search queries to obtain the BgZ information. These queries and expected responses are based on profiles listed in [[#List_of_profiles| this section]].

{| class="wikitable collapsible" width="100%" style="horizontal-align: right"
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | #
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | BgZ Section
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | HCIM EN
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Content
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Search URL<ref>See [[MedMij:Vprepub-2020.01/FHIR_IG#Search_URLs_and_search_parameters|Search URLs and search parameters]] for the interpretation of these search URLs</ref>
|-
| 1
| Patient information
| Patient
| Identification, birth date, gender, deceased indicator, contact details, last known marital status, and general practitioner (practitioner or organization)
| <pre>GET [base]/Patient?_include=Patient:general-practitioner</pre>
|-
| 2
| Payment details
| Payer
| Insurance information
| <pre>GET [base]/Coverage?_include=Coverage:payor:Patient&_include=Coverage:payor:Organization</pre>
|-
| rowspan="2" | 3
| rowspan="2" | Treatment directives
| TreatmentDirective
| Known treatment directives
| <pre>GET [base]/Consent?category=http://snomed.info/sct|11291000146105</pre>
|-
| AdvanceDirective
| Known advance directives
| <pre>GET [base]/Consent?category=http://snomed.info/sct|11341000146107</pre>
|-
| 4
| Contact persons
| ContactPerson
| First relation/contact
| <pre style="font-style: italic;">see Patient</pre>
|-
| 5
| Functional status
| FunctionalOrMentalStatus
| Last known functional / mental status
| <pre>GET [base]/Observation/$lastn?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006</pre>
{{NoteBox|The NL-CM:4.26.6 StatusDate concept is incorrectly mapped on the <code>effective[x]:effectivePeriod.start</code> element in the HCIM FunctionalOrMentalStatus profile, it is a date rather than a period. Presumed solution will come from a future HCIM release. See [https://bits.nictiz.nl/browse/MM-1570 MM-1570] for more information.}}
|-
| 6
| Problems
| Concern
| All known problems
| <pre>GET [base]/Condition</pre>
|-
| rowspan="5" | 7
| rowspan="5" | Social history
| LivingSituation
| Current living situation
| <pre>GET [base]/Observation/$lastn?code=http://snomed.info/sct|365508006</pre>
|-
| DrugUse
| All known drug use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|228366006</pre>
|-
| AlcoholUse
| All known alcohol use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|228273003</pre>
|-
| TobaccoUse
| All known tobacco use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|365980008</pre>
|-
| NutritionAdvice
| All known current dietary recommendations
| <pre>GET [base]/NutritionOrder</pre>
|-
| 8
| Alerts
| Alert
| All known alerts
| <pre>GET [base]/Flag</pre>
|-
| 9
| Allergies
| AllergyIntolerance
| All known information regarding allergies
| <pre>GET [base]/AllergyIntolerance</pre>
|-
| rowspan="3" | 10
| rowspan="3" | Medication
| MedicationUse
| Known medication use
| <pre>GET [base]/MedicationStatement?category=urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6&_include=MedicationStatement:medication</pre>
|-
| MedicationAgreement
| Known medication agreements
| <pre>GET [base]/MedicationRequest?category=http://snomed.info/sct|16076005&_include=MedicationRequest:medication</pre>
|-
| AdministrationAgreement
| Known administration agreements
| <pre>GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&_include=MedicationDispense:medication</pre>
{{NoteBox|The search on {{fhir|MedicationDispense.category}} requires a {{Simplifier|http://nictiz.nl/fhir/SearchParameter/Medications-category|nictiz.fhir.nl.stu3.zib2017|title= custom SearchParameter}} not represented in the FHIR specification. }}
|-
| 11
| Medical aids
| MedicalDevice
| Known medical aids
| <pre>GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device</pre>
|-
| 12
| Vaccinations
| Vaccination
| Known vaccinations
| <pre>GET [base]/Immunization?status=completed</pre>
|-
| rowspan="3" | 13
| rowspan="3" | Vital signs
| BloodPressure
| Last known blood pressure
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|85354-9</pre>
|-
| BodyWeight
| Last known body weight
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|29463-7</pre>
|-
| BodyHeight
| Last known body height
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9</pre>
|-
| 14
| Results
| LaboratoryTestResult
| Last known laboratory results per type
| <pre>GET [base]/Observation/$lastn?category=http://snomed.info/sct|275711006&_include=Observation:related-target&_include=Observation:specimen</pre>
|-
| 15
| Procedures
| Procedure
| Known surgical procedures
| <pre>GET [base]/Procedure?category=http://snomed.info/sct|387713003</pre>
|-
| 16
| Encounters
| Contact
| Known hospital admissions (no outpatient contacts)
| <pre>GET [base]/Encounter?class=http://hl7.org/fhir/v3/ActCode|IMP,http://hl7.org/fhir/v3/ActCode|ACUTE,http://hl7.org/fhir/v3/ActCode|NONAC</pre>
|-
| 17
| Planned care
| PlannedCareActivityForTransfer
| Known planned care activities
| {{NoteBox|The HCIM PlannedCareActivityForTransfer represents a planned activity as a (reference to) the HCIM for that activity in the 'planned' status. However, FHIR doesn't recognize this status; instead it uses dedicated resources for planning. Therefore, the FHIR implementation of this HCIM uses these dedicated resources instead of a distinct profile::

