vpk:V3.1 FHIR eOverdracht Proeftuin

Introduction

This page details the HL7 FHIR requirements for exchanging the data in the Verpleegkundige eOverdracht Proeftuin pilot described in this functional design.

Implementation of these transactions is spread over multiple phases.

Phase one consists of the implementation of four HCIMs for both the Aanmeldbericht and the Overdrachtsbericht. The remaining information from eOverdracht may be sent unstructured in a PDF file.

Phase two consists of the complete Aanmeldbericht as well as an incomplete Overdrachtsbericht. the Overdrachtsbericht is a subset of 11 HCIM's (complete set used in Aanmeldbericht) and an unstructured PDF containing the remaining data which are not part of the HCIM's.

Phase three is the complete dataset of the aanmeldbericht, overdrachtsbericht volwassenen, overdrachtsbericht 0-1 jaar, overdrachtsbericht 1-18 jaar as PUSH messages.

Invocations

Send eOverdrachtbericht (PUSH)

Trigger events

This transaction is invoked when the XIS needs to send the eOverdrachtbericht to the receiving XIS.

Message Semantics

The eOverdrachtbericht is sent as a FHIR Document. To create this document, a FHIR Composition resource should be created according to the relevant Composition profiles.

The Composition resources reference each of the relevant resources included in the eOverdrachtbericht. The Composition resource and the relevant resources are subsequently assembled into a FHIR Bundle resource which Bundle.type set to document. The Composition resource should be the first entry in the Bundle.

For the Bundle, the following rules apply:

• The Bundle resource SHALL include all the resources listed as described in the different use cases, each in a separate Bundle.entry.
• The resources in the message SHALL be a valid instances of these profiles listed in the use cases.
• All resources SHALL include their related profile canonical URL in the meta.profile element in order to show compliance.
• The Bundle SHOULD include the resources that are linked from the included resources

The Send eOverdrachtbericht transaction is an HTTP POST method on the target XIS's base:

POST [base] {?_format=[mime-type]}

where the body of the POST request is the assembled Bundle.

Expected actions

The document Bundle should be processed as a transaction by the receiving XIS and each Bundle.entry should be treated as a create interaction for the Bundle.entry.resource.

When the resource syntax or data is incorrect or invalid and cannot be used to create a new resource, or when the server rejects the content of the resource because of business rules, it should perform a rollback of the creation of any previous entries and send the appropriate response (see below).

eOverdrachtbericht response (PUSH)

Trigger events

The target XIS completed processing of the Send eOverdrachtbericht transaction.

Message semantics

The target XIS responds to the Send eOverdrachtbericht transaction with an HTTP Response, where:

• The status code SHALL be set appropriate to the processing outcome. When the resource syntax or data is incorrect or invalid, and cannot be used to create a new resource, the server returns a 400 Bad Request HTTP status code. When the server rejects the content of the resource because of business rules, the server returns a 422 Unprocessable Entity error HTTP status code. Additional HTTP status code may be used if more appropriate.
• On success, the response body SHALL be set to a FHIR Bundle resource containing one entry for each entry in the request, in the same order, with the outcome of processing the entry.
• On failure, the response body SHOULD be set to a FHIR OperationOutcome resource with detailed error messages describing the reason for the error, and perform a rollback of the creation of any previous entries.

A client may use the returned Bundle to track the outcomes of processing the entry, and the identities assigned to the resources by the server. Each entry element SHALL contain a response element which details the outcome of processing the entry - the HTTP status code, and the location and ETag header values, which are used for identifying and versioning the resources. In addition, a resource may be included in the entry, as specified by the Prefer header.

Use case: Aanmeldbericht

Introduction

The Send Aanmeldbericht scenario is used by the sending XIS to send the relevant data for the patient intake to the receiving XIS, and constitutes a subset of the Overdrachtsbericht. The structure of the eventual scenario is described in the functional design and additionally in Opbouw eOverdracht aanmelding. For the pilot a limited subset is implemented.

