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.

Technical details of the FHIR resources and structure definitions described in this Implementation Guide (IG) can be found in the Simplifier Geboortezorg STU3 project. This IG provides links to the required resources and structure definitions for each use case.

A high level overview:

FHIR Resources and StructureDefinitions

Types of resources and relations between them

For Observations, which are often very similar, we follow patterns: an implementer will only need to implement the pattern and an associated table with codes, and be able to support all Observations. So for Observations pertaining to a particular pregnancy (not to the woman - she may have multiple pregnancies on record, neither to the delivery) all Observations will link to the Pregnancy Condition. So instead of having to inspect StructureDefinitions separately for each pregnancy observations, following a single pattern will do. The pattern has it's own StructureDefinition, so the FHIR profile is still complete. Likewise Observations for the mother, delivery and child follow patterns. See links below.

Name	FHIR resource	Description
Woman (Vrouw)	Patient	The core of each pregnancy is the pregnant woman, a FHIR Patient.
Partner	RelatedPerson	The partner of the pregnant woman (not necessarily the biological father).
Generic resources	Practitioner, PractitionerRole, Organization	Those are not used differently than in other Dutch projects.
Referral details	ReferralRequest	Referral details (such as type of referral, reason code, referrer and target of the referral) are described in ReferralRequest. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare).
Involvement pediatrician	CareTeam	A CareTeam describes the involvement of different care providers, such as a pediatrician. These care providers are included as participants in the CareTeam using the CareTeam.participant.member element. Participants may either be Practitioners or Organizations. Their role and period of involvement are described at the participant level (that is CareTeam.participant.role and CareTeam.participant.period). The reason of involvement is described in CareTeam.reasonCode
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
Pregnancy-related Observations	Observation	Observations such as gravidity and parity do not (only) pertain to the Patient but to a particular pregnancy. Pregnancy-related Observations use focus extension to point to Condition they're about. Without this, all gravidities would only be Observations about a Patient. Pregnancy-related Observations refer to the EpisodeOfCare with Observation.context.reference
Childbirth Assistance	Encounter	Childbirth Assistance is modeled as an Encounter. The woman Patient is subject of the Encounter. The place of birth is described in Encounter.class using a ConceptMap to map values to available FHIR codes The Encounter.diagnosis element refers to the Pregnancy (Condition) The Encounter.participant element containts a list of care providers that were present during delivery. Family members and even the woman Patient could also be included in this list. Additional details can be defined at participant level, such as participant type and time of arrival. The latter uses an extension at participant level with a coded list of time of arrival. Childbirth Assistance refers to the EpisodeOfCare with Encounter.EpisodeOfCare.reference
Delivery (Bevalling)	Procedure	Delivery is modeled with Procedure (even for uncomplicated natural births for consistency). A pregnancy can lead to one DeliveryProcedure even in multiple birth. The Patient is the subject. Delivery refers to the EpisodeOfCare with Procedure.context.reference Delivery refers to the Pregnancy with Procedure.reasonReference.reference
Delivery-related Observations	Observation	Observations such as onset of labor or blood loss pertain to a delivery Procedure. Delivery-related Observations use focus extension to point to the delivery Procedure they're about. Delivery-related Observations refer to the EpisodeOfCare with Observation.context.reference
Placenta	BodySite	The placenta is a body structure of the woman Patient and is modeled as a BodySite. The BodySite.patient element refers to the woman Patient.
Placenta-related Observations	Observation	Observations related to the Placenta (such as date/time of birth placenta) use the focus element to refer to the Placenta. The woman Patient is still the subject of the Observation. Placenta-related Observations use focus extension to point to the placenta. Placenta-related Observations refer to the EpisodeOfCare with Observation.context.reference
Birth	Procedure	A birth pertains to a delivery Procedure as well as a child, especially in multiple birth where multiple birth instances point to the same delivery Procedure. A birth also provides the relation between a child and its mother. The mother Patient is the subject of the delivery Procedure and the child Patient is the subject of the birth Procedure, which is part of the delivery Procedure. A pregnancy can lead to one delivery Procedure and multiple birth Procedures. Birth refers to the delivery Procedure with Procedure.partOf Birth refers to the EpisodeOfCare with Procedure.context.reference Delivery refers to the Pregnancy with Procedure.reasonReference.reference
Birth-related Observations	Observation	Observations such as parturition type pertain to a birth. They are also about the mother, which still is the subject. Birth-related Observations use focus extension to point to a birth. Birth-related Observations refer to the EpisodeOfCare with Observation.context.reference
Child	Patient	Child is a separate Patient. Procedure-related Observations use focus extension to point to the child Patient they're about.
Child-related Observations	Observation	Observations such as Apgar score and birthweight pertain to the child Patient, which is the subject of these Observations. Child observations refer to the EpisodeOfCare with Observation.context.reference
Child disorders	Condition	Child disorders such as chromosomal and congenital abnormalities or other problems are conditions. The child is the subject. Child disorders can refer to the EpisodeOfCare with Condition.context.reference A ConceptMap is available to map verification status to accepted FHIR codes
Digital vaginal examination	DiagnosticReport	The digital vaginal examination DiagnosticReport groups Observations related to the digital vaginal examination. The woman Patient is the subject of the report. Digital vaginal examination refers to the EpisodeOfCare with DiagnosticReport.context.reference