*Planning an Encounter is done by using an Appointment
*Planning a Procedure is done by using a ProcedureRequest
*Planning an Immunization is done by using an ImmunizationRecommendation
*Planning a MedicalDevice is done by using a DeviceRequest
}}
<pre>GET [base]/ProcedureRequest?status=active</pre>
<pre>GET [base]/ImmunizationRecommendation</pre>
{{NoteBox|The NL-CM:11.1.5 DesiredDateForRevaccination concept is incorrectly mapped onto the {{fhir|.recommendation.date}} element in the HCIM ImmunizationRecommendation profile. The proper element is actually {{fhir|.recommendation.dateCriterion}}. This will be fixed in the next breaking release. See [https://bits.nictiz.nl/browse/MM-2281 MM-2281] for more information.}}<pre style="text-decoration: line-through;">GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication</pre>
{{NoteBox|PlannedCareActivityForTransfer for MedicationAdministration was found unimplementable as-is. Presumed solution will come from a future HCIM release. See [https://bits.nictiz.nl/browse/MM-115 MM-115] for more information.}}
<pre>GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device</pre>
<pre>GET [base]/Appointment?status=booked,pending,proposed</pre>
|-
| 18
| General practitioner
| HealthProfessional
| General Practitioner of the patient
| <pre style="font-style: italic;">see Patient</pre>
|}
<references/>

===XIS: response message===
The returned data to the PHR should conform to the profiles listed in [[#List_of_profiles]].

===The {{fhir|$lastn}} operation===
The following [http://hl7.org/fhir/STU3/operations.html operation] is needed for this use case.
* [http://hl7.org/fhir/STU3/observation-operations.html#lastn Last N Observations Query]

The {{fhir|$lastn}} query meets the common need for searching for the most recent or last n=number of observations for a subject. For example, retrieving the last 5 temperatures for a patient to view trends or fetching the most recent laboratory results or vital signs. The link will provide more detailed information and examples regarding this operation.

The [http://hl7.org/fhir/STU3/observation-operations.html#{{fhir|$lastn}} FHIR STU3] specification is vague regarding the sorting mechanism of {{fhir|$lastn}}. In [http://hl7.org/fhir/R4/observation-operation-lastn.html FHIR R4] however, this has been clarified and can be read as follows: when using {{fhir|$lastn}}, the {{fhir|effective[x]}} element is used for sorting of Observations, sorted from most recent to the oldest.

{{NoteBox|The {{fhir|$lastn}} operation applies differently to the FunctionalOrMentalStatus and BodyHeight measurements, as it may respectively return up to two and three Observation resources instead of just one for each. This is due to the fact that FunctionalOrMentalStatus has two different categories (functional finding and mental state, behavior and/or psychosocial function finding) and BodyHeight three (body height, body height lying and body height standing), resulting respectively in two and three possible values for {{fhir|Observation.code}}. To query on FunctionalOrMentalStatus and BodyHeight, the {{fhir|$lastn}} query for these Observations should include all these two/three values, but this will result in the latest Observation for ''each'' of these values.}}

==List of profiles==
The profiles represent their entire respective HCIM, to make them applicable in a broader context than the exchange of BgZ or a MedMij context. An example of reuse of existing profiles is those of the patient administration resources and vital signs.

{{MedMij:Vprepub-2020.01/NoteBoxPackage|p1=nictiz.fhir.nl.stu3.bgz|p2=nictiz.fhir.nl.stu3.zib2017|v2Min=2.0.0|p3=nictiz.fhir.nl.stu3.eafspraak}}

