MedMij:V2020.01/FHIR BGZ 2017: verschil tussen versies

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Regel 1: Regel 1:
 
__NUMBEREDHEADINGS__
 
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{{DISPLAYTITLE:MedMij FHIR Implementation Guide: BgZ {{VersieInfo|V2019.01|BgZ}}}}
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{{DISPLAYTITLE:MedMij FHIR Implementation Guide: BgZ {{VersieInfo|BgZ}}}}
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{{MedMij:Vprepub/Issuebox_FHIR_IG}}
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{{MedMij:V2020.01/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]                 
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circle 1013 224 212 [[MedMij:Vprepub/OntwerpBGZ_2017|Functioneel]]                 
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circle 1013 224 212 [[MedMij:V2020.01/OntwerpBGZ_2017|Functioneel]]                 
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circle 1787 230 212 [[MedMij:Vprepub/FHIR_IG|Technisch]]                 
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circle 1787 230 212 [[MedMij:V2020.01/FHIR_IG|Technisch]]                 
 
desc none                     
 
desc none                     
 
</imagemap>
 
</imagemap>
Regel 15: Regel 15:
  
 
==Introduction==
 
==Introduction==
−
[[Bestand:Functioneel-02.png|link=MedMij:Vprepub/Ontwerpen |100px|rechts|Functional design|Go to functional design]]
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[[Bestand:Functioneel-02.png|link=MedMij:V2020.01/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.
 
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/FHIR_BGZ_2017#List_of_StructureDefinitions|list of StructureDefinitions]].  
+
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:V2020.01/FHIR_BGZ_2017#List_of_profiles|list of profiles]].  
  
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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 [https://informatiestandaarden.nictiz.nl/wiki/MedMij:Vprepub/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.
+
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:V2020.01/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:V2020.01/FHIR_IG#Use case overarching principles|use case overarching principles]].
  
 
==Actors involved==
 
==Actors involved==
Regel 37: Regel 39:
 
|-
 
|-
 
| Patient
 
| Patient
−
| The user of a personal healthcare enviorment.
+
| The user of a personal healthcare environment.
 
| PHR
 
| PHR
 
| Personal health record
 
| Personal health record
−
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-clientcapabilities|CapabilityStatement: Client}}
+
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-clientcapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Client}}
 
| FHIR Client requirements  
 
| FHIR Client requirements  
 
|-
 
|-
Regel 47: Regel 49:
 
| XIS
 
| XIS
 
| Healthcare information system
 
| Healthcare information system
−
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-servercapabilities|CapabilityStatement: Server}}
+
|[[Bestand: Verwijzing.png| 20px]] {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/bgz2017-servercapabilities|nictiz.fhir.nl.stu3.bgz|title=CapabilityStatement: Server}}
 
| FHIR Server requirements  
 
| FHIR Server requirements  
 
|}
 
|}
Regel 56: Regel 58:
 
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.
 
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.
  
−
==List of invocations==
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==Use Case: Retrieve BGZ information==
 
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to MedMij Afsprakenstelsel]]
 
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to MedMij Afsprakenstelsel]]
  
−
This FHIR implementation guide assumes that the PHR system is able to make a connection to the XIS that contains the patients BgZ information. It does not provide information on finding the right XIS nor does it provide information about security. These infrastructure and interface specifications are described in the [https://www.medmij.nl/afsprakenstelsel/ 'MedMij Afsprakenstelsel'].
+
{{FHIR-IG-Afsprakenstelsel-Note}}
−
 
 
−
===Client - PHR===
 
−
The PHR system requests the BgZ using individual 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 interaction can be performed by an HTTP GET or command as shown:
 
  
−
<code>GET [base]/[type]/{?[parameters]{&_format=[mime-type]}}</code>
+
===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:
  
−
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 are based on StructureDefinitions listed in [[#List_of_StructureDefinitions| this section]]. See [https://informatiestandaarden.nictiz.nl/wiki/MedMij:Vprepub_FHIR_IG#Use_of_search_parameters| here] for general rules on search parameters.
+
<code>GET [base]/[type]{?[parameters]}</code>
  
−
{{FHIR-IG-Afsprakenstelsel-Note}}
+
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"   
 
{| class="wikitable collapsible" width="100%" style="horizontal-align: right"   
Regel 75: Regel 75:
 
