MedMij:Vprepub-2020.01/FHIR GGZ: verschil tussen versies
(MM-1461 Added notebox with FreedomRestrictingMeasures remark) |
(MM-3450 Opmerking in FO en TO geplaatst dat GezinssituatieKind geen onderdeel is van lijst vippggz regeling) |
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| (8 tussenliggende versies door 4 gebruikers niet weergegeven) | |||
| Regel 1: | Regel 1: | ||
__NUMBEREDHEADINGS__ | __NUMBEREDHEADINGS__ | ||
{{DISPLAYTITLE:MedMij FHIR Implementation Guide basic GGZ data {{VersieInfo|BgGGZ}}}} | {{DISPLAYTITLE:MedMij FHIR Implementation Guide basic GGZ data {{VersieInfo|BgGGZ}}}} | ||
| − | {{MedMij:Vprepub/Issuebox_FHIR_IG}} | + | {{MedMij:Vprepub-2020.01/Issuebox_FHIR_IG}} |
[[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]] | [[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]] | ||
| Regel 7: | Regel 7: | ||
<imagemap>Bestand:Leeswijzer-technisch-banner 03 white.png|center|400px|alt=Afspraken-Functioneel-Technisch | <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 241 216 211 [https://www.medmij.nl/afsprakenstelsel Afsprakenstelsel] | ||
| − | circle 1013 224 212 [[MedMij:Vprepub/OntwerpGGZ|Functioneel]] | + | circle 1013 224 212 [[MedMij:Vprepub-2020.01/OntwerpGGZ|Functioneel]] |
| − | circle 1787 230 212 [[MedMij:Vprepub/FHIR_IG|Technisch]] | + | circle 1787 230 212 [[MedMij:Vprepub-2020.01/FHIR_IG|Technisch]] |
desc none | desc none | ||
</imagemap> | </imagemap> | ||
| Regel 17: | Regel 17: | ||
The page describes the FHIR requirements for exchanging GGZ information between the patients and healthcare providers in the context of MedMij. | The page describes the FHIR requirements for exchanging GGZ information between the patients and healthcare providers in the context of MedMij. | ||
| − | '''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:Vprepub/FHIR_IG#Use case overarching principles|use case overarching principles]]. | + | '''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= | =Actors involved= | ||
| Regel 68: | Regel 68: | ||
!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" | 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" | Content | ||
| − | !style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left; background-color: #E3E3E3 width:10px" | Search URL<ref>See [[MedMij:Vprepub/FHIR_IG#Search_URLs_and_search_parameters|Search URLs and search parameters]] for the interpretation of these search URLs</ref> | + | !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> |
|- | |- | ||
| Patient | | Patient | ||
| Regel 116: | Regel 116: | ||
| All known functional / mental status | | All known functional / mental status | ||
| <pre>GET [base]/Observation?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006</pre> | | <pre>GET [base]/Observation?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006</pre> | ||
| + | <span id="FunctionalOrMentalStatusRemark"></span>{{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.}} | ||
|- | |- | ||
| Probleem | | Probleem | ||
| Regel 147: | Regel 148: | ||
| <pre>GET [base]/Observation?code=http://snomed.info/sct|365470003</pre> | | <pre>GET [base]/Observation?code=http://snomed.info/sct|365470003</pre> | ||
|- | |- | ||
| − | | GezinssituatieKind | + | | GezinssituatieKind |
| FamilySituationChild | | FamilySituationChild | ||
| All known family situations of child patient | | All known family situations of child patient | ||
| − | | <pre>GET [base]/Observation?code=http://snomed.info/sct|55801000146105</pre> | + | | <pre>GET [base]/Observation?code=http://snomed.info/sct|55801000146105</pre> {{IssueBox|FamilySituationChild is not part of the required list by the VIPP GGZ regulation.}} |
|- | |- | ||
| Taalvaardigheid | | Taalvaardigheid | ||
| Regel 218: | Regel 219: | ||