{| class="wikitable" style="horizontal-align: right"
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Section
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | Zib NL
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | HCIM EN
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | FHIR Resource
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:400px" | FHIR Profile
|-
| rowspan="2" | 1
| Patient
| Patient
| Patient
| rowspan="2" | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| BurgerlijkeStaat
| MaritalStatus
| Patient.maritalStatus
|-
| rowspan="3" | 2
| rowspan="3" | Betaler
| rowspan="3" | Payer
| Coverage
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Payer|nictiz.fhir.nl.stu3.zib2017}}
|-
| Organization
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
|-
| Patient
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 3
| BehandelAanwijzing
| TreatmentDirective
| Consent
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective|nictiz.fhir.nl.stu3.zib2017}}
|-
| Wilsverklaring
| AdvanceDirective
| Consent
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective|nictiz.fhir.nl.stu3.zib2017}}
|-
| 4
| Contactpersoon
| ContactPerson
| Patient.contact
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| 5
| FunctioneleOfMentaleStatus
| FunctionalOrMentalStatus
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus|nictiz.fhir.nl.stu3.zib2017}}
|-
| 6
| Probleem
| Problem
| Condition
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Problem|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="5" | 7
| Woonsituatie
| LivingSituation
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation|nictiz.fhir.nl.stu3.zib2017}}
|-
| DrugsGebruik
| DrugUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| AlcoholGebruik
| AlcoholUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| TabakGebruik
| TobaccoUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| Voedingsadvies
| NutritionAdvice
| NutritionOrder
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice|nictiz.fhir.nl.stu3.zib2017}}
|-
| 8
| Alert
| Alert
| Flag
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Alert|nictiz.fhir.nl.stu3.zib2017}}
|-
| 9
| AllergieIntolerantie
| AllergyIntolerance
| AllergyIntolerance
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="3" | 10
| MedicatieGebruik2
| MedicationUse2
| MedicationStatement
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| Medicatieafspraak
| MedicationAgreement
| MedicationRequest
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| Toedieningsafspraak
| AdministrationAgreement
| MedicationDispense
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 11
| rowspan="2" | MedischHulpmiddel
| rowspan="2" | MedicalDevice
| Device
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct|nictiz.fhir.nl.stu3.zib2017}}
|-
| DeviceUseStatement
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 12
| rowspan="2" | Vaccinatie
| rowspan="2" | Vaccination
| Immunization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination|nictiz.fhir.nl.stu3.zib2017}}
|-
| ImmunizationRecommendation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="3" | 13
| Bloeddruk
| BloodPressure
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure|nictiz.fhir.nl.stu3.zib2017}}
|-
| LichaamsGewicht
| BodyWeight
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight|nictiz.fhir.nl.stu3.zib2017}}
|-
| LichaamsLengte
| BodyHeight
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 14
| rowspan="2" | LaboratoriumUitslag
| rowspan="2" | LaboratoryTestResult
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation|nictiz.fhir.nl.stu3.zib2017}}
|-
| Specimen
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen|nictiz.fhir.nl.stu3.zib2017}}
|-
| 15
| Verrichting
| Procedure
| Procedure
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Procedure|nictiz.fhir.nl.stu3.zib2017}}
|-
| 16
| Contact
| Encounter
| Encounter
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Encounter|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="5" | 17
| rowspan="5" | OverdrachtGeplandeZorgActiviteit
| rowspan="5" | PlannedCareActivityForTransfer
| ProcedureRequest [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest|nictiz.fhir.nl.stu3.zib2017}}
|-
| MedicationDispense [[#MM115Remark|**]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| ImmunizationRecommendation [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
|-
| DeviceRequest [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest|nictiz.fhir.nl.stu3.zib2017}}
|-
| Appointment [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/eAfspraak-Appointment|nictiz.fhir.nl.stu3.eafspraak}}
|-
| rowspan="3" | 18
| rowspan="2" | Zorgverlener
| rowspan="2" | HealthProfessional
| Practitioner
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner|nictiz.fhir.nl.stu3.zib2017}}
|-
| PractitionerRole
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole|nictiz.fhir.nl.stu3.zib2017}}
|-
| Zorgaanbieder
| HealthcareProvider
| Organization
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
|}

=Release notes=
Release notes can be found on the [[MedMij:Vprepub-2020.01/OntwerpBGZ_2017#Release_notes|functional design page]].

MedMij:Vissue-MM-3961/FHIR BGZ 2017

2022-11-18T10:00:30Z

Terrence Young: Clone of V2020.01 production page for issue MM-3961

{{IssuePaginaWaarschuwing|MM-3961|MedMij:V2020.01/FHIR_BGZ_2017}}
__NOINDEX__
__NUMBEREDHEADINGS__
{{DISPLAYTITLE:MedMij FHIR Implementation Guide: BgZ {{VersieInfo|BgZ}}}}
{{MedMij:Vprepub-2020.01/Issuebox_FHIR_IG}}

[[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]]
[[Bestand:BGZ_icoon.png |link=|links|90px|Use case BgZ 2017|Patient Summary (BgZ)]]
<imagemap>Bestand:Leeswijzer-technisch-banner 03 white.png|center|400px|alt=Afspraken-Functioneel-Technisch
circle 241 216 211 [https://www.medmij.nl/afsprakenstelsel Afsprakenstelsel]
circle 1013 224 212 [[MedMij:Vprepub-2020.01/OntwerpBGZ_2017|Functioneel]]
circle 1787 230 212 [[MedMij:Vprepub-2020.01/FHIR_IG|Technisch]]
desc none
</imagemap>

