Gebz:FHIR Guidelines

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FHIR Recipes Geboortezorg v2.3

List of recipes for Birthcare. A recipe (terms such as template, pattern, definition etc. are already used in similar contexts) contains:

  • an XML and/or JSON fragment
    • all non-bracketed code is fixed
    • parts in [[square brackets]] are variable and contain instructions on how to populate those
    • a pipeline | separates text from example value
    • bracketed blocks start with [[# text]] and end with [[/ text]], text will contain information on how to populate the block in instances
    • for instance: Observation.value[x], if 'x' can vary, information about the content is provided
    • (square brackets do not clash too much with either XML or JSON syntax, other than that we follow Mustache syntax very loosely)
    • (fragments are not intended to be machine-processable, but are for documentation, do not rely on fragments syntax to be faultless)
    • (not are recipes intended to replace StructureDefinitions, just to provide more readable documentation for implementers)
  • a valuation table
    • with a dataset concept id
    • fixed values for the valuation of bracketed elements of the fragment (i.e. those are fixed for that particular concept)
    • bracketed values for per-instance variable data (i.e. those are not fixed for that particular concept, usually the actual values that are exchanged)

bc-PregnancyObservation

XML fragment

This is a recipe for pregnacy-related Observations in Birthcare. Note that the meta.profile element should at least include nl-core-observation and preferably bc-DeliveryObservation. 

<Observation xmlns="http://hl7.org/fhir">
    <id value="[[a unique id]]"/>
    <meta>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-observation"/>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyObservation"/>
    </meta>
    <extension url="http://nictiz.nl/fhir/StructureDefinition/Observation-focus-stu3">
        <valueReference>
            <reference value="[[reference to the pregnancy | Condition/wouden-zwanger1]]" />
        </valueReference>
    </extension>
    <status value="[['final' for completed pregnancies, 'active' for ongoing ones]]"/>
    <code>
        <coding>
            <system value="[[system, see below | http://loinc.org]]"/>
            <code value="[[code, see below | 11996-6"/>
            <display value="[[display, see below | Gravidity]]"/>
        </coding>
    </code>
    <subject>
        <reference value="[[reference to the Mother Patient | Patient/XXX-VDWOUDEN" />
        <display value="[[display of reference | Patient van der Wouden]]" />
    </subject>
    <context>
        <reference value="[[reference to the EpisodeOfCare | EpisodeOfCare/wouden-dossier-zwanger1]]"/>
    </context>
    <performer>
        <reference value="[[reference to the performer should be included if known | Practitioner/nl-core-practitioner-01]]" />
        <display value="[[display of reference | Vera de Los]]" />
    </performer>
    [[#observation.value, see below]]
    <valueQuantity>
        <value value="1"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="1"/>
    </valueQuantity>
    [[/observation.value]]
</Observation>

Valuation table

pwd id name system code display datatype value system unit
peri23-dataelement-20010 Graviditeit http://loinc.org 11996-6 Gravidity valueQuantity [[Het aantal keren dat de vrouw zwanger is geworden (inclusief deze).]] http://unitsofmeasure.org 1
peri23-dataelement-20150 Pariteit (vóór deze zwangerschap) http://loinc.org 11977-6 Parity valueQuantity [[Aantal voorafgaande zwangerschappen vóór deze zwangerschap die eindigden met een partus (>= 16w 0d / 112 dagen). De waarde van dit item is minimaal 1 minder dan graviditeit.]] http://unitsofmeasure.org 1
peri23-dataelement-80625 Wijze einde zwangerschap urn:oid:2.16.840.1.113883.2.4.4.13 EindeZw Wijze einde zwangerschap valueCodeableConcept WijzeEindeZwangerschap

bc-DeliveryObservation

XML fragment

This is a recipe for delivery-related Observations in Birthcare. Not for Observations to a particular child in that delivery. Note that the meta.profile element should at least include nl-core-observation and preferably bc-DeliveryObservation. 

<Observation xmlns="http://hl7.org/fhir">
    <id value="[[a unique id]]"/>
    <meta>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-observation"/>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/bc-DeliveryObservation"/>
    </meta>
    <extension url="http://nictiz.nl/fhir/StructureDefinition/Observation-focus-stu3">
        <valueReference>
            <reference value="[[reference to the delivery | Procedure/bevallingprocedure-wouden-zwanger1]]" />
        </valueReference>
    </extension>
    <status value="final"/>
    <code>
        <coding>
            <system value="[[system, see below | http://snomed.info/sct]]"/>
            <code value="[[code, see below | 64332008"/>
            <display value="[[display, see below | Blood loss in labour]]"/>
        </coding>
    </code>
    <subject>
        <reference value="[[reference to the Mother Patient | Patient/XXX-VDWOUDEN" />
        <display value="[[display of reference | Patient van der Wouden]]" />
    </subject>
    <context>
        <reference value="[[reference to the EpisodeOfCare | EpisodeOfCare/wouden-dossier-zwanger1]]"/>
    </context>
    [[#observation.value, see below]]
    <valueQuantity>
        <value value="600"/>
        <unit value="ml"/>
        <system value="http://unitsofmeasure.org"/>
    </valueQuantity>
    [[/observation.value]]
</Observation>

Valuation table

pwd id name system code display datatype value system unit
peri23-dataelement-20640 Hoeveelheid bloedverlies http://snomed.info/sct 64332008 Blood loss in labour valueQuantity [[Hoeveelheid bloedverlies tijdens baring/nageboortetijdperk.]] http://unitsofmeasure.org ml
peri23-dataelement-80673 Conditie perineum postpartum http://snomed.info/sct 364297003 Female perineum observable (observable entity) valueCodeableConcept Conditie perineum

bc-BirthObservation

XML fragment

This is a recipe for delivery- and child-related Observations in Birthcare. Note that the meta.profile element should at least include nl-core-observation and preferably bc-DeliveryObservation. 

<Observation xmlns="http://hl7.org/fhir">
    <id value="[[a unique id]]"/>
    <meta>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-observation"/>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/bc-BirthObservation"/>
    </meta>
    <extension url="http://nictiz.nl/fhir/StructureDefinition/Observation-focus-stu3">
        <valueReference>
            <reference value="[[reference to the birth | Observation/geboorte1-wouden]]" />
        </valueReference>
    </extension>
    <status value="final"/>
    <code>
        <coding>
            <system value="[[system, see below | http://snomed.info/sct]]"/>
            <code value="[[code, see below | 364336006"/>
            <display value="[[display, see below | Pattern of delivery (observable entity)]]"/>
        </coding>
    </code>
    <subject>
        <reference value="[[reference to the Mother Patient | Patient/XXX-VDWOUDEN" />
        <display value="[[display of reference | Patient van der Wouden]]" />
    </subject>
    <context>
        <reference value="EpisodeOfCare/wouden-dossier-zwanger1" />
    </context>
    <context>
        <reference value="[[reference to the EpisodeOfCare | EpisodeOfCare/wouden-dossier-zwanger1]]"/>
    </context>
    [[#observation.value see below]]
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="3311000146109"/>
            <display value="Vaginale kunstverlossing"/>
        </coding>
    </valueCodeableConcept>
    [[/observation.value]]
</Observation>

Valuation table

pwd id name system code display datatype value value-system value-code
peri23-dataelement-80626 Type partus http://snomed.info/sct 364336006 Pattern of delivery (observable entity) valueCodeableConcept TypePartus
peri23-dataelement-30030 Tijdstip actief meepersen http://snomed.info/sct 249163006 Onset of pushing (in labor) (observable entity) valueDateTime

bc-ChildObservation

XML fragment

This is a recipe for child-related Observations in Birthcare. 

<Observation xmlns="http://hl7.org/fhir">
    <id value="[[a unique id]]"/>
    <meta>
        <profile value="http://nictiz.nl/fhir/StructureDefinition/bc-ChildObservation"/>
    </meta>
    <status value="final"/>
    <code>
        <coding>
            <system value="[[system, see below | http://loinc.org]]"/>
            <code value="[[code, see below | 8339-4"/>
            <display value="[[display, see below | Birth weight Measured]]"/>
        </coding>
    </code>
    <subject>
        <reference value="[[reference to the Child Patient | Patient/XXX-KIND2VDWOUDEN" />
        <display value="[[display of reference | Kind 2 van der Wouden]]" />
    </subject>
    <context>
        <reference value="[[reference to the EpisodeOfCare | EpisodeOfCare/wouden-dossier-zwanger1]]"/>
    </context>
    [[#observation.value, see below]]
    <valueQuantity>
        <value value="2845"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="gram"/>
    </valueQuantity>
    [[/observation.value]]
</Observation>

Valuation table

pwd id name system code display datatype value value-system value-code
peri23-dataelement-40060 Geboortegewicht http://loinc.org 8339-4 Birth weight Measured valueQuantity [[Meting van het lichaamsgewicht zo kort mogelijk na de geboorte.]] http://unitsofmeasure.org gram
peri23-dataelement-40071 Apgarscore na 5 min. http://loinc.org 9274-2 5 minute Apgar Score valueQuantity [[Apgarscore na 5 min.]]
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