The use of focus extensions is a pre-adopt of FHIR R4, where it is part of Observation: "What the observation is about, when it is not about the subject of record." Focus is required for all Observations which do not pertain to the Patient. In R4, use of focus permits "reverse include" queries (give me all Observations with focus element X). In STU3, this could be a custom search.

The use of context is encouraged for all resources which have a context element. It is a reference to an EpisodeOfCare or an Encounter. Context should point to an Encounter when appropriate (scheduled maternity checks etc.) and to the EpisodeOfCare in all other cases. Possibly it will be absent in Observations where the source is not birth care, so readers should not rely on it's presence.

Observations should include a performer if known.

Pattern tables can be found on individual pattern pages and on Gebz:V2.3_FHIR_mapping_addendum.

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'.

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

The source executes two HTTP requests:

1. HTTP POST request

A HTTP POST request of a Bundle with Bundle.type = transaction to the target's base endpoint. The first Bundle.entry contains a Composition resource, and each subsequent entry contains a resource that is referenced from the Composition resource.

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

Each Bundle.entry shall contain an entry.request with request.method = PUT. Each Bundle.entry shall contain either:

1. A client assigned UUID in the entry.resource and the entry.request.url
2. A conditional reference in the entry.fullUrl and the entry.request.url

The first applies to resources (e.g. Observations) of which multiple instances are allowed to live on the server.

The second applies to resources (e.g. Patients) for which no duplicates are allowed, e.g. by identifier. Please note that resource instances with conditional references are only created when no resource instance on the server meets the condition, updated when one such an instance exists and the transaction is fully rejected when multiple resource instances meet the condition. Also note that the internal references in the transaction pointing to these kind of resource instances are conditional ones.

Below are examples of transaction Bundles for the prio1 transaction:

• Current pregnancy
• Previous pregnancy

2. HTTP GET request

A HTTP GET request to the target's Composition endpoint, handling the createDocumentOperation with persist=true. The target's response is a FHIR Document Bundle, which is generated from the Composition resource and stored to the target's Bundle endpoint.

GET [base]/Composition/[id]/$document?persist=true{&_format=[mime-type]}

Retrieving XIS: request message

FHIR Document Bundles can be retrieved by a HTTP GET request to the target's Bundle endpoint. Note that FHIR Document Bundles are immutable and its entries refer to a time-related version of a resource which is not necessarily its latest version.

GET [base]/Bundle/[id]{&_format=[mime-type]}

Individual resources can be retrieved by HTTP GET requests to specific resource endpoints, see the Search section and list of StructureDefinitions below.

Examples

Example FHIR resources can be found here: [1]

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

List of StructureDefinitions

Please note that many birth care specific profiles are derived from nl-core profiles (e.g. bc-PregnancyObservation is derived from nl-core-observation) to support (re)use of profiles in multiple use cases. The meta.profile element of FHIR instances conforming these profiles should at least include the generic nl-core profile and preferably the specific birth care profile.

Prio 1 huidig

PWD 2.3 to FHIR
Type	#	Concept	Card	Profile	Example	Search URL
	1	Zorgverlener/Zorginstelling	1 .. 1
	10020	Zorginstelling	1 .. 1	nl-core-organization	example	GET [base]/Organization/[zorginstellingid] GET [base]/Organization?identifier=[lvrid]
	10021	Zorginstelling OID	0 .. 1
	10022	Zorginstelling AGB-ID	0 .. 1
	10023	Zorginstelling LVR-ID	0 .. 1
	10024	Zorginstelling URA	0 .. 1
	10026	Naam zorginstelling	0 .. 1
	10027	Adres zorginstelling	0 .. 1
	10032	Straatnaam	0 .. 1
	10033	Huisnummer	0 .. 1
	10034	Huisletter/huisnummertoevoeging	0 .. 1
	10041	Postcode	0 .. 1
	10036	Plaatsnaam	0 .. 1
	10037	Gemeentenaam	0 .. 1
	10038	Land	0 .. 1
	10039	Adrestype	0 .. 1
	10029	Type zorginstelling	0 .. 1
	82019	Type zorginstelling (bij verwijzing)	0 .. 1
	2	Vrouw	1 .. 1	bc-Woman	example	GET [base]/Patient/[vrouwid] GET [base]/Patient?identifier=[bsn]
	10030	Burgerservicenummer	1 .. 1
	10035	Naamgegevens	0 .. 1
	10042	Voornamen	0 .. 1
	82359	Initialen	0 .. 1
	82360	Roepnaam	0 .. 1
	82361	Achternaam	1 .. 1
	82362	Soort naam	0 .. 1
	82363	Voorvoegsel	0 .. 1
	10043	Achternaam	1 .. 1
	10810	Bloedgroep vrouw	0 .. 1	zib-LaboratoryTestResult-Observation	example
	10811	Rhesus D Factor vrouw	0 .. 1	zib-LaboratoryTestResult-Observation	example	GET [base]/Observation?code=1305-2{&subject=[vrouwid]&context=[dossierid]}
	10816	Rhesus c Factor	0 .. 1	zib-LaboratoryTestResult-Observation	example	GET [base]/Observation?code=1159-3{&subject=[vrouwid]&context=[dossierid]}
	3	Zwangerschap	1 .. 1	zib-Pregnancy	example	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
	20010	Graviditeit	1 .. 1	zib-Pregnancy-Gravidity	example	GET [base]/Observation?code=11996-6{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	20153	Pariteit	1 .. 1
	20029	A terme datum (groep)	1 .. 1
	20030	A terme datum	1 .. 1	zib-Pregnancy-TermDate	example	GET [base]/Observation?code=11778-8{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	14	Medisch onderzoek	0 .. *
	50020	Datum onderzoek	1 .. 1
	142	Maternale onderzoeksgegevens	1 .. 1
	80959	Urine-, bloed- en aanvullende onderzoeken	1 .. 1
	10814	Hb	1 .. 1	zib-LaboratoryTestResult-Observation	example	GET [base]/Observation?code=718-7{&subject=[vrouwid]&context=[dossierid]}

Prio 1 vorig

PWD 2.3 to FHIR
Type	#	Concept	Card	Profile	Example	Search URL
	1	Zorgverlener/Zorginstelling	1 .. 1
	10020	Zorginstelling	1 .. 1	nl-core-organization	example	GET [base]/Organization/[zorginstellingid] GET [base]/Organization?identifier=[lvrid]
	10021	Zorginstelling OID	0 .. 1
	10022	Zorginstelling AGB-ID	0 .. 1
	10023	Zorginstelling LVR-ID	0 .. 1
	10024	Zorginstelling URA	0 .. 1
	10026	Naam zorginstelling	0 .. 1
	10027	Adres zorginstelling	0 .. 1
	10032	Straatnaam	0 .. 1
	10033	Huisnummer	0 .. 1
	10034	Huisletter/huisnummertoevoeging	0 .. 1
	10041	Postcode	0 .. 1
	10036	Plaatsnaam	0 .. 1
	10037	Gemeentenaam	0 .. 1
	10038	Land	0 .. 1
	10039	Adrestype	0 .. 1
	10029	Type zorginstelling	0 .. 1
	82019	Type zorginstelling (bij verwijzing)	0 .. 1
	2	Vrouw	1 .. 1	bc-Woman	example	GET [base]/Patient/[vrouwid] GET [base]/Patient?identifier=[bsn]
	10030	Burgerservicenummer	1 .. 1
	10035	Naamgegevens	0 .. 1
	10042	Voornamen	0 .. 1
	82359	Initialen	0 .. 1
	82360	Roepnaam	0 .. 1
	82361	Achternaam	1 .. 1
	82362	Soort naam	0 .. 1
	82363	Voorvoegsel	0 .. 1
	10043	Achternaam	1 .. 1
	3	Zwangerschap	0 .. 1	zib-Pregnancy	example	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
	20010	Graviditeit	0 .. 1	zib-Pregnancy-Gravidity	example	GET [base]/Observation?code=11996-6{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	20150	Pariteit (vóór deze zwangerschap)	0 .. 1	zib-Pregnancy-Parity	example	GET [base]/Observation?code=11977-6{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	80625	Wijze einde zwangerschap	0 .. 1	bc-PregnancyObservation	example	GET [base]/Observation?code=EindeZw{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	20540	Datum einde zwangerschap	0 .. 1	bc-PregnancyObservation	example	GET [base]/Observation?code=code=118951000146109{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
	6	Bevalling	0 .. 1	bc-DeliveryProcedure	example	GET [base]/Procedure?code=236973005{&subject=[vrouwid]&context=[dossierid]&reasonReference=[zwangerschapid]}
	20590	Tijdstip begin actieve ontsluiting	0 .. 1	bc-DeliveryObservation	example	GET [base]/Observation?code=249120008{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
	82869	Duur actieve ontsluitingsfase (Ontsluitingsduur)	0 .. 1
	82870	Duur uitdrijving vanaf actief meepersen	0 .. 1
	20640	Hoeveelheid bloedverlies	0 .. 1	bc-DeliveryObservation	example	GET [base]/Observation?code=64332008{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
	80673	Conditie perineum postpartum	0 .. 1	bc-DeliveryObservation	example	GET [base]/Observation?code=364297003{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
	7	Uitkomst (per kind)	0 .. *
	40002	Baring	1 .. 1	bc-Birth	example	GET [base]/Observation?code=3950001{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]&focus=[kindid]}
	40006	Demografische gegevens	0 .. 1	bc-Child	example	GET [base]/Patient/[kindid]
	40050	Geboortedatum	0 .. 1	bc-Child	example	GET [base]/Patient/[kindid]
	71	Kindspecifieke maternale gegevens	0 .. 1
	30030	Tijdstip actief meepersen	0 .. 1	bc-BirthObservation	example	GET [base]/Observation?code=249163006{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]}
	72	Kindspecifieke uitkomstgegevens	0 .. 1
	80626	Type partus	0 .. 1	bc-BirthObservation	example	GET [base]/Observation?code=364336006{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]}
	20062	Zwangerschapsduur	0 .. 1
	40189	Vaginale kunstverlossing (groep)	0 .. 1
	40190	Vaginale kunstverlossing	0 .. 1	bc-ObstetricProcedure	example	GET [base]/Procedure?code=3311000146109{&subject=[vrouwid]&context=[dossierid]&partof=[bevallingid,uitdrijvingsfaseid]}
	80766	Lichamelijk onderzoek kind	0 .. 1
	40071	Apgarscore na 5 min.	0 .. 1	zib-ApgarScore	example	GET [base]/Observation?code=9274-2{&subject=[kindid]&context=[dossierid]}
	40060	Geboortegewicht	0 .. 1	bc-BirthWeight	example	GET [base]/Observation?code=8339-4{&subject=[kindid]&context=[dossierid]}

Use case: Register Parturition Record

Introduction

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

Actors

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

Invocations

Sending XIS: request message

Message Semantics

The source executes two HTTP requests:

1. HTTP POST request

A HTTP POST request of a Bundle with Bundle.type = transaction to the target's base endpoint. The first Bundle.entry contains a Composition resource, and each subsequent entry contains a resource that is referenced from the Composition resource.

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

Each Bundle.entry shall contain an entry.request with request.method = PUT. Each Bundle.entry shall contain either:

1. A client assigned UUID in the entry.resource and the entry.request.url
2. A conditional reference in the entry.fullUrl and the entry.request.url

The first applies to resources (e.g. Observations) of which multiple instances are allowed to live on the server.

The second applies to resources (e.g. Patients) for which no duplicates are allowed, e.g. by identifier. Please note that resource instances with conditional references are only created when no resource instance on the server meets the condition, updated when one such an instance exists and the transaction is fully rejected when multiple resource instances meet the condition. Also note that the internal references in the transaction pointing to these kind of resource instances are conditional ones.

Below are examples of transaction Bundles for the prio1 transaction:

• Current pregnancy
• Previous pregnancy

2. HTTP GET request

A HTTP GET request to the target's Composition endpoint, handling the createDocumentOperation with persist=true. The target's response is a FHIR Document Bundle, which is generated from the Composition resource and stored to the target's Bundle endpoint.

GET [base]/Composition/[id]/$document?persist=true{&_format=[mime-type]}

Retrieving XIS: request message

FHIR Document Bundles can be retrieved by a HTTP GET request to the target's Bundle endpoint. Note that FHIR Document Bundles are immutable and its entries refer to a time-related version of a resource which is not necessarily its latest version.

GET [base]/Bundle/[id]{&_format=[mime-type]}

Individual resources can be retrieved by HTTP GET requests to specific resource endpoints, see the Search section and list of StructureDefinitions below.

Examples

Example FHIR resources can be found here: [2]

Search

Example search URLs can be found in the list of StructureDefinitions below.

List of StructureDefinitions

Please note that many birth care specific profiles are derived from nl-core profiles (e.g. bc-PregnancyObservation is derived from nl-core-observation) to support (re)use of profiles in multiple use cases. The meta.profile element of FHIR instances conforming these profiles should at least include the generic nl-core profile and preferably the specific birth care profile.

Name	PWD 2.3 id	FHIR Profile	FHIR Example	Example SEARCH URL
Vrouw		bc-Woman (nl-core-patient)	Patient	GET [base]/Patient/[vrouwid]
				GET [base]/Patient?identifier=[bsn]
Partner	peri23-dataelement-80633	nl-core-relatedperson	RelatedPerson	GET [base]/RelatedPerson?patient=[vrouwid]
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	PractitionerRole	GET [base]/PractitionerRole/[zorgverlenerrolid]
				GET [base]/PractitionerRole?practitioner:Practitioner.identifier=[lvrid]
Verwijsdetails	peri23-dataelement-82012	bc-ReferralRequest	ReferralRequest	GET [base]/ReferralRequest?subject=[vrouwid]
				GET [base]/ReferralRequest?context=[dossierid]
Zwangerschapsdossier		bc-MaternalRecord (nl-core-episodeofcare)	EpisodeOfCare	GET [base]/EpisodeOfCare/[dossierid]
				GET [base]/Observation,Condition,Procedure?context=[dossierid]
				GET [base]/Observation,Condition,Procedure?context: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]&context=[dossierid]}
Rhesus D Factor vrouw	peri23-dataelement-10811		Observation	GET [base]/Observation?code=1305-2{&subject=[vrouwid]&context=[dossierid]}
Hb waarde	peri23-dataelement-10814		Observation	GET [base]/Observation?code=718-7{&subject=[vrouwid]&context=[dossierid]}
Voorgenomen plaats baring	peri23-dataelement-20261	bc-PregnancyObservation	Observation	GET [base]/Observation?code=PRN4209{&subject=[vrouwid]&context=[dossierid]}
Voorgenomen voeding	peri23-dataelement-82009		Observation	GET [base]/Observation?code=169740003{&subject=[vrouwid]&context=[dossierid]}
A terme datum	peri23-dataelement-20030	zib-Pregnancy-DueDate	Observation	GET [base]/Observation?code=11778-8{&subject=[vrouwid]&context=[dossierid]&focus=[zwangerschapid]}
Partusassistentie	peri23-dataelement-80839	bc-ChildBirthAssistance	Encounter	GET [base]/Procedure?code=236973005{&subject=[vrouwid]&context=[dossierid]&reasonReference=[zwangerschapid]}
Bevalling	peri23-dataelement-6	bc-DeliveryProcedure	Procedure	GET [base]/Procedure?code=236973005{&subject=[vrouwid]&context=[dossierid]&reasonReference=[zwangerschapid]}
Tijdstip begin actieve ontsluiting	peri23-dataelement-20590	bc-DeliveryObservation (nl-core-observation)	Observation	GET [base]/Observation?code=249120008{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
Compleetheid vliezen	peri23-dataelement-80792		Observation	GET [base]/BodySite?subject=[vrouwid]
Hoeveelheid bloedverlies	peri23-dataelement-20640		Observation	GET [base]/Observation?code=64332008{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
Conditie perineum postpartum	peri23-dataelement-80673		Observation	GET [base]/Observation?code=364297003{&subject=[vrouwid]&context=[dossierid]&focus=[bevallingid]}
Placenta	peri23-dataelement-80612	bc-Placenta	BodySite	GET [base]/BodySite?subject=[vrouwid]
Placenta compleet	peri23-dataelement-20631	bc-PlacentaObservation	Observation	GET [base]/Observation?code=364343000{&subject=[vrouwid]&context=[dossierid]&focus=placenta}
Datum/tijd geboorte placenta	peri23-dataelement-80791		Observation	GET [base]/Observation?code=[XXXX]{&subject=[vrouwid]&context=[dossierid]&focus=placenta}
Geboorte		bc-Birth	Procedure	GET [base]/Observation?code=3950001{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]&focus=[kindid]}
Tijdstip breken vliezen	peri23-dataelement-80619	bc-BirthObservation (nl-core-observation)	Observation	GET [base]/Observation?code=289251005{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]}
Tijdstip actief meepersen	peri23-dataelement-30030		Observation	GET [base]/Observation?code=249163006{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]}
Type partus	peri23-dataelement-80626		Observation	GET [base]/Observation?code=364336006{&subject=[vrouwid]&context=[dossierid]&focus=[geboorteid]}
Kind		bc-Child (of nl-core-patient)	Patient	GET [base]/Patient/[kindid]
Apgarscore na 1 min.	peri23-dataelement-40070	zib-ApgarScore	Observation	GET [base]/Observation?code=9272-6{&subject=[kindid]&context=[dossierid]}
Apgarscore na 5 min.	peri23-dataelement-40071			GET [base]/Observation?code=9274-2{&subject=[kindid]&context=[dossierid]}
Apgarscore na 10 min.	peri23-dataelement-80757			GET [base]/Observation?code=9271-8{&subject=[kindid]&context=[dossierid]}
Geboortegewicht	peri23-dataelement-40060	bc-BirthWeight	Observation	GET [base]/Observation?code=8339-4{&subject=[kindid]&context=[dossierid]}
Schedelomtrek	peri23-dataelement-80760	nl-core-observation	Observation	GET [base]/Observation?code=169876006{&subject=[kindid]&context=[dossierid]}
Ligging bij geboorte	peri23-dataelement-40140	bc-BirthObservation (nl-core-observation)	Observation	GET [base]/Observation?code=LigGbrt{&subject=[kindid]&context=[dossierid]}
Navelstreng vaten	peri23-dataelement-80793		Observation	GET [base]/Observation?code=249191003{&subject=[kindid]&context=[dossierid]}
Vitamine K	peri23-dataelement-80761		Observation	GET [base]/Observation?code=[698350008]{&subject=[kindid]&context=[dossierid]}
Vaginaal toucher	peri23-dataelement-40060	bc-DigitalVaginalExamination	DiagnosticReport	GET [base]/DiagnosticReport?code=51597003{&subject=[vrouwid]&context=[dossierid]}
Portio	peri23-dataelement-20612	bc-MaternalObservation (nl-core-observation)	Observation	GET [base]/Observation?code=[249021005]{&subject=[kindid]&context=[dossierid]}
Positie portio	peri23-dataelement-82372		Observation	GET [base]/Observation?code=[248920001]{&subject=[kindid]&context=[dossierid]}
Ontsluiting	peri23-dataelement-20613		Observation	GET [base]/Observation?code=[289761004]{&subject=[kindid]&context=[dossierid]}
Vliezen	peri23-dataelement-20614		Observation	GET [base]/Observation?code=[112074005]{&subject=[kindid]&context=[dossierid]}
Indaling Hodge	peri23-dataelement-20615		Observation	GET [base]/Observation?code=[364611006]{&subject=[kindid]&context=[dossierid]}
Aard van het voorliggend deel	peri23-dataelement-80616		Observation	GET [base]/Observation?code=[364612004]{&subject=[kindid]&context=[dossierid]}
Stand	peri23-dataelement-80618		Observation	GET [base]/Observation?code=[163520002]{&subject=[kindid]&context=[dossierid]}