__TOC__

==Introduction==
[[Bestand:Functioneel-02.png|link=MedMij:Vprepub-2020.01/Ontwerpen |100px|rechts|Functional design|Go to functional design]]

The program ‘Registratie aan de bron’ (Clinical documentation at the point of care) has defined Health and Care Information models ([https://zibs.nl/wiki/HCIM_Mainpage HCIMs] (English) or [https://zibs.nl/wiki/ZIB_Hoofdpagina zibs] (Dutch)) for The Netherlands. Next to these HCIMs, the program ‘Registratie aan de bron’ also made a selection of these HCIMs into the so-called ‘Basisgegevensset Zorg’ (Common Clinical Dataset, a Dutch version of a ‘patient summary’, further referred to as ‘BgZ’). The BgZ serves as a minimal healthcare dataset that is always appropriate for caregivers in order to provide continuity of care for a patient and can be seen as a representation of a patient summary.

A subselection of the published [https://zibs.nl/wiki/HCIM_Release_2017(EN) HCIMs release 2017] constitute the [https://www.registratieaandebron.nl/pdf/BgZ_specificatie_obv_zibs_2017_v1.1.pdf BgZ 2017]. The BgZ makes a subselection of the information concepts within the HCIMs or restricts the HCIMs to a certain category. For example, only include the general practitioner of the patient or only the last known value of 'X'. MedMij created FHIR profiles that represent these HCIMs completely if no existing and usable profiles were available. The profiles represent their entire respective HCIM, to make them applicable in a broader context than a patient summary or even the MedMij context. An overview of the profiles can be found at the [[MedMij:Vprepub-2020.01/FHIR_BGZ_2017#List_of_profiles|list of profiles]].

The patient journey of [https://www.nictiz.nl/ehealth/MedMij Thomas van Beek], provides a patients context for exchanging a patient summary from a healthcare provider's system (XIS) to a personal health record (PHR). MedMij created a [[MedMij:Vprepub-2020.01/Ontwerpen|functional design]] of the BgZ use case. This use case consists of enabling a patient to view his own BgZ in a PHR. This page will elaborate further on the HL7 FHIR details needed to exchange the BgZ information using FHIR.

'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:Vprepub-2020.01/FHIR_IG#Use case overarching principles|use case overarching principles]].

==Actors involved==
{| class="wikitable"
! colspan="2" style="text-align:left;" | Actors
! colspan="2" style="text-align:left;" | Systems
! colspan="2" style="text-align:left;" | FHIR Capability Statements
|-
! style="text-align:left;" |Name
! style="text-align:left;" |Description
! style="text-align:left;" |Name
! style="text-align:left;" |Description
! style="text-align:left;" |Name
! style="text-align:left;" |Description
|-
| Patient
| The user of a personal healthcare environment.
| PHR
| Personal health record
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-clientcapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Client}}
| FHIR Client requirements
|-
| Healthcare professional
| The user of a XIS
| XIS
| Healthcare information system
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-servercapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Server}}
| FHIR Server requirements
|}

==Boundaries and Relationships==
The BgZ 2017 v1.1 use case follows the BgZ v1.0 use case. The difference between the two is the underlying HCIMs, which have been upgraded from release 2015 to release 2017. The changes are documented in a [https://github.com/Nictiz/Nictiz-STU3-Zib2017/raw/master/ReleaseNotes%20FHIR%20profielen%20ZIB2017.pdf release notes] document.

The BgZ use case has similarities and differences with other use cases such as Medication Process, Vital Signs and Lab Results. These use cases use the same HCIM based FHIR profiles for exchanging information. The BgZ use case covers practically all profiles included in the other use cases. However, the BgZ differs in the scope of the actual health information content that should be exchanged. For example, the BgZ conveys only the last known lab result of each type while the Lab Results use case may cover all known information.

==Use Case: Retrieve BGZ information==
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to MedMij Afsprakenstelsel]]

{{FHIR-IG-Afsprakenstelsel-Note}}

===PHR: request message===
The PHR system requests the BgZ using individual [https://www.hl7.org/fhir/stu3/search.html search] interactions. The BgZ consists of multiple FHIR resources with certain constraints. To obtain the patient's BgZ, the client can use multiple individual search operations based on specified search queries. The interactions are performed by an HTTP GET as shown:

<code>GET [base]/[type]{?[parameters]}</code>

The table below shows in the first four columns the BgZ sections, the HCIMs that constitute those sections and the specific content of the BgZ. The last column shows the FHIR search queries to obtain the BgZ information. These queries and expected responses are based on profiles listed in [[#List_of_profiles| this section]].

