Huidige versie van 22 nov 2022 om 10:29

1 Introduction

This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the functional design wiki page. This use case consists of enabling a patient to view his own administered vaccinations in a PHR. The technical specification is described here. HL7 FHIR R4 is used for this purpose. Vaccinations are represented by the Immunization resources in FHIR. A transaction will retrieve all administered vaccinations from the XIS.

Note: This implementation guide builds on the general guidelines described in the use case overarching principles.

2 Actors involved

Actors		Systems		FHIR CapabilityStatements
Name	Description	Name	Description	Name	Description
Patient	The user of a personal healthcare environment.	PHR	Personal health record	CapabilityStatement: Retrieve Serve	FHIR client/server requirements
(Healthcare) provider	The user of a XIS	XIS	(Healthcare) information system	CapabilityStatement: Retrieve Serve	FHIR client/server requirements

3 Use case 1: Retrieve vaccinations

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.

3.1 Introduction

The retrieve vaccinations transaction is used by the PHR to retrieve vaccinations from a XIS.

3.2 Actors

Transaction group	Transaction	Actor	Role
Retrieve vaccinations(PULL)	Retrieve vaccinations request	Patient (using a PHR)	Request vaccinations from the XIS
Retrieve vaccinations(PULL)	Retrieve vaccinations response	(Healthcare) provider (using a XIS)	Serves vaccinations to the PHR

3.3 Invocations

3.3.1 PHR: request message

The request message represents an HTTP GET parameterized query from the PHR to the XIS.

3.3.1.1 Trigger events

When the patient (PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.

3.3.1.2 Message semantics

The PHR executes an HTTP GET conform to the FHIR RESTful and search specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format:

GET [base]/Immunization{?_include=Immunization:patient&_include:iterate=Immunization:performer}

At this point in time, there are no use cases for filter parameters on the query. The stated query will return a Bundle with all known administered immunizations. Each immunization is conveyed in an Immunization resource. The Immunization resource will contain references to actors such as the Patient and the Health Professional/Organization. If those references are not in the Bundle, a client SHALL be able to resolve them at the source. The client may wish to have these references resolved in the Bundle by specifying the _include parameter on the query. The server SHALL support this _include parameter. It MAY include referenced resources even if the client doesn't ask for them if it doesn't support read operations for these resources.

3.3.1.2.1 Expected actions

The XIS SHALL process the query to retrieve patient's Immunization resources and the included referenced resources.

3.3.2 XIS: response message

The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.

3.3.2.1 Trigger events

The XIS completed processing of the retrieve vaccinations request message.

3.3.2.2 Message semantics

The returned data to the PHR should conform to the profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the .meta.profile element in order to show compliance.

Profile name	FHIR Resource	HCIM EN	Canonical URL
nl core Vaccination event	Immunization	Vaccination	http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-event
nl core Patient	Patient	Patient	http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
nl core HealthProfessional	Practitioner	HealthProfessional	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner
nl core HealthProfessional PractitionerRole	PractionerRole	HealthProfessional	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole
nl core HealthcareProvider Organization	Organization	HealthcareProvider	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization
nl core HealthcareProvider	Location	HealthcareProvider	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
nl core PharmaceuticalProduct	Medication	PharmaceuticalProduct	http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct

3.3.2.3 Expected actions

The PHR SHALL process the results. The PHR SHOULD contain all the resources that match the query and all the reference resources that are included in the Bundle.

4 Release notes

Release notes can be found on the functional design page.

5 Support

For questions and change requests regarding this IG, please create a ticket in BITS.

