Gebz:V1.0 FHIR IG

{{#customtitle:FHIR Implementation Guide Geboortezorg v2.3 | FHIR Implementation Guide Geboortezorg v2.3}}

Introduction

This page details the HL7 FHIR requirements for exchanging the Geboortezorg v2.3 data described in Functioneel.

Use case: Register Prio1 data

Introduction

The Register Prio1 transaction is used by the sending XIS to send the relevant data to the registry.

Actors

Transaction group	Transaction	Actor	Role
Register Prio1(PUSH)	Register Prio1	Healthcare professional (using a XIS)	Sends Prio1 data to registry
Retrieve Prio1(PULL)	Querying XIS	Healthcare professional (using a XIS)	Retrieves Prio1 data from registry

Invocations

Sending XIS: request message

Message Semantics

Because the data needed will most likely consist of multiple FHIR resources, a document Bundle is used.

The interaction is performed by an HTTP POST command as shown:

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

The body of the post submission is a Bundle with Bundle.type = document. The first entry contains a Composition resource, and each subsequent entry contains a resource that is referenced from the Composition resource. By sending it to the target's base, the document Bundle will be processed as a transaction and each Bundle.entry will be treated as a create interaction for the entry.resource.

Examples

Example FHIR resources can be found here: Birthcare FHIR examples

Search

Example search URLs can be found in the list of StructureDefinitions below. Some searches require the implementation of custom search parameters. These parameters can be found here: https://simplifier.net/geboortezorg-stu3/~resources?category=SearchParameter

FHIR Resources and StructureDefinitions

Graphical overview

The following link Media:FHIR Geboortezorg Profielen Prio1 27-02-2020.png provides a graphical overview of the structure definitions and their relations.

Types of resources and relations between them

FHIR resource	Name	Description
Woman (Vrouw)	Patient	The core of each pregnancy is the pregnant woman, a FHIR Patient.
Regular resources	Practitioner, Organization	Those are not used differently than in other Dutch projects.
Pregnancy, Pregnancy file (Zwangerschap, zwangerschapsdossier)	Condition, EpisodeOfCare	Each pregnancy is a Condition. It is also represented as an EpisodeOfCare for each involved Organization. The pregnancy includes references to an Organization and responsible Practitioner. (Practitioners responsible for the actual data may be included there, i.e. in Procedures, Observations.) Condition points to the EpisodeOfCare through a EpisodeOfCare.context.reference element. (Note: different providers may each have their own Condition resource.) EpisodeOfCare points to the Condition through a EpisodeOfCare.diagnosis.condition element. Condition points to the Patient with Condition.subject.reference Condition.status must be 'active' for ongoing pregnancies and 'inactive' for past ones.
Patient-related Observations	Observation	Observations such as blood type pertain to the Patient. Observations can refer to an EpisodeOfCare with Observation.context.reference
Condition-related Observations	Observation	Observations such as gravidity and parity do pertain to the Patient but to a particular pregnancy. Condition-related Observations use focus extension to point to Condition they're about. Without this, all gravidities would only be Observations about a Patient.
Woman (Vrouw)	Patient	The core of each pregnancy is the pregnant woman, a FHIR Patient
Woman (Vrouw)	Patient	The core of each pregnancy is the pregnant woman, a FHIR Patient
Woman (Vrouw)	Patient	The core of each pregnancy is the pregnant woman, a FHIR Patient

List of StructureDefinitions

Name	PWD 2.3 id	FHIR Profile	FHIR Example	Example SEARCH URL
Vrouw		bc-Woman (derived from nl-core-patient)	Patient	GET [base]/Patient/[vrouwid]
				GET [base]/Patient?identifier=[bsn]
Zorgverlener		nl-core-practitioner	Practitioner	GET [base]/Practitioner/[zorgverlenerid]
				GET [base]/Practitioner?identifier=[lvrid]
Zorginstelling		nl-core-organization	Organization	GET [base]/Organization/[zorginstellingid]
				GET [base]/Organization?identifier=[lvrid]
Zorgverlenerrol		nl-core-practitionerrole	Patient	GET [base]/PractitionerRole/[zorgverlenerrolid]
				GET [base]/PractitionerRole?practitioner:Practitioner.identifier=[lvrid]
Zwangerschapsdossier		bc-MaternalRecord	EpisodeOfCare	GET [base]/EpisodeOfCare/[dossierid]
				GET [base]/Observation,Condition,Procedure?eoc=[dossierid]
				GET [base]/Observation,Condition,Procedure?eoc:EpisodeOfCare.condition:Condition.clinical-status=active
Zwangerschap	peri23-dataelement-3	zib-Pregnancy	Condition	GET [base]/Condition/[zwangerschapid]
				GET [base]/Condition?clinicalstatus=active
				GET [base]/Condition?clinicalstatus=inactive&_sort=_-id&_count=1
				GET [base]/Condition?subject=[patientid]&_revinclude=Observation:focus
Bloedgroep vrouw	peri23-dataelement-10810	zib-LaboratoryTestResult-Observation	Observation	GET [base]/Observation?code=883-9{&subject=[vrouwid]&eoc=[dossierid]}
Rhesus D Factor vrouw	peri23-dataelement-10811	zib-LaboratoryTestResult-Observation	Observation	GET [base]/Observation?code=1305-2{&subject=[vrouwid]&eoc=[dossierid]}
Rhesus c Factor	peri23-dataelement-10816	zib-LaboratoryTestResult-Observation	Observation	GET [base]/Observation?code=1159-3{&subject=[vrouwid]&eoc=[dossierid]}
Hb waarde	peri23-dataelement-10814	zib-LaboratoryTestResult-Observation	Observation	GET [base]/Observation?code=718-7{&subject=[vrouwid]&eoc=[dossierid]}
A terme datum	peri23-dataelement-20030	zib-Pregnancy-DueDate	Observation	GET [base]/Observation?code=11778-8{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Graviditeit	peri23-dataelement-20010	zib-Pregnancy-Gravidity	Observation	GET [base]/Observation?code=11996-6{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Pariteit	peri23-dataelement-20150	zib-Pregnancy-Parity	Observation	GET [base]/Observation?code=11977-6{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Wijze einde zwangerschap	peri23-dataelement-80625	bc-Pregnancy-EndType	Observation	GET [base]/Observation?code=EindeZw{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Datum einde zwangerschap	peri23-dataelement-20540	bc-Pregnancy-EndDate	Observation	GET [base]/Observation?code=xxx{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Zwangerschapsduur	peri23-dataelement-20062	zib-Pregnancy-Duration		GET [base]/Observation?code=57036006{&subject=[vrouwid]&eoc=[dossierid]&focus=[zwangerschapid]}
Bevalling	peri23-dataelement-6	bc-DeliveryProcedure	Procedure	GET [base]/Procedure?code=236973005{&subject=[vrouwid]&eoc=[dossierid]&reasonReference=[zwangerschapid]}
Ontsluitingsfase, uitdrijvingsfase, nageboortefase	peri23-dataelement-6	bc-Delivery-StageOfLabor	Observation	GET [base]/Observation?code=6893006,42857002,15898009{&subject=[vrouwid]&eoc=[dossierid]&partof=[bevallingid]&focus=[kindid]}
Tijdstip begin actieve ontsluiting	peri23-dataelement-20590	bc-OnsetOfLaborFirstStage	Observation	GET [base]/Observation?code=249120008{&subject=[vrouwid]&eoc=[dossierid]&focus=[ontsluitingsfaseid]}
Tijdstip actief meepersen	peri23-dataelement-30030	bc-OnsetOfPushing	Observation	GET [base]/Observation?code=249163006{&subject=[vrouwid]&eoc=[dossierid]&focus=[uitdrijvingsfaseid]}
Type partus	peri23-dataelement-80626	bc-ParturitionType	Observation	GET [base]/Observation?code=364336006{&subject=[vrouwid]&eoc=[dossierid]&focus=[uitdrijvingsfaseid]}
Hoeveelheid bloedverlies	peri23-dataelement-20640	bc-BloodLoss	Observation	GET [base]/Observation?code=64332008{&subject=[vrouwid]&eoc=[dossierid]&focus=[uitdrijvingsfaseid]}
Vaginale kunstverlossing	peri23-dataelement-40190	bc-ObstetricProcedure	Procedure	GET [base]/Procedure?code=3311000146109{&subject=[vrouwid]&eoc=[dossierid]&partof=[bevallingid,uitdrijvingsfaseid]}
Conditie perineum postpartum	peri23-dataelement-80673	bc-StatePerineumPostPartum	Observation	GET [base]/Observation?code=364297003{&subject=[vrouwid]&eoc=[dossierid]&focus=[nageboortefaseid]}
Kind		bc-Child (of nl-core-patient)	Patient	GET [base]/Patient/[kindid]
Geboortedatum	peri23-dataelement-40050	bc-Child (of nl-core-patient)	Patient.birthdate	GET [base]/Patient/[kindid]
Apgarscore na 5 min.	peri23-dataelement-40071	zib-ApgarScore	Observation	GET [base]/Observation?code=9274-2{&subject=[kindid]&eoc=[dossierid]}
Geboortegewicht	peri23-dataelement-40060	zib-BodyWeight	Observation	GET [base]/Observation?code=29463-7{&subject=[kindid]&eoc=[dossierid]}

Terminology, NamingSystems, Mappings

Terminology

Relevant value sets can be found here. 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'.