{| class="wikitable collapsible" width="100%" style="horizontal-align: right"
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | #
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | BgZ Section
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | HCIM EN
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Content
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Search URL<ref>See [[MedMij:Vprepub-2020.01/FHIR_IG#Search_URLs_and_search_parameters|Search URLs and search parameters]] for the interpretation of these search URLs</ref>
|-
| 1
| Patient information
| Patient
| Identification, birth date, gender, deceased indicator, contact details, last known marital status, and general practitioner (practitioner or organization)
| <pre>GET [base]/Patient?_include=Patient:general-practitioner</pre>
|-
| 2
| Payment details
| Payer
| Insurance information
| <pre>GET [base]/Coverage?_include=Coverage:payor:Patient&_include=Coverage:payor:Organization</pre>
|-
| rowspan="2" | 3
| rowspan="2" | Treatment directives
| TreatmentDirective
| Known treatment directives
| <pre>GET [base]/Consent?category=http://snomed.info/sct|11291000146105</pre>
|-
| AdvanceDirective
| Known advance directives
| <pre>GET [base]/Consent?category=http://snomed.info/sct|11341000146107</pre>
|-
| 4
| Contact persons
| ContactPerson
| First relation/contact
| <pre style="font-style: italic;">see Patient</pre>
|-
| 5
| Functional status
| FunctionalOrMentalStatus
| Last known functional / mental status
| <pre>GET [base]/Observation/$lastn?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006</pre>
{{NoteBox|The NL-CM:4.26.6 StatusDate concept is incorrectly mapped on the <code>effective[x]:effectivePeriod.start</code> element in the HCIM FunctionalOrMentalStatus profile, it is a date rather than a period. Presumed solution will come from a future HCIM release. See [https://bits.nictiz.nl/browse/MM-1570 MM-1570] for more information.}}
|-
| 6
| Problems
| Concern
| All known problems
| <pre>GET [base]/Condition</pre>
|-
| rowspan="5" | 7
| rowspan="5" | Social history
| LivingSituation
| Current living situation
| <pre>GET [base]/Observation/$lastn?code=http://snomed.info/sct|365508006</pre>
|-
| DrugUse
| All known drug use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|228366006</pre>
|-
| AlcoholUse
| All known alcohol use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|228273003</pre>
|-
| TobaccoUse
| All known tobacco use
| <pre>GET [base]/Observation?code=http://snomed.info/sct|365980008</pre>
|-
| NutritionAdvice
| All known current dietary recommendations
| <pre>GET [base]/NutritionOrder</pre>
|-
| 8
| Alerts
| Alert
| All known alerts
| <pre>GET [base]/Flag</pre>
|-
| 9
| Allergies
| AllergyIntolerance
| All known information regarding allergies
| <pre>GET [base]/AllergyIntolerance</pre>
|-
| rowspan="3" | 10
| rowspan="3" | Medication
| MedicationUse
| Known medication use
| <pre>GET [base]/MedicationStatement?category=urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6&_include=MedicationStatement:medication</pre>
|-
| MedicationAgreement
| Known medication agreements
| <pre>GET [base]/MedicationRequest?category=http://snomed.info/sct|16076005&_include=MedicationRequest:medication</pre>
|-
| AdministrationAgreement
| Known administration agreements
| <pre>GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&_include=MedicationDispense:medication</pre>
{{NoteBox|The search on {{fhir|MedicationDispense.category}} requires a {{Simplifier|http://nictiz.nl/fhir/SearchParameter/Medications-category|nictiz.fhir.nl.stu3.zib2017|title= custom SearchParameter}} not represented in the FHIR specification. }}
|-
| 11
| Medical aids
| MedicalDevice
| Known medical aids
| <pre>GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device</pre>
|-
| 12
| Vaccinations
| Vaccination
| Known vaccinations
| <pre>GET [base]/Immunization?status=completed</pre>
|-
| rowspan="3" | 13
| rowspan="3" | Vital signs
| BloodPressure
| Last known blood pressure
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|85354-9</pre>
|-
| BodyWeight
| Last known body weight
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|29463-7</pre>
|-
| BodyHeight
| Last known body height
| <pre>GET [base]/Observation/$lastn?code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9</pre>
|-
| 14
| Results
| LaboratoryTestResult
| Last known laboratory results per type
| <pre>GET [base]/Observation/$lastn?category=http://snomed.info/sct|275711006&_include=Observation:related-target&_include=Observation:specimen</pre>
|-
| 15
| Procedures
| Procedure
| Known surgical procedures
| <pre>GET [base]/Procedure?category=http://snomed.info/sct|387713003</pre>
|-
| 16
| Encounters
| Contact
| Known hospital admissions (no outpatient contacts)
| <pre>GET [base]/Encounter?class=http://hl7.org/fhir/v3/ActCode|IMP,http://hl7.org/fhir/v3/ActCode|ACUTE,http://hl7.org/fhir/v3/ActCode|NONAC</pre>
|-
| 17
| Planned care
| PlannedCareActivityForTransfer
| Known planned care activities
| {{NoteBox|The HCIM PlannedCareActivityForTransfer represents a planned activity as a (reference to) the HCIM for that activity in the 'planned' status. However, FHIR doesn't recognize this status; instead it uses dedicated resources for planning. Therefore, the FHIR implementation of this HCIM uses these dedicated resources instead of a distinct profile::