Actors and transactions

Actor	Role	Transaction
Sending XIS	Sends signup message to the receiving XIS	Send Aanmeldbericht
Receiving XIS	Acknowledges the signup message with sending XIS	Aanmeldbericht response

Structure of the Aanmeldbericht phase 1

The Aanmeldbericht consists of multiple FHIR resources, which are assembled into a FHIR Bundle. The table below lists the FHIR StructureDefinitions that are applicable for the pilot implementation of the 'Aanmeldbericht' transactions.

Section	FHIR profile	FHIR resource	HCIM name	HCIM version	Remarks
-	eOverdrachtAanmeldbericht-phase-one	Composition	-	-	Declaration of the Send Aanmeldbericht transaction.
Datum overplaatsing	eOverdracht-TransferDate	-	-	-	DateTime extension used in eOverdracht composition profiles
Persoonsgegevens	nl-core-patient	Patient	Patient	v3.1(2017NL)	-
	zib-Payer	Coverage	Betaler	v3.1(2017NL)	-
Sturende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
Ontvangende organisatie	nl-core-organization
PDF	Binary	Binary	-	-	Should be used to send unstructured PDF data.

Structure of the Aanmeldbericht phase 2 (complete)

The Aanmeldbericht consists of multiple FHIR resources, which are assembled into a FHIR Bundle. The table below lists the FHIR StructureDefinitions that are applicable for the pilot implementation of the 'Aanmeldbericht' transactions. The Phase Two aanmeldbericht implements the complete aanmeldbericht as described in the functional design.

Section	FHIR profile	FHIR resource	HCIM name	HCIM version	Remarks
-	eOverdrachtAanmeldbericht	Composition	-	-	Declaration of the Send Aanmeldbericht transaction.
Datum overplaatsing	eOverdracht-TransferDate	-	-	-	DateTime extension used in eOverdracht composition profiles
Persoonsgegevens	nl-core-patient	Patient	Patient	v3.1(2017NL)	-
	zib-Payer	Coverage	Betaler	v3.1(2017NL)	-
	nl-core-relatedperson	RelatedPerson	Contactpersoon	v3.1(2017NL)	-
Sturende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
Ontvangende organisatie	nl-core-organization
Medische diagnose	zib-Problem	Condition	Probleem	v4.1(2017NL	-
Voorgeschiedenis	zib-Problem	Condition	Probleem	v4.1(2017NL	-
Let op	zib-Alert	Flag	Alert	v3.2(2017NL)	-
Vrijheidsbeperking	zib-FreedomRestrictingMeasures	Procedure	VrijheidsBeperkendeMaatregelen	v3.1(2017NL)	-
Actuele patiëntenproblemen	zib-Problem	Condition	Probleem	v4.1(2017NL)	-
Afspraken patiënt	zib-ProcedureRequest	ProcedureRequest	OverdrachtGeplandeZorgActiviteit	v3.1(2017NL)	-
Wensen en behoeften patiënt en/of naasten	-	-	-	-	Declared as a text section. See composition profile.
Voeding/vocht	zib-FeedingTubeSystem	DeviceUseStatement	SondeSysteem	v3.2(2017NL)	-
	zib-Infusion	DeviceUseStatement	Infuus	v3.2(2017NL)	-
Uitscheiding	zib-Stoma	Observation	Stoma	v3.2(2017NL)	-

Examples

• Aanmeldbericht phase one Composition
• Aanmeldbericht phase one Bundle
• Aanmeldbericht Composition
• Aanmeldbericht Bundle

Use case: Overdrachtsbericht Volwassenen

Introduction

During the pilot, the transfer information is based on a subset of the Overdrachtsbericht Volwassenen (transfer message for adults). Phase one consists of the implementation of four HCIMs. The remaining information from eOverdracht may be sent unstructured in a PDF file.