@@ Regel 1: / Regel 1: @@
 __NOINDEX__
-{{DISPLAYTITLE:FHIR Implementation Guide: Vaccinations 0.1.0}}
-{{NoteBox|Draft version of the FHIR IG for Vaccinations. Currently in development and therefore not yet suitable for implementation. The draft version of the functional design can be found [https://informatiestandaarden.nictiz.nl/wiki/MedMij:Vdraft/OntwerpVaccinaties here].}}
-{{NoteBox|This version will eventually be tested in a proof of concept (PoC) and should not be used outside this PoC.
-The repository containing the FHIR conformance materials can be found on [https://github.com/Nictiz/Nictiz-R4-Immunization GitHub] and [https://simplifier.net/nictiz-r4-Immunization Simplifier] and the functional design can be found [[https://informatiestandaarden.nictiz.nl/wiki/MedMij:Vdraft/OntwerpVaccinaties here]].
-For questions regarding the contents of this information standard, please create a ticket in [https://bits.nictiz.nl/projects/MM Nictiz BITS]. For PoC (and PROVES) related questions, contact Victor Teunissen on [mailto:victor.teunissen@vzvz.nl victor.teunissen@vzvz.nl].
-}}
 __NUMBEREDHEADINGS__
- {{VersieInfo|Vaccinaties}}
+{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization {{VersieInfo|Vaccinatie-Immunisatie}}}}
-{{MedMij:V2020.01/Issuebox_FHIR_IG}}
+{{MedMij:Vprepub-6/Issuebox_FHIR_IG}}
 [[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]]
-[[Bestand:Immunisatie.png |link=|links |87px|Immunisatie]]
+[[Bestand:Icoon_Nictiz_Cirkel_Informatiestandaard_Vaccinatie.svg|link=|87px|Vaccinatie-Immunisatie]]
-<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:Vdraft/OntwerpVaccinaties|Functioneel]]
-circle 1787 230 212 [[MedMij:MedMij:Vdraft/FHIR_Vaccinations|Technisch]]
-desc none
-</imagemap>
 =Introduction=
-[[Bestand:Functioneel-02.png|link=MedMij:V2020.01/Ontwerpen |100px|rechts|Functional design|Go to functional design]]
+This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the [[MedMij:Vprepub-6/Ontwerp_Vaccinatie-Immunisatie| functional design wiki page]]. This use case consists of enabling a patient to view his own administered vaccinations in a PHR. The technical specification is described here. HL7 FHIR R4 is used for this purpose. Vaccinations are represented by the Immunization resources in FHIR. A transaction will retrieve all administered vaccinations from the XIS.
-This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the [[MedMij:V2020.01/Ontwerpen| functional design wiki page]]. This use case consists of enabling a patient to view his own administered vaccinations in a PHR. The technical specification is described here. HL7 FHIR R4 is used for this purpose.
-'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:V2020.01/FHIR_IG#Use case overarching principles|use case overarching principles]].
-====Vaccinations====
-Vaccination results are represented by the Immunization resources. It contains the relevant data elements per single vaccination about the administered vaccination such as DateTime of administration, vaccination indication and pharmaceutical product.
-The transaction consists of all available administered vaccinations at the XIS. The transactions:
-[[MedMij:Vdraft/FHIR_Vaccinations#Use_case_1:_Retrieve_vaccinations| Retrieve vaccinations]]
+'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:IG:V1/FHIR_IG#Overarching principles|use case overarching principles]].
 =Actors involved=
 {| class="wikitable"
-! colspan="2" style="text-align:left;" | Persons
+! colspan="2" style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | Actors
-! colspan="2" style="text-align:left;" | Systems
+! colspan="2" style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | Systems
-! colspan="2" style="text-align:left;" | FHIR Capability Statements
+! colspan="2" style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | FHIR CapabilityStatements
 |-
 ! style="text-align:left;" |Name
@@ Regel 52: / Regel 29: @@
 | PHR
 | Personal health record
-|[[Bestand: Verwijzing.png| 20px]] {}
+| rowspan="2" | {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/imm-RetrieveServe|nictiz.fhir.nl.r4.vaccinationimmunization|pkgVersion=1.0.0-rc.1|title=CapabilityStatement: Retrieve Serve}}
-| Vaccination process client requirements
+| rowspan="2" | FHIR client/server requirements
 |-
 | (Healthcare) provider
@@ Regel 59: / Regel 36: @@
 | XIS
 | (Healthcare) information system
-|[[Bestand: Verwijzing.png| 20px]] {}
-| Vaccination server requirements
 |}
@@ Regel 72: / Regel 47: @@
 ==Actors==
 {| class="wikitable" "cellpadding="10"
-! style="text-align:left;"| '''Transaction group'''
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;"| '''Transaction group'''
-! style="text-align:left;"| '''Transaction'''
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;"| '''Transaction'''
-! style="text-align:left;"| '''Actor'''
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;"| '''Actor'''
-! style="text-align:left;"| '''Role'''
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;"| '''Role'''
 |-
 |style="background-color: white;vertical-align:top;" rowspan="2"|Retrieve vaccinations(PULL)
@@ Regel 91: / Regel 66: @@
 The request message represents an HTTP GET parameterized query from the PHR to the XIS.
-====Trigger Events====
+====Trigger events====
-When the patient(PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.
+When the patient (PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.
-====Message Semantics====
+====Message semantics====
 The PHR executes an HTTP GET conform to the FHIR [http://hl7.org/fhir/http.html RESTful] and [http://hl7.org/fhir/search.html search] specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format:
-<pre>GET [base]/immunization</pre>
+<pre>GET [base]/Immunization{?_include=Immunization:patient&_include:iterate=Immunization:performer}</pre>
-The PHR may use, and the XIS shall be capable of processing, the following parameters to configure the search query:
+At this point in time, there are no use cases for filter parameters on the query. The stated query will return a Bundle with all known administered immunizations. Each immunization is conveyed in an Immunization resource. The Immunization resource will contain references to actors such as the Patient and the Health Professional/Organization. If those references are not in the Bundle, a client SHALL be able to resolve them at the source. The client may wish to have these references resolved in the Bundle by specifying the [http://hl7.org/fhir/R4/search.html#include {{fhir|_include}}] parameter on the query. The server SHALL support this {{fhir|_include}} parameter. It MAY include referenced resources even if the client doesn't ask for them if it doesn't support read operations for these resources.
-{| class="wikitable"
-! Description
-! Examples
-|-
-| Retrieve all zib Immunization resources in the search results:
-|  <pre>GET [base]/immunization</pre>
-|}
-Alternatively an operation may be defined that returns a bundle with the list of immunization resources and a patient resource.
+=====Expected actions=====
-=====Expected Actions=====
+The XIS SHALL process the query to retrieve patient's Immunization resources and the included referenced resources.
-The XIS shall process the query to retrieve Immunization resources that match the search parameters given.
 ===XIS: response message===
-The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching observation information.
+The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.
-====Trigger Events====
+====Trigger events====
 The XIS completed processing of the retrieve vaccinations request message.
-====Message Semantics====
+====Message semantics====
-The returned data to the PHR should conform to the HCIMs and their associated profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the ''meta.profile'' element in order to show compliance.
+The returned data to the PHR should conform to the profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the {{fhir|.meta.profile}} element in order to show compliance.
+{{MedMij:V2020.01/NoteBoxPackage|p1=nictiz.fhir.nl.r4.vaccinationimmunization|p2=nictiz.fhir.nl.r4.zib2020|v2=0.7.0-beta.1}}
-{{MedMij:V2020.01/NoteBoxPackage|p1=nictiz.fhir.nl.R4.zib2020}}
-{| class="wikitable" width="1400px"
+{| class="wikitable"
-|-style="background-color: #1F497D; color: white; font-weight: bold; "
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | Profile name
-|Zib name NL||Zib name EN||FHIR Resources||URL profile|
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | FHIR Resource
-|-style="vertical-align:top; background-color: #E3E3E3;
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | HCIM EN
+! style="text-align:left; background-color: #4AB8A7; color: white; font-weight: bold;" | Canonical URL
 |-
-| Vaccinatie
+| nl core Vaccination event
-| Vaccination
 | Immunization
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-event|nictiz.fhir.nl.R4.zib2020}}
+| [https://zibs.nl/wiki/Vaccinatie-v4.0(2020NL) Vaccination]
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-event|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
+| nl core Patient
 | Patient
-| #Zib Patient|Patient
+| [https://zibs.nl/wiki/Patient-v3.2(2020EN) Patient]
-| Patient
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient}}
 |-
-| rowspan="2" | Zorgverlener
+| nl core HealthProfessional
-| rowspan="2" | HealthProfessional
 | Practitioner
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner}}
+| rowspan="2" | [https://zibs.nl/wiki/HealthProfessional-v3.5(2020EN) HealthProfessional]
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
+| nl core HealthProfessional PractitionerRole
 | PractionerRole
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole}}
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
-| rowspan="2" | Zorgaanbieder
+| nl core HealthcareProvider Organization
-| rowspan="2" | HealthcareProvider
 | Organization
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization}}
+| rowspan="2" | [https://zibs.nl/wiki/HealthcareProvider-v3.4(2020EN) HealthcareProvider]
+|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
+| nl core HealthcareProvider
 | Location
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider}}
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
-| FarmaceutischProduct
+| nl core PharmaceuticalProduct
-| PharmaceuticalProduct
 | Medication
-| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct|nictiz.fhir.nl.R4.zib2020}}
+| [https://zibs.nl/wiki/PharmaceuticalProduct-v2.1.2(2020EN) PharmaceuticalProduct]
+| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct|nictiz.fhir.nl.r4.zib2020|pkgVersion=0.7.0-beta.1}}
 |-
 |}
-====Expected Actions====
+====Expected actions====
-The PHR shall process the results according to application-defined rules. The PHR should contain all the resources that match the query parameters.
+The PHR SHALL process the results. The PHR SHOULD contain all the resources that match the query and all the reference resources that are included in the Bundle.
 =Release notes=
-Release notes can be found on the [[MedMij:V2020.01/OntwerpVaccinaties#Release_notes| functional design page]].
+Release notes can be found on the [[MedMij:Vprepub-6/Ontwerp_Vaccinatie-Immunisatie#Release_notes| functional design page]].
+=Support=
+For questions and change requests regarding this IG, please create a ticket in [https://bits.nictiz.nl/projects/MM BITS].

MedMij:Vprepub-6/FHIR Vaccination-Immunization: verschil tussen versies