*Planning an Encounter is done by using an Appointment
*Planning a Procedure is done by using a ProcedureRequest
*Planning an Immunization is done by using an ImmunizationRecommendation
*Planning a MedicalDevice is done by using a DeviceRequest
}}
<pre>GET [base]/ProcedureRequest?status=active</pre>
<pre>GET [base]/ImmunizationRecommendation</pre>
{{NoteBox|The NL-CM:11.1.5 DesiredDateForRevaccination concept is incorrectly mapped onto the {{fhir|.recommendation.date}} element in the HCIM ImmunizationRecommendation profile. The proper element is actually {{fhir|.recommendation.dateCriterion}}. This will be fixed in the next breaking release. See [https://bits.nictiz.nl/browse/MM-2281 MM-2281] for more information.}}<pre style="text-decoration: line-through;">GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication</pre>
{{NoteBox|PlannedCareActivityForTransfer for MedicationAdministration was found unimplementable as-is. Presumed solution will come from a future HCIM release. See [https://bits.nictiz.nl/browse/MM-115 MM-115] for more information.}}
<pre>GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device</pre>
<pre>GET [base]/Appointment?status=booked,pending,proposed</pre>
|-
| 18
| General practitioner
| HealthProfessional
| General Practitioner of the patient
| <pre style="font-style: italic;">see Patient</pre>
|}
<references/>

===XIS: response message===
The returned data to the PHR should conform to the profiles listed in [[#List_of_profiles]].

===The <code>lastn</code> operation===
The following [http://hl7.org/fhir/STU3/operations.html operation] is needed for this use case.
* [http://hl7.org/fhir/STU3/observation-operations.html#lastn Last N Observations Query]

The <code>lastn</code> query meets the common need for searching for the most recent or last n=number of observations for a subject. For example, retrieving the last 5 temperatures for a patient to view trends or fetching the most recent laboratory results or vital signs. The link will provide more detailed information and examples regarding this operation.

The FHIR STU3 specification is vague regarding the sorting mechanism of <code>lastn</code>. In FHIR R4 however, this has been clarified and can be read as follows: when using <code>lastn</code>, the <code>effective[x]</code> element is used for sorting of Observations, sorted from most recent to the oldest.

==List of profiles==
The profiles represent their entire respective HCIM, to make them applicable in a broader context than the exchange of BgZ or a MedMij context. An example of reuse of existing profiles is those of the patient administration resources and vital signs.

{{MedMij:Vprepub-2020.01/NoteBoxPackage|p1=nictiz.fhir.nl.stu3.bgz|p2=nictiz.fhir.nl.stu3.zib2017|v2Min=2.0.0|p3=nictiz.fhir.nl.stu3.eafspraak}}