The profiles represent their entire respective HCIM and are applicable in a broader context than the exchange of GGZ information. | The profiles represent their entire respective HCIM and are applicable in a broader context than the exchange of GGZ information. | ||
| − | {{MedMij:NoteBoxPackage|p1=nictiz.fhir.nl.stu3.zib2017}} | + | {{MedMij:Vprepub-2020.01/NoteBoxPackage|p1=nictiz.fhir.nl.stu3.zib2017|v1Min=2.0.0}} |
{| class="wikitable" style="horizontal-align: right" | {| class="wikitable" style="horizontal-align: right" | ||
| Regel 250: | Regel 251: | ||
| LegalStatus* | | LegalStatus* | ||
| Extension | | Extension | ||
| − | | {{Simplifier|http:// | + | | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017|see Patient}} <s> or {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures|nictiz.fhir.nl.stu3.zib2017|see FreedomRestrictingMeasures}} </s> |
|- | |- | ||
| − | | VrijheidbeperkendeMaatregelen | + | | <s>VrijheidbeperkendeMaatregelen</s> |
| − | | FreedomRestrictingMeasures | + | | <s>FreedomRestrictingMeasures</s> |
| − | | Procedure | + | | <s>Procedure</s> |
| − | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures|nictiz.fhir.nl.stu3.zib2017}} | + | | <s>{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures|nictiz.fhir.nl.stu3.zib2017}}</s> |
|- | |- | ||
| FunctioneleOfMentaleStatus | | FunctioneleOfMentaleStatus | ||
| Regel 292: | Regel 293: | ||
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FamilySituation|nictiz.fhir.nl.stu3.zib2017}} | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FamilySituation|nictiz.fhir.nl.stu3.zib2017}} | ||
|- | |- | ||
| − | | GezinssituatieKind | + | | <s> GezinssituatieKind </s> |
| − | | FamilySituationChild | + | | <s> FamilySituationChild </s> |
| − | | Observation | + | | <s> Observation </s> |
| − | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FamilySituationChild|nictiz.fhir.nl.stu3.zib2017}} | + | | <s> {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FamilySituationChild|nictiz.fhir.nl.stu3.zib2017}} </s> |
|- | |- | ||
| Taalvaardigheid | | Taalvaardigheid | ||
| LanguageProficiency | | LanguageProficiency | ||
| Patient | | Patient | ||
| − | | {{Simplifier|http:// | + | | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017|see Patient}} |
|- | |- | ||
| ParticipatieInMaatschappij | | ParticipatieInMaatschappij | ||
| Regel 347: | Regel 348: | ||
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-careteam|nictiz.fhir.nl.stu3.zib2017}} | | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-careteam|nictiz.fhir.nl.stu3.zib2017}} | ||
|} | |} | ||
| + | <span id="FunctionalOrMentalStatusRemark">{{IssueBox|Due to legislation (the 'Wet verplichte ggz' (Wvggz)) HCIM FreedomRestrictingMeasures-v3.1 (release 2017) has become obsolete. Therefore, this version of the BgGGZ will not require the use and exchange of this HCIM. | ||
| + | }}</span> | ||
<blockquote>* LegalStatus is a single concept of the HCIM FreedomRestrictingMeasures and does not represent a complete HCIM yet. This concept will become an independent HCIM in a future release of the HCIM.</blockquote> | <blockquote>* LegalStatus is a single concept of the HCIM FreedomRestrictingMeasures and does not represent a complete HCIM yet. This concept will become an independent HCIM in a future release of the HCIM.</blockquote> | ||
| − | |||
| − | |||
| − | |||
| − | |||
=Release notes= | =Release notes= | ||
| − | Release notes can be found on the [[MedMij:Vprepub/OntwerpGGZ#Release_notes|functional design page]]. | + | Release notes can be found on the [[MedMij:Vprepub-2020.01/OntwerpGGZ#Release_notes|functional design page]]. |
Huidige versie van 22 sep 2022 om 08:14
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Work in progress - See official publication here. |
1 Introduction
The page describes the FHIR requirements for exchanging GGZ information between the patients and healthcare providers in the context of MedMij.
Note: This implementation guide builds on the general guidelines described in the use case overarching principles.
2 Actors involved
| Actors | Systems | FHIR Capability Statements | |||
|---|---|---|---|---|---|
| Name | Description | Name | Description | Name | Description |
| Patient | The user of a personal healthcare environment. | PHR | Personal health record |  CapabilityStatement: Client
|
FHIR Client requirements |
| Healthcare professional | The user of a XIS | XIS | Healthcare information system | CapabilityStatement: Server
|
FHIR Server requirements |
3 Boundaries and Relationships
The GGZ use case has similarities and differences with other use cases such as the BgZ, Medication Process, Vital Signs, GP Patient Data and Lab Results. These use cases use much of the same HCIM based FHIR profiles for exchanging information. Wherever possible every attempt is made to re-use the profiles as used in the BgZ. The GGZ use case also has unique profiles compared to the aforementioned use cases. In addition, it has a CareTeam profile without an underlying HCIM. A second thing to note is that while the selection criteria of certain sections like procedure do not match with the BgZ or other use cases, this does not affect the profiles in use. For example, it is irrelevant for the response profile for procedures if you request ' surgical procedures' or 'every procedure'.
4 Use case: retrieve GGZ information
This FHIR implementation guide assumes that the PHR system is able to make a connection to the right XIS that contains the patient's information. It does not provide information on finding the right XIS nor does it provide information about security. Moreover, each transaction is performed in the context of a specific authenticated patient, for whose context (token) has been established using the authentication mechanisms described in the 'Afsprakenstelsel'. Each XIS Gateway is required to perform filtering based on the patient associated with the context for the request, so only the records associated with the authenticated patient are returned. For this reason, search parameters should not be included for patient identification.
4.1 PHR: request message
The PHR system requests the patients GGZ information using individual search interactions. The BgGGZ consists of multiple FHIR resources with certain constraints. To obtain the patient's BgGGZ, the client can use multiple individual search operations based on specified search queries. The interactions are performed by an HTTP GET as shown:
GET [base]/[type]{?[parameters]}
The table below shows in the first three columns the HCIM name in Dutch, in English and what HCIM content is requested. The last column shows the FHIR search queries to obtain this information. These queries and expected responses are based on profiles listed in this section.
| HCIM NL | HCIM EN | Content | Search URL[1] | ||
|---|---|---|---|---|---|
| Patient | Patient | Identification, birthdate, gender, deceasedindicator, contact details, marital status, legal status, and general practitioner (practitioner or organization) | GET [base]/Patient?_include=Patient:general-practitioner | ||
| BurgerlijkeStaat | MaritalStatus | Known marital status | see Patient | ||
| Betaler | Payer | Insurance information | GET [base]/Coverage?_include=Coverage:payor:Patient&_include=Coverage:payor:Organization | ||
| BehandelAanwijzing | TreatmentDirective | All known treatment directives | GET [base]/Consent?category=http://snomed.info/sct|11291000146105 | ||
| Wilsverklaring | AdvanceDirective | All known advance directives | GET [base]/Consent?category=http://snomed.info/sct|11341000146107 | ||
| JuridischeStatus | LegalStatus | Known legal status | see Patient and FreedomRestrictingMeasures procedure | ||
| VrijheidbeperkendeMaatregelen | FreedomRestrictingMeasures | All known freedom restricting measures | see Procedure
| ||
| Contactpersoon | Contact | First relation/contact | see Patient.contact | ||
| FunctioneleOfMentaleStatus | FunctionalOrMentalStatus | All known functional / mental status | GET [base]/Observation?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006
| ||
| Probleem | Problem | All known problems | GET [base]/Condition | ||
| Druggebruik | DrugUse | All known drug use | GET [base]/Observation?code=http://snomed.info/sct|228366006 | ||
| Alcoholgebruik | AlcoholUse | All known alcohol use | GET [base]/Observation?code=http://snomed.info/sct|228273003 | ||
| Tabakgebruik | TobaccoUse | All known tobacco use | GET [base]/Observation?code=http://snomed.info/sct|365980008 | ||
| Woonsituatie | LivingSituation | Last known living situation | GET [base]/Observation/$lastn?code=http://snomed.info/sct|365508006 | ||
| Gezinssituatie | FamilySituation | All known family situations | GET [base]/Observation?code=http://snomed.info/sct|365470003 | ||
| GezinssituatieKind | FamilySituationChild | All known family situations of child patient | GET [base]/Observation?code=http://snomed.info/sct|55801000146105
| ||
| Taalvaardigheid | LanguageProficiency | Known language proficiency | see Patient | ||
| ParticipatieInMaatschappij | ParticipationInSociety | All known participation in society status | GET [base]/Observation?code=http://snomed.info/sct|314845004 | ||
| HulpVanAnderen | HelpFromOthers | All known help from others | GET [base]/CarePlan?category=http://snomed.info/sct|243114000 | ||
| LaboratoriumUitslag | LaboratoryTestResult | Last known laboratory results per type (incl. medication levels like lithium) | GET [base]/Observation/$lastn?category=http://snomed.info/sct|275711006&_include=Observation:related-target&_include=Observation:specimen | ||
| AlgemeneMeting | GeneralMeasurement | All known questionaire (for example HONOS, OQ-45, CQ index, 4DKL) outcome scores. | GET [base]/Observation?category=http://hl7.org/fhir/observation-category|survey | ||
| Verrichting | Procedure | All known GGZ procedures (includes all known freedom restricting measures) | GET [base]/Procedure | ||
| TekstUitslag | TextResult | All known text results of GGZ procedures | GET [base]/DiagnosticReport | ||
| - | - | CareTeam: primary healthprofessional and other relevant healthprofessionals including the healthcare provider. | GET [base]/CareTeam?_include=CareTeam:participant | ||
| Zorgverlener | HealthProfessional | General Practitioner of the patient | see Patient, CareTeam | ||
| Zorgaanbieder | HealthProvider | General Practitioner's organization of the patient | see Patient, CareTeam |
- ↑ See Search URLs and search parameters for the interpretation of these search URLs
4.2 Server - XIS
The returned data to the PHR should conform to the profiles listed in #List_of_profiles.
4.3 The lastn operation
The following operation is needed for this use case.
The 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 FHIR STU3 specification is vague regarding the sorting mechanism of lastn. In FHIR R4 however, this has been clarified and can be read as follows: when using lastn, the effective[x] element is used for sorting of Observations, sorted from most recent to the oldest.
4.4 List of profiles
The profiles represent their entire respective HCIM and are applicable in a broader context than the exchange of GGZ information.
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MedMij uses the FHIR Packaging mechanism. This conveniently bundles all profiles, terminology, example material and other conformance resources you need into a single archive, which can be downloaded or installed using the appropriate FHIR tooling. This version of the information standard uses the following packages:
Note: packages use Semantic Versioning. Other versions can be used at will as long as they have the same major.minor number or a minor number higher than the stated version. |
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Due to legislation (the 'Wet verplichte ggz' (Wvggz)) HCIM FreedomRestrictingMeasures-v3.1 (release 2017) has become obsolete. Therefore, this version of the BgGGZ will not require the use and exchange of this HCIM. |
* LegalStatus is a single concept of the HCIM FreedomRestrictingMeasures and does not represent a complete HCIM yet. This concept will become an independent HCIM in a future release of the HCIM.
5 Release notes
Release notes can be found on the functional design page.