Actors and transactions

Actor	Role	Transaction
Sending XIS	Sends transfer message to the receiving XIS	Send Overdrachtsbericht
Receiving XIS	Acknowledges transfer message to sending XIS	Overdrachtsbericht response

Structure of the Overdrachtsbericht phase 1: 4 HCIMs + PDF

The Overdrachtsbericht consists of multiple FHIR resources, which are assembled into a FHIR Bundle. The table below lists the FHIR StructureDefinitions that are applicable for the pilot implementation of the 'Overdrachtsbericht' transactions. During phase 1, the Overdrachtsbericht is based on the same 4 HCIMs as the aanmeldbericht (Patient, Betaler, Contactpersoon en Zorgaanbieder).

Section	FHIR profile	FHIR resource	HCIM name	HCIM version	Remarks
	eOverdracht-Overdrachtsbericht-volwassenen-phase-one	Composition	-	-	Declaration of the Send Overdrachtsbericht volwassenen phase one transaction.
Datum overplaatsing	eOverdracht-TransferDate	-	-	-	DateTime extension used in eOverdracht composition profiles
Persoonsgegevens	nl-core-patient	Patient	Patient	v3.1(2017NL)	-
	zib-Payer	Coverage	Betaler	v3.1(2017NL)	-
Sturende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
Ontvangende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
PDF	Binary	Binary	-	-	Should be used to send unstructured PDF data.

Structure of the Overdrachtsbericht phase 2: 11 HCIMs + PDF

The Overdrachtsbericht consists of multiple FHIR resources, which are assembled into a FHIR Bundle. The table below lists the FHIR StructureDefinitions that are applicable for the pilot implementation of the 'Overdrachtsbericht' transactions. During phase 2, the Overdrachtsbericht is based on the same 11 HCIMs as the aanmeldbericht. The remaining information is made available via an unstructured PDF.

Section	FHIR profile	FHIR resource	HCIM name	HCIM version	Remarks
	eOverdrachtOverdrachtsbericht-volwassenen-phase-two	Composition	-	-	Declaration of the Send Overdrachtsbericht volwassenen phase two transaction.
Datum overplaatsing	eOverdracht-TransferDate	-	-	-	DateTime extension used in eOverdracht composition profiles
Persoonsgegevens	nl-core-patient	Patient	Patient	v3.1(2017NL)	-
	zib-Payer	Coverage	Betaler	v3.1(2017NL)	-
	nl-core-relatedperson	RelatedPerson	Contactpersoon	v3.1(2017NL)	-
Sturende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
Ontvangende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
Medische diagnose	zib-Problem	Condition	Probleem	v4.1(2017NL	-
Voorgeschiedenis	zib-Problem	Condition	Probleem	v4.1(2017NL	-
Let op	zib-Alert	Flag	Alert	v3.2(2017NL)	-
Vrijheidsbeperking	zib-FreedomRestrictingMeasures	Procedure	VrijheidsBeperkendeMaatregelen	v3.1(2017NL)	-
Actuele patiëntenproblemen	zib-Problem	Condition	Probleem	v4.1(2017NL)	-
Afspraken patiënt	zib-ProcedureRequest	ProcedureRequest	OverdrachtGeplandeZorgActiviteit	v3.1(2017NL)	-
Wensen en behoeften patiënt en/of naasten	-	-	-	-	Declared as a text section. See composition profile.
Voeding/vocht	zib-FeedingTubeSystem	DeviceUseStatement	SondeSysteem	v3.2(2017NL)	-
	zib-Infusion	DeviceUseStatement	Infuus	v3.2(2017NL)	-
Uitscheiding	zib-Stoma	Observation	Stoma	v3.2(2017NL)	-
PDF	Binary	Binary	-	-	Should be used to send unstructured PDF data.

FHIR CapabilityStatements

Phase one

• Link to Server CapabilityStatement
• Link to Client CapabilityStatement

Phase two

• Link to Server CapabilityStatement
• Link to Client CapabilityStatement