{| class="wikitable" style="horizontal-align: right"
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Section
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | Zib NL
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | HCIM EN
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:100px" | FHIR Resource
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:400px" | FHIR Profile
|-
| rowspan="2" | 1
| Patient
| Patient
| Patient
| rowspan="2" | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| BurgerlijkeStaat
| MaritalStatus
| Patient.maritalStatus
|-
| rowspan="3" | 2
| rowspan="3" | Betaler
| rowspan="3" | Payer
| Coverage
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Payer|nictiz.fhir.nl.stu3.zib2017}}
|-
| Organization
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
|-
| Patient
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 3
| BehandelAanwijzing
| TreatmentDirective
| Consent
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective|nictiz.fhir.nl.stu3.zib2017}}
|-
| Wilsverklaring
| AdvanceDirective
| Consent
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective|nictiz.fhir.nl.stu3.zib2017}}
|-
| 4
| Contactpersoon
| ContactPerson
| Patient.contact
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
|-
| 5
| FunctioneleOfMentaleStatus
| FunctionalOrMentalStatus
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus|nictiz.fhir.nl.stu3.zib2017}}
|-
| 6
| Probleem
| Problem
| Condition
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Problem|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="5" | 7
| Woonsituatie
| LivingSituation
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation|nictiz.fhir.nl.stu3.zib2017}}
|-
| DrugsGebruik
| DrugUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| AlcoholGebruik
| AlcoholUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| TabakGebruik
| TobaccoUse
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| Voedingsadvies
| NutritionAdvice
| NutritionOrder
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice|nictiz.fhir.nl.stu3.zib2017}}
|-
| 8
| Alert
| Alert
| Flag
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Alert|nictiz.fhir.nl.stu3.zib2017}}
|-
| 9
| AllergieIntolerantie
| AllergyIntolerance
| AllergyIntolerance
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="3" | 10
| MedicatieGebruik2
| MedicationUse2
| MedicationStatement
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse|nictiz.fhir.nl.stu3.zib2017}}
|-
| Medicatieafspraak
| MedicationAgreement
| MedicationRequest
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| Toedieningsafspraak
| AdministrationAgreement
| MedicationDispense
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 11
| rowspan="2" | MedischHulpmiddel
| rowspan="2" | MedicalDevice
| Device
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct|nictiz.fhir.nl.stu3.zib2017}}
|-
| DeviceUseStatement
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 12
| rowspan="2" | Vaccinatie
| rowspan="2" | Vaccination
| Immunization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination|nictiz.fhir.nl.stu3.zib2017}}
|-
| ImmunizationRecommendation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="3" | 13
| Bloeddruk
| BloodPressure
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure|nictiz.fhir.nl.stu3.zib2017}}
|-
| LichaamsGewicht
| BodyWeight
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight|nictiz.fhir.nl.stu3.zib2017}}
|-
| LichaamsLengte
| BodyHeight
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="2" | 14
| rowspan="2" | LaboratoriumUitslag
| rowspan="2" | LaboratoryTestResult
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation|nictiz.fhir.nl.stu3.zib2017}}
|-
| Specimen
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen|nictiz.fhir.nl.stu3.zib2017}}
|-
| 15
| Verrichting
| Procedure
| Procedure
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Procedure|nictiz.fhir.nl.stu3.zib2017}}
|-
| 16
| Contact
| Encounter
| Encounter
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Encounter|nictiz.fhir.nl.stu3.zib2017}}
|-
| rowspan="5" | 17
| rowspan="5" | OverdrachtGeplandeZorgActiviteit
| rowspan="5" | PlannedCareActivityForTransfer
| ProcedureRequest [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest|nictiz.fhir.nl.stu3.zib2017}}
|-
| MedicationDispense [[#MM115Remark|**]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}
|-
| ImmunizationRecommendation [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
|-
| DeviceRequest [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest|nictiz.fhir.nl.stu3.zib2017}}
|-
| Appointment [[#PlannedCareRemark|*]]
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/eAfspraak-Appointment|nictiz.fhir.nl.stu3.eafspraak}}
|-
| rowspan="3" | 18
| rowspan="2" | Zorgverlener
| rowspan="2" | HealthProfessional
| Practitioner
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner|nictiz.fhir.nl.stu3.zib2017}}
|-
| PractitionerRole
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole|nictiz.fhir.nl.stu3.zib2017}}
|-
| Zorgaanbieder
| HealthcareProvider
| Organization
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
|}

=Release notes=
Release notes can be found on the [[MedMij:Vprepub-2020.01/OntwerpBGZ_2017#Release_notes|functional design page]].

Bestand:Beoordelingsformulier BgZ Beschikbaarstellen 01-02-2022.pdf

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2022-04-22T10:01:00Z

Terrence Young: Terrence Young heeft een nieuwe versie van Bestand:Beoordelingsformulier AllergieIntolerantieVertaling Beschikbaarstellen 01-02-2022.pdf geüpload

Bestand:Beoordelingsformulier AllergieIntolerantie Beschikbaarstellen 01-02-2022.pdf

2022-04-22T10:00:28Z

Terrence Young: Terrence Young heeft een nieuwe versie van Bestand:Beoordelingsformulier AllergieIntolerantie Beschikbaarstellen 01-02-2022.pdf geüpload

Bestand:CCG AIV Beschikbaarstellen v2020.01 v4.2.zip

2022-03-17T14:41:31Z

Terrence Young:

Bestand:CCG AI-V Beschikbaarstellen v2020.01 v4.2.zip

2022-03-17T14:34:38Z

Terrence Young:

Bestand:CCG AI Beschikbaarstellen v2020.01 v4.2.zip

2022-03-17T13:56:46Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Basisgegevens Langdurige Zorg 2020.02 20210324.pdf.pptx.zip

2021-03-18T11:08:02Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Basisgegevens Langdurige Zorg 2020.02 20210324.pdf.pptx.zip

2021-03-18T11:07:53Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Laboratoriumresultaten 20210324 2019.01.pptx.zip

2021-03-18T10:39:21Z

Terrence Young: Terrence Young heeft een nieuwe versie van Bestand:Aanleverformat - Raadplegen Laboratoriumresultaten 20210324 2019.01.pptx.zip geüpload

Bestand:Beoordelingsformulier Medicatiegegevens Beschikbaarstellen 20210324 2019.01.pdf

2021-03-18T10:32:41Z

Terrence Young:

Bestand:Beoordelingsformulier Medicatiegegevens Raadplegen 20210324 2019.01.pdf

2021-03-18T10:27:54Z

Terrence Young: Terrence Young heeft een nieuwe versie van Bestand:Beoordelingsformulier Medicatiegegevens Raadplegen 20210324 2019.01.pdf geüpload

Bestand:Beoordelingsformulier Verstrekkingenvertaling Beschikbaarstellen 20210324 2019.01.pdf

2021-03-18T10:27:00Z

Terrence Young:

Bestand:Beoordelingsformulier Medicatiegegevens Raadplegen 20210324 2019.01.pdf

2021-03-18T10:17:48Z

Terrence Young: Terrence Young heeft een nieuwe versie van Bestand:Beoordelingsformulier Medicatiegegevens Raadplegen 20210324 2019.01.pdf geüpload

Bestand:Beoordelingsformulier Medicatieoverzicht Beschikbaarstellen 20210324 2019.01.pdf

2021-03-18T10:15:47Z

Terrence Young:

Bestand:Beoordelingsformulier Medicatiegegevens Raadplegen 20210324 2019.01.pdf

2021-03-18T10:11:48Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Verstrekkingsverzoek 20210324 2019.01.pptx.zip

2021-03-18T09:51:39Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Verstrekkingenvertaling 20210324 2019.01.pptx.zip

2021-03-18T09:51:22Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Medicatieoverzicht 20210324 2019.01.pptx.zip

2021-03-18T09:50:04Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Medicatieafspraak 20210324 2019.01.pptx.zip

2021-03-18T09:49:37Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Verstrekkingsverzoek 20210324 2019.01.pptx.zip

2021-03-18T08:58:58Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Verstrekkingenvertaling 20210324 2019.01.pptx.zip

2021-03-18T08:58:01Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Toedieningsafspraak 20210324 2019.01.pptx.zip

2021-03-18T08:57:38Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Medicatieverstrekking 20210324 2019.01.pptx.zip

2021-03-18T08:57:17Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Medicatieoverzicht 20210324 2019.01.pptx.zip

2021-03-18T08:56:55Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Medicatiegegevens 20210324 2019.01.pptx.zip

2021-03-18T08:56:37Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Medicatiegebruik 20210324 2019.01.pptx.zip

2021-03-18T08:56:15Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Medicatieafspraak 20210324 2019.01.pptx.zip

2021-03-18T08:51:35Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen en sturen vragenlijsten 20210324 2019.01.pptx.zip

2021-03-17T14:27:45Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen en Ontvangen vragenlijsten 20210324 2019.01.pptx.zip

2021-03-17T14:27:12Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Basisgegevens Langdurige Zorg 20210324 2019.01.pptx.zip

2021-03-17T14:24:30Z

Terrence Young:

Bestand:3. Aanleverformat - Beschikbaarstellen Basisgegevens Langdurige Zorg 20210324 2019.01.pptx.zip

2021-03-17T14:22:24Z

Terrence Young:

Bestand:Aanleverformat - Sturen Beelden 20210324 2019.01.pptx.zip

2021-03-17T14:20:39Z

Terrence Young:

Bestand:Aanleverformat - Ontvangen Beelden 20210324 2019.01.pptx.zip

2021-03-17T14:19:56Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Basisgegevens GGZ 20210324 2019.01.pptx.zip

2021-03-17T14:17:22Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen Basisgegevens GGZ 20210324 2019.01.pptx.zip

2021-03-17T14:15:55Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen en Sturen PDFA 20210324 2019.01.pptx.zip

2021-03-17T14:12:09Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen en Ontvangen PDFA 20210324 2019.01.pptx.zip

2021-03-17T14:11:51Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen eAfspraak 20210324 2019.01.pptx.zip

2021-03-17T14:09:23Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen en Sturen Zelfmetingen 20210324 2019.01.pptx.zip

2021-03-17T14:08:09Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen en Ontvangen Zelfmetingen 20210324 2019.01.pptx.zip

2021-03-17T14:07:33Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen eAfspraak 20210324 2019.01.pptx.zip

2021-03-17T14:04:31Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen AllergieIntolerantieVertaling 20210324 2019.01.pptx.zip

2021-03-17T13:59:58Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen AllergieIntolerantieVertaling 20210324 2019.01.pptx.zip

2021-03-17T13:59:40Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen AllergieIntolerantie 20210324 2019.01.pptx.zip

2021-03-17T13:58:31Z

Terrence Young:

Bestand:Aanleverformat - Beschikbaarstellen AllergieIntolerantie 20210324 2019.01.pptx.zip

2021-03-17T13:58:08Z

Terrence Young:

Bestand:3. Aanleverformat - Beschikbaarstellen AllergieIntolerantie 20210324 2019.01.pptx.zip

2021-03-17T13:55:13Z

Terrence Young:

Bestand:Aanleverformat - Raadplegen Laboratoriumresultaten 20210324 2019.01.pptx.zip

2021-03-17T13:46:44Z

Terrence Young: