FHIR Implementation Guide: Vaccinations 0.1.0
|
|
Draft version of the FHIR IG for Vaccinations. Currently in development and therefore not yet suitable for implementation. The draft version of the functional design can be found here. |
1 Introduction
This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the functional design wiki page. The technical specification is described here. HL7 FHIR R4 is used for this purpose.
Note: This implementation guide builds on the general guidelines described in the use case overarching principles.
1.1 Vaccinations
Vaccination results are represented by the Immunization resources. It contains the relevant data elements per single vaccination about the administered vaccination such as DateTime of administration, vaccination indication and pharmaceutical product. The transaction consists of all available administered vaccinations at the XIS. The transactions:
2 Actors involved
| Persons | Systems | FHIR Capability Statements | |||
|---|---|---|---|---|---|
| Name | Description | Name | Description | Name | Description |
| Patient | The user of a personal healthcare environment. | PHR | Personal health record |  CapabilityStatement: Client
|
Vaccination process client requirements |
| (Health)care provider | The user of a XIS | XIS | (Healthcare) information system | CapabilityStatement: Server
|
Vaccination server requirements |
3 Use case 1: Retrieve vaccinations
This FHIR implementation guide assumes that the PHR system is able to make a connection to the right XIS that contains the patient's information. It does not provide information on finding the right XIS nor does it provide information about security. Moreover, each transaction is performed in the context of a specific authenticated patient, for whose context (token) has been established using the authentication mechanisms described in the 'Afsprakenstelsel'. Each XIS Gateway is required to perform filtering based on the patient associated with the context for the request, so only the records associated with the authenticated patient are returned. For this reason, search parameters should not be included for patient identification.
3.1 Introduction
The retrieve vaccinations transaction is used by the PHR to retrieve vaccinations from a XIS.
3.2 Actors
| Transaction group | Transaction | Actor | Role |
|---|---|---|---|
| Retrieve vaccinations(PULL) | Retrieve vaccinations request | Patient (using a PHR) | Request vaccinations from the XIS |
| Retrieve vaccinations response | (Healthcare) professional (using a XIS) | Serves vaccinations to the PHR |
3.3 Invocations
3.3.1 PHR: request message
The request message represents an HTTP GET parameterized query from the PHR to the XIS.
3.3.1.1 Trigger Events
When the patient(PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.
3.3.1.2 Message Semantics
The PHR executes an HTTP GET conform to the FHIR RESTful and search specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format:
---> ANDER VOORBEELD CODE HIER???????????????
GET [base]/Observation?category=http://snomed.info/sct|49581000146104{&[parameters]}
The PHR may use, and the XIS shall be capable of processing, the following parameters to configure the search query:
| Name | Description | Examples |
|---|---|---|
| date | Obtained date/time for the result. If the result was obtained over a period, this parameter should be interpreted as a date that falls in this period. | Retrieve all zib LaboratoryTestResults Observation resources that have an effective date greater than 01-01-2010:
GET [base]/Observation?category=http://snomed.info/sct|49581000146104&date=ge2010-01-01 Retrieve all zib LaboratoryTestResults Observation resources that have an effective date within a 2 year period: GET [base]/Observation?_include=Observation:specimen&category=http://snomed.info/sct|49581000146104date=ge2010-01-01&date=le2011-12-31 |
| category | The classification of the type of observation. | Retrieve all zib LaboratoryTestResults Observation resources:
GET [base]/Observation?category=http://snomed.info/sct|49581000146104 |
| _include | The PHR may request that the XIS returns resources related to the search results, in order to reduce the overall network delay of repeated retrievals of related resources. | Retrieve all zib LaboratoryTestResults Observation resources and include Specimen information in the search results:
GET [base]/Observation?_include=Observation:specimen&category=http://snomed.info/sct|49581000146104 |
3.3.1.2.1 Expected Actions
The XIS shall process the query to discover Observation resources that match the search parameters given.
3.3.2 XIS: response message
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching observation information.
3.3.2.1 Trigger Events
The XIS completed processing of the retrieve laboratory results request message.
3.3.2.2 Message Semantics
The returned data to the PHR should conform to the HCIMs and their associated profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the meta.profile element in order to show compliance.
|
|
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. |
| Zib name NL | Zib name EN | FHIR Resource | |
| Patient | Patient | Patient | http://fhir.nl/fhir/StructureDefinition/nl-core-patient |
| Zorgverlener | HealthProfessional | Practitioner | http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner |
| Zorgaanbieder | HealthcareProvider | Organization | http://fhir.nl/fhir/StructureDefinition/nl-core-organization |
| LaboratoriumUitslag | LaboratoryTestResult | Observation | http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation |
3.3.2.3 Expected Actions
The PHR shall process the results according to application-defined rules. The PHR should be robust as the response may contain observation and specimen resources that match the query parameters.
4 Use case: retrieve laboratory results DiagnosticReport
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 Introduction
The retrieve laboratory diagnostic report transaction is used by the PHR to retrieve laboratory results from a XIS.
4.2 Actors
| Transaction group | Transaction | Actor | Role |
|---|---|---|---|
| Retrieve Laboratory Results(PULL) | Retrieve laboratory diagnostic report request | Patient (using a PHR) | Request laboratory diagnostic report from the XIS |
| Retrieve laboratory diagnostic report response | Healthcare professional (using a XIS) | Serves laboratory diagnostic report to the PHR |
4.3 Invocations
4.3.1 PHR: request message
The request message represents an HTTP GET parameterized query from the PHR to the XIS.
4.3.1.1 Trigger Events
When the patient(PHR) wants to obtain laboratory diagnostic report, it issues a retrieve laboratory diagnostic report request message.
4.3.1.2 Message Semantics
The PHR executes an HTTP GET conform to the FHIR RESTfull and search specification against the XIS's DiagnosticReport endpoint. This search query URL is configurable by the PHR and has the following format.
GET [base]/DiagnosticReport?category=http://snomed.info/sct|4241000179101{&[parameters]}
The PHR may use, and the XIS shall be capable of processing, the following parameters to configure the search query:
| Name | Description | Example(s) |
|---|---|---|
| date | The clinically relevant time of the report. | Retrieve all zib LaboratoryTestResult DiagnosticReport resources that have an effective date greater than 01-01-2010.
GET [base]/DiagnosticReport?category=http://snomed.info/sct|4241000179101&date=ge2010-01-01 Retrieve all zib LaboratoryTestResult DiagnosticReport resources that have an effective date within a 2 year period. GET [base]/DiagnosticReport?category=http://snomed.info/sct|4241000179101&date=ge2010-01-01&date=le2011-12-31 |
| category | Which diagnostic discipline/department created the report. | |
| _include | The PHR may request that the XIS returns resources related to the search results, in order to reduce the overall net | Retrieves all zib LaboratoryTestResult DiagnosticReport resources and include the referenced Observation resources in the search results.
GET [base]/DiagnosticReport?category=http://snomed.info/sct|4241000179101&include=DiagnosticReport:result&date=ge2010-01-01&date=le2011-12-31 |
4.3.1.2.1 Expected Actions
The XIS shall process the query to discover DiagnosticReport resources that match the search parameters given.
4.3.2 XIS: response message
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching laboratory diagnostic report information.
4.3.2.1 Trigger Events
The XIS completed processing of the retrieve laboratory diagnostic report request message.
4.3.2.2 Message Semantics
The returned data to the PHR should conform to the HCIMS and their associate profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the meta.profile element in order to show compliance.
|
|
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. |
| Zib name NL | Zib name EN | FHIR Resource | |
| Patient | Patient | Patient | http://fhir.nl/fhir/StructureDefinition/nl-core-patient |
| Zorgverlener | HealthProfessional | Practitioner | http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner |
| Zorgaanbieder | HealthcareProvider | Organization | http://fhir.nl/fhir/StructureDefinition/nl-core-organization |
| LaboratoriumUitslag | LaboratoryTestResult | DiagnosticReport | http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-DiagnosticReport |
| Observation | http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation |
4.3.2.3 Expected Actions
The PHR shall process the results according to application-defined rules. The PHR should be robust as the response may contain DiagnosticReport, Observation and Specimen resources that match the query parameters.
5 Release notes
Release notes can be found on the functional design page.