!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
+
!style="background-color: #4AB8A7; color: white; font-weight: bold; text-align:left;  background-color: #E3E3E3  width:10px" | Search URL<ref>See [[MedMij:V2020.01/FHIR_IG#Search_URLs_and_search_parameters|Search URLs and search parameters]] for the interpretation of these search URLs</ref>
 
|-
 
|-
 
| 1
 
| 1
Regel 110: Regel 110:
 
| Last known functional / mental status
 
| Last known functional / mental status
 
| <pre>GET [base]/Observation/$lastn?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006</pre>
 
| <pre>GET [base]/Observation/$lastn?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.}}
 
|-
 
|-
 
| 6
 
| 6
Regel 137: Regel 138:
 
| NutritionAdvice
 
| NutritionAdvice
 
| All known current dietary recommendations
 
| All known current dietary recommendations
−
| <pre>GET [base]/NutritionOrder?status=active</pre>
+
| <pre>GET [base]/NutritionOrder</pre>
 
|-
 
|-
 
| 8
 
| 8
Regel 164: Regel 165:
 
| Known administration agreements
 
| Known administration agreements
 
| <pre>GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&_include=MedicationDispense:medication</pre>
 
| <pre>GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&_include=MedicationDispense:medication</pre>
 +
<span id="AdministrationAgreementRemark"></span>{{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
 
| 11
 
| Medical aids
 
| Medical aids
−
| MedicalAid
+
| MedicalDevice
 
| Known medical aids
 
| Known medical aids
 
| <pre>GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device</pre>
 
| <pre>GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device</pre>
Regel 217: Regel 219:
 
*Planning an Encounter is done by using an Appointment
 
*Planning an Encounter is done by using an Appointment
 
*Planning a Procedure is done by using a ProcedureRequest
 
*Planning a Procedure is done by using a ProcedureRequest
−
*Planning a Vaccination is done by using a VaccinationRecommendation  
+
*Planning an Immunization is done by using an ImmunizationRecommendation  
−
*Planning a MedicalDevice is done by using a MedicalDeviceRequest
+
*Planning a MedicalDevice is done by using a DeviceRequest
 
}}
 
}}
 
<pre>GET [base]/ProcedureRequest?status=active</pre>
 
<pre>GET [base]/ProcedureRequest?status=active</pre>
 
<pre>GET [base]/ImmunizationRecommendation</pre>
 
<pre>GET [base]/ImmunizationRecommendation</pre>
−
<pre style="text-decoration: line-through;">GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication</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>
 
<span id="MM115Remark"></span>{{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.}}
 
<span id="MM115Remark"></span>{{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]/DeviceRequest?status=active&_include=DeviceRequest:device</pre>
Regel 233: Regel 235:
 
| <pre style="font-style: italic;">see Patient</pre>
 
| <pre style="font-style: italic;">see Patient</pre>
 
|}
 
|}
−
{{Sjabloon:Voorbeelden}}
+
<references/>
−
 
 
−
===Server - XIS===
 
−
Important sections of the FHIR specification for a server in this use case are the [http://hl7.org/fhir/STU3/http.html#2.21.0 RESTful API section] the [http://hl7.org/fhir/STU3/search.html search section] and [http://hl7.org/fhir/STU3/operations.html operation section] (for the lastn operation).
 
−
 
 
−
====Response to resource requests====
 
−
If the search succeeds, the server SHALL return a 200 OK HTTP status code and the returned content SHALL be a Bundle with type = searchset containing the results of the search as a collection of zero or more resources in a defined order. The returned content SHALL conform to the StructureDefinition applicable for the specific HCIM request. The list of a StructureDefinitions relevant for this use case is shown in the following paragraph: [[#List_of_StructureDefinitions | List of StructureDefinitions]]
 
−
 
 
−
The result collection can be long, so servers may use paging. If they do, they SHALL use the method described below (adapted from RFC 5005 (Feed Paging and Archiving ) for breaking the collection into pages if appropriate. The server MAY also return an [http://hl7.org/fhir/stu3/operationoutcome.html OperationOutcome resource] within the searchset Bundle entries that contains additional information about the search; if one is sent it SHALL NOT include any issues with a fatal or error severity, and it SHALL be marked with a Bundle.entry.search.mode of outcome.
 
  
−
In order to allow the client to be confident about what search parameters were used as criteria by the server, the server SHALL return the parameters that were actually used to process the search. Applications processing search results SHALL check these returned values where necessary. For example, if the server did not support some of the filters specified in the search, a client might manually apply those filters to the retrieved result set, display a warning message to the user or take some other action.
+
===XIS: response message===
 +
The returned data to the PHR should conform to the profiles listed in [[#List_of_profiles]].
  
−
In the case of a RESTful search, these parameters are encoded in the self-link in the bundle that is returned:
+
===The <code>lastn</code> operation===
−
<pre>
 
−
  <link>
 
−
    <relation value="self"/>
 
−
    <url value="http://example.org/Patient?identifier=[Patient-ID]/>
 
−
  </link>
 
−
</pre>
 
−
 
 
−
Link to the relevant FHIR specification: http://hl7.org/fhir/STU3/http.html#search
 
−
 
 
−
====Handling errors====
 
−
If the search fails '''(cannot be executed, not that there are no matches)''', the return value is a status code 4xx or 5xx with an OperationOutcome. An HTTP status code of 403 signifies that the server refused to perform the search, while other 4xx and 5xx codes signify that some sort of error has occurred. The HTTP status code 404 is returned if a XIS did not implement an endpoint used in a request by a PHR. When the search fails, a server SHOULD return an OperationOutcome detailing the cause of the failure. For example, in case of a not implemented FHIR endpoint, the OperationOutcome would state that the resource type is not supported. Note: an empty search result is not a failure.
 
−
 
 
−
Common HTTP Status codes returned on FHIR-related errors (in addition to normal HTTP errors related to security, header and content type negotiation issues):
 
−
 
 
−
* 400 Bad Request - search could not be processed or failed basic FHIR validation rules
 
−
* 401 Not Authorized - authorization is required for the interaction that was attempted
 
−
* 404 Not Found - resource type not supported, or not a FHIR end-point
 
−
 
 
−
In some cases, parameters may cause an error. For instance:
 
−
 
 
−
* A parameter may refer to a non-existent resource e.g. <code>GET [base]/Observation?subject=101</code>, where "101" does not exist
 
−
* A parameter may refer to an unknown code e.g. <code>GET [base]/Observation?code=loinc|1234-1</code>, where the LOINC code "1234-1" is not known to the server
 
−
* A parameter may refer to a time that is out of scope e.g. <code>GET [base]/Condition?onset=le1995</code>, where the system only has data going back to 2001
 
−
* A parameter may use an illegal or unacceptable modifier e.g. <code>GET [base]/Condition?onset:text=1995</code>, where the modifier cannot be processed by the server
 
−
* A date/time parameter may have incorrect format e.g. <code>GET [base]/Condition?onset=23%20May%202009</code>
 
−
* A parameter may be unknown or unsupported
 
−
Where the content of the parameter is syntactically incorrect, servers SHOULD return an error. However, where the issue is a logical condition (e.g. unknown subject or code), the server SHOULD process the search, including processing the parameter - with the result of returning an empty search set, since the parameter cannot be satisfied.
 
−
 
 
−
In such cases, the search process MAY include an OperationOutcome in the search set that contains additional hints and warnings about the search process. This is included in the search results as an entry with search mode = outcome. Clients can use this information to improve future searches.
 
−
 
 
−
Link to relevant FHIR specification: http://hl7.org/fhir/STU3/search.html#errors
 
−
 
 
−
==Interactions, operations, search parameters==
 
−
 
 
−
===Interactions===
 
−
 
 
−
The following logical interactions are needed for the BgZ use case:
 
−
* [http://hl7.org/fhir/STU3/http.html#search Search]
 
−
 
 
−
===Operations===
 
 
The following [http://hl7.org/fhir/STU3/operations.html operation] is needed for this use case.
 
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]
 
* [http://hl7.org/fhir/STU3/observation-operations.html#lastn Last N Observations Query]
  
−
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 <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.
  
−
===Search parameters===
+
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.
−
The following search parameter types and search result parameters need to be supported for this use case.
 
  
−
Search parameter types:
+
==List of profiles==
−
* [http://hl7.org/fhir/STU3/search.html#token token]
 
−
** Including modifier 'in'
 
−
* [http://hl7.org/fhir/STU3/search.html#reference reference]
 
−
 
 
−
Search result parameters:
 
−
* [http://hl7.org/fhir/STU3/search.html#include _include]
 
−
 
 
−
==List of StructureDefinitions==
 
 
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.
 
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.
  
−
{{NoteBoxPackage|https://simplifier.net/NictizSTU3-Zib2017/~packages|1.3.x|MedMij:Vprepub/FHIR_IG}}
+
{{MedMij:V2020.01/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"  
 
{| class="wikitable" style="horizontal-align: right"  
Regel 314: Regel 260:
 
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left;  background-color: #E3E3E3 width:400px" | FHIR Profile
 
!style="background-color: #1F497D; color: white; font-weight: bold; text-align:left;  background-color: #E3E3E3 width:400px" | FHIR Profile
 
|-
 
|-
−
| 1  
+
| rowspan="2" | 1  
 +
| Patient
 
| Patient
 
| Patient
−
| #Zib Patient|Patient
 
 
| Patient
 
| Patient
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-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" | 2
 
| rowspan="3" | Betaler
 
| rowspan="3" | Betaler
 
| rowspan="3" | Payer
 
| rowspan="3" | Payer
 
| Coverage
 
| Coverage
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Payer}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Payer|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Organization
 
| Organization
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Patient
 
| Patient
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
−
| rowspan="2" |3  
+
| rowspan="2" | 3  
 
| BehandelAanwijzing
 
| BehandelAanwijzing
 
| TreatmentDirective
 
| TreatmentDirective
 
| Consent
 
| Consent
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective}}  
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective|nictiz.fhir.nl.stu3.zib2017}}  
 
|-
 
|-
 
| Wilsverklaring
 
| Wilsverklaring
 
| AdvanceDirective
 
| AdvanceDirective
 
| Consent
 
| Consent
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 4  
 
| 4  
Regel 347: Regel 297:
 
| ContactPerson
 
| ContactPerson
 
| Patient.contact
 
| Patient.contact
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 5
 
| 5
−
| Funct. OfMentaleStatus
+
| FunctioneleOfMentaleStatus
 
| FunctionalOrMentalStatus
 
| FunctionalOrMentalStatus
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 6
 
| 6
Regel 359: Regel 309:
 
| Problem
 
| Problem
 
| Condition
 
| Condition
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Problem}}  
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Problem|nictiz.fhir.nl.stu3.zib2017}}  
 
|-
 
|-
 
| rowspan="5" | 7
 
| rowspan="5" | 7
Regel 365: Regel 315:
 
| LivingSituation
 
| LivingSituation
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation}}  
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation|nictiz.fhir.nl.stu3.zib2017}}  
 
|-
 
|-
 
| DrugsGebruik
 
| DrugsGebruik
 
| DrugUse
 
| DrugUse
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse}}  
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse|nictiz.fhir.nl.stu3.zib2017}}  
 
|-
 
|-
 
| AlcoholGebruik
 
| AlcoholGebruik
 
| AlcoholUse
 
| AlcoholUse
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| TabakGebruik
 
| TabakGebruik
 
| TobaccoUse
 
| TobaccoUse
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Voedingsadvies
 
| Voedingsadvies
 
| NutritionAdvice
 
| NutritionAdvice
 
| NutritionOrder
 
| NutritionOrder
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 8
 
| 8
Regel 391: Regel 341:
 
| Alert
 
| Alert
 
| Flag
 
| Flag
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Alert}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Alert|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 9
 
| 9
Regel 397: Regel 347:
 
| AllergyIntolerance
 
| AllergyIntolerance
 
| AllergyIntolerance
 
| AllergyIntolerance
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="3" | 10  
 
| rowspan="3" | 10  
−
| rowspan="3" | MedicatieGebruik
+
| MedicatieGebruik2
−
| MedicationUse
+
| MedicationUse2
 
| MedicationStatement
 
| MedicationStatement
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 +
| Medicatieafspraak
 
| MedicationAgreement
 
| MedicationAgreement
 
| MedicationRequest
 
| MedicationRequest
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 +
| Toedieningsafspraak
 
| AdministrationAgreement
 
| AdministrationAgreement
 
| MedicationDispense
 
| MedicationDispense
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="2" | 11  
 
| rowspan="2" | 11  
Regel 417: Regel 369:
 
| rowspan="2" | MedicalDevice
 
| rowspan="2" | MedicalDevice
 
| Device
 
| Device
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| DeviceUseStatement
 
| DeviceUseStatement
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="2" | 12  
 
| rowspan="2" | 12  
Regel 426: Regel 378:
 
| rowspan="2" | Vaccination
 
| rowspan="2" | Vaccination
 
| Immunization
 
| Immunization
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| ImmunizationRecommendation
 
| ImmunizationRecommendation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="3" | 13
 
| rowspan="3" | 13
Regel 435: Regel 387:
 
| BloodPressure
 
| BloodPressure
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| LichaamsGewicht
 
| LichaamsGewicht
 
| BodyWeight
 
| BodyWeight
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| LichaamsLengte
 
| LichaamsLengte
 
| BodyHeight
 
| BodyHeight
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="2" | 14
 
| rowspan="2" | 14
Regel 451: Regel 403:
 
| rowspan="2" | LaboratoryTestResult
 
| rowspan="2" | LaboratoryTestResult
 
| Observation
 
| Observation
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Specimen
 
| Specimen
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 15  
 
| 15  
Regel 460: Regel 412:
 
| Procedure
 
| Procedure
 
| Procedure
 
| Procedure
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Procedure}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Procedure|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| 16  
 
| 16  
Regel 466: Regel 418:
 
| Encounter
 
| Encounter
 
| Encounter
 
| Encounter
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Encounter}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-Encounter|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| rowspan="5" | 17  
 
| rowspan="5" | 17  
Regel 472: Regel 424:
 
| rowspan="5" | PlannedCareActivityForTransfer
 
| rowspan="5" | PlannedCareActivityForTransfer
 
| ProcedureRequest [[#PlannedCareRemark|*]]
 
| ProcedureRequest [[#PlannedCareRemark|*]]
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| <span style="text-decoration: line-through;">MedicationDispense</span> [[#MM115Remark|**]]
 
| <span style="text-decoration: line-through;">MedicationDispense</span> [[#MM115Remark|**]]
−
| <span style="text-decoration: line-through;">{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement}}</span>
+
| <span style="text-decoration: line-through;">{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement|nictiz.fhir.nl.stu3.zib2017}}</span>
 
|-
 
|-
 
| ImmunizationRecommendation [[#PlannedCareRemark|*]]
 
| ImmunizationRecommendation [[#PlannedCareRemark|*]]
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| DeviceRequest [[#PlannedCareRemark|*]]
 
| DeviceRequest [[#PlannedCareRemark|*]]
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Appointment [[#PlannedCareRemark|*]]
 
| Appointment [[#PlannedCareRemark|*]]
−
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/eAfspraak-Appointment}}
+
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/eAfspraak-Appointment|nictiz.fhir.nl.stu3.eafspraak}}
 
|-
 
|-
 
| rowspan="3" | 18
 
| rowspan="3" | 18
Regel 490: Regel 442:
 
| rowspan="2" | HealthProfessional
 
| rowspan="2" | HealthProfessional
 
| Practitioner
 
| Practitioner
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| PractitionerRole
 
| PractitionerRole
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole|nictiz.fhir.nl.stu3.zib2017}}
 
|-
 
|-
 
| Zorgaanbieder
 
| Zorgaanbieder
 
| HealthcareProvider
 
| HealthcareProvider
 
| Organization
 
| Organization
−
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization}}
+
| {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017}}
 
|}
 
|}
−
 
−
==Terminology, NamingSystems, Mappings==
 
−
 
−
===Terminology===
 
−
Relevant value sets can be found [https://simplifier.net/NictizSTU3-Zib2017/~resources?category=ValueSet using the ValueSet category]. All resources can be downloaded in a .zip in XML or JSON format. In the .zip, the value sets are stored in the directory 'value sets'.
 
−
 
−
===NamingSystems===
 
−
Relevant NamingSystems can be found [https://simplifier.net/NictizSTU3-Zib2017/~resources?category=NamingSystem using the NamingSystem category].
 
−
 
−
===Mappings===
 
−
A FHIR ConceptMap resource is provided when a FHIR value set is used instead of a HCIM value set. A ConceptMap maps the values between the two value sets. These ConceptMaps can be found [https://simplifier.net/NictizSTU3-Zib2017/~resources?category=ConceptMap here].
 
−
 
−
An explanation about mappings can be found at [[MedMij:Vprepub/FHIR_IG#Mapping_of_coded_concepts|Mapping of coded concepts]].
 
  
 
=Release notes=
 
=Release notes=
−
Release notes can be found on the [[MedMij:Vprepub/OntwerpBGZ_2017#Release_notes|functional design page]].
+
Release notes can be found on the [[MedMij:V2020.01/OntwerpBGZ_2017#Release_notes|functional design page]].

Huidige versie van 22 nov 2022 om 13:35



Naar medmij.nl
Patient Summary (BgZ)
AfsprakenstelselFunctioneelTechnischAfspraken-Functioneel-Technisch

1 Introduction

Go to functional design

The program ‘Registratie aan de bron’ (Clinical documentation at the point of care) has defined Health and Care Information models (HCIMs (English) or 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 HCIMs release 2017 constitute the 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 list of profiles.

The patient journey of 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 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 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 Verwijzing.png CapabilityStatement: Client FHIR Client requirements
Healthcare professional The user of a XIS XIS Healthcare information system Verwijzing.png CapabilityStatement: Server FHIR Server requirements

3 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 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.

4 Use Case: Retrieve BGZ information

Go to MedMij Afsprakenstelsel

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 BgZ using individual 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:

GET [base]/[type]{?[parameters]}

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 this section.

# BgZ Section HCIM EN Content Search URL[1]
1 Patient information Patient Identification, birth date, gender, deceased indicator, contact details, last known marital status, and general practitioner (practitioner or organization) 
GET [base]/Patient?_include=Patient:general-practitioner
2 Payment details Payer Insurance information 
GET [base]/Coverage?_include=Coverage:payor:Patient&_include=Coverage:payor:Organization
3 Treatment directives TreatmentDirective Known treatment directives 
GET [base]/Consent?category=http://snomed.info/sct|11291000146105
AdvanceDirective Known advance directives 
GET [base]/Consent?category=http://snomed.info/sct|11341000146107
4 Contact persons ContactPerson First relation/contact 
see Patient
5 Functional status FunctionalOrMentalStatus Last known functional / mental status 
GET [base]/Observation/$lastn?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006

Em.png

The NL-CM:4.26.6 StatusDate concept is incorrectly mapped on the effective[x]:effectivePeriod.start element in the HCIM FunctionalOrMentalStatus profile, it is a date rather than a period. Presumed solution will come from a future HCIM release. See MM-1570 for more information.

6 Problems Concern All known problems 
GET [base]/Condition
7 Social history LivingSituation Current living situation 
GET [base]/Observation/$lastn?code=http://snomed.info/sct|365508006
DrugUse All known drug use 
GET [base]/Observation?code=http://snomed.info/sct|228366006
AlcoholUse All known alcohol use 
GET [base]/Observation?code=http://snomed.info/sct|228273003
TobaccoUse All known tobacco use 
GET [base]/Observation?code=http://snomed.info/sct|365980008
NutritionAdvice All known current dietary recommendations 
GET [base]/NutritionOrder
8 Alerts Alert All known alerts 
GET [base]/Flag
9 Allergies AllergyIntolerance All known information regarding allergies 
GET [base]/AllergyIntolerance
10 Medication MedicationUse Known medication use 
GET [base]/MedicationStatement?category=urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6&_include=MedicationStatement:medication
MedicationAgreement Known medication agreements 
GET [base]/MedicationRequest?category=http://snomed.info/sct|16076005&_include=MedicationRequest:medication
AdministrationAgreement Known administration agreements 
GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&_include=MedicationDispense:medication

Em.png

The search on MedicationDispense.category requires a custom SearchParameter not represented in the FHIR specification.

11 Medical aids MedicalDevice Known medical aids 
GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device
12 Vaccinations Vaccination Known vaccinations 
GET [base]/Immunization?status=completed
13 Vital signs BloodPressure Last known blood pressure 
GET [base]/Observation/$lastn?code=http://loinc.org|85354-9
BodyWeight Last known body weight 
GET [base]/Observation/$lastn?code=http://loinc.org|29463-7
BodyHeight Last known body height 
GET [base]/Observation/$lastn?code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9
14 Results LaboratoryTestResult Last known laboratory results per type 
GET [base]/Observation/$lastn?category=http://snomed.info/sct|275711006&_include=Observation:related-target&_include=Observation:specimen
15 Procedures Procedure Known surgical procedures 
GET [base]/Procedure?category=http://snomed.info/sct|387713003
16 Encounters Contact Known hospital admissions (no outpatient contacts) 
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
17 Planned care PlannedCareActivityForTransfer Known planned care activities

Em.png

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
 
GET [base]/ProcedureRequest?status=active
GET [base]/ImmunizationRecommendation

Em.png

The NL-CM:11.1.5 DesiredDateForRevaccination concept is incorrectly mapped onto the .recommendation.date element in the HCIM ImmunizationRecommendation profile. The proper element is actually .recommendation.dateCriterion. This will be fixed in the next breaking release. See MM-2281 for more information. 

GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication

Em.png

PlannedCareActivityForTransfer for MedicationAdministration was found unimplementable as-is. Presumed solution will come from a future HCIM release. See MM-115 for more information. 

GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device
GET [base]/Appointment?status=booked,pending,proposed
18 General practitioner HealthProfessional General Practitioner of the patient 
see Patient
  1. ↑ See Search URLs and search parameters for the interpretation of these search URLs

4.2 XIS: response message

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.

5 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.

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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.

Section Zib NL HCIM EN FHIR Resource FHIR Profile
1 Patient Patient Patient http://fhir.nl/fhir/StructureDefinition/nl-core-patient
BurgerlijkeStaat MaritalStatus Patient.maritalStatus
2 Betaler Payer Coverage http://nictiz.nl/fhir/StructureDefinition/zib-Payer
Organization http://fhir.nl/fhir/StructureDefinition/nl-core-organization
Patient http://fhir.nl/fhir/StructureDefinition/nl-core-patient
3 BehandelAanwijzing TreatmentDirective Consent http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective
Wilsverklaring AdvanceDirective Consent http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective
4 Contactpersoon ContactPerson Patient.contact http://fhir.nl/fhir/StructureDefinition/nl-core-patient
5 FunctioneleOfMentaleStatus FunctionalOrMentalStatus Observation http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus
6 Probleem Problem Condition http://nictiz.nl/fhir/StructureDefinition/zib-Problem
7 Woonsituatie LivingSituation Observation http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation
DrugsGebruik DrugUse Observation http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse
AlcoholGebruik AlcoholUse Observation http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse
TabakGebruik TobaccoUse Observation http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse
Voedingsadvies NutritionAdvice NutritionOrder http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice
8 Alert Alert Flag http://nictiz.nl/fhir/StructureDefinition/zib-Alert
9 AllergieIntolerantie AllergyIntolerance AllergyIntolerance http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance
10 MedicatieGebruik2 MedicationUse2 MedicationStatement http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse
Medicatieafspraak MedicationAgreement MedicationRequest http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement
Toedieningsafspraak AdministrationAgreement MedicationDispense http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement
11 MedischHulpmiddel MedicalDevice Device http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct
DeviceUseStatement http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice
12 Vaccinatie Vaccination Immunization http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination
ImmunizationRecommendation http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation
13 Bloeddruk BloodPressure Observation http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure
LichaamsGewicht BodyWeight Observation http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight
LichaamsLengte BodyHeight Observation http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight
14 LaboratoriumUitslag LaboratoryTestResult Observation http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation
Specimen http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen
15 Verrichting Procedure Procedure http://nictiz.nl/fhir/StructureDefinition/zib-Procedure
16 Contact Encounter Encounter http://nictiz.nl/fhir/StructureDefinition/zib-Encounter
17 OverdrachtGeplandeZorgActiviteit PlannedCareActivityForTransfer ProcedureRequest * http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest
MedicationDispense ** http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement
ImmunizationRecommendation * http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation
DeviceRequest * http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceRequest
Appointment * http://nictiz.nl/fhir/StructureDefinition/eAfspraak-Appointment
18 Zorgverlener HealthProfessional Practitioner http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner
PractitionerRole http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole
Zorgaanbieder HealthcareProvider Organization http://fhir.nl/fhir/StructureDefinition/nl-core-organization

6 Release notes

Release notes can be found on the functional design page.

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