MedMij FHIR use case AllergyIntolerance
Introduction
This page describes a patient's use case, in a personal health record (PHR) context, in relation to the information standard Medication Process for allergy and intolerance information. This use case is based on version 6.12.X of this standard. Functional specification of this use case is described in the functional design wiki page. The technical specification is described here. HL7 FHIR STU3 is used for this purpose.
Actors involved
| Persons | Systems | FHIR Capability Statements | |||
|---|---|---|---|---|---|
| Name | Description | Name | Description | Name | Description |
| Patient | The user of a personal healthcare enviorment. | PHR | Personal health record |  CapabilityStatement: Client
|
AllergyIntolerance client requirements |
| Healthcare professional | The user of a XIS | XIS | Healthcare information system | CapabilityStatement: Server
|
AllergyIntolerance server requirements |
Use case: Retrieve AllergyIntolerance information
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.
Introduction
The retrieve AllergyIntolerance transaction is used by the PHR to retrieve allergy and intolerance information from the XIS.
Actors
| Transaction group | Transaction | Actor | Role |
|---|---|---|---|
| Retrieve AllergyIntolerance(PULL) | Retrieve AllergyIntolerance request | Patient (using a PHR) | Request allergy and intolerance information from the XIS |
| Retrieve AllergyIntolerance response | Healthcare professional (using a XIS) | Serves allergy and intolerance information to the PHR |
Invocations
PHR: request message
The request message represents an HTTP GET parameterized query from the PHR to the XIS.
Trigger Events
When the patient(PHR) wants to obtain allergy and intolerance information, it issues a retrieve AllergyIntolerance request message.
Message Semantics
The PHR executes an HTTP GET conform to the FHIR RESTfull and search specification against the XIS's AllergyIntolerance endpoint. This search query URL is configurable by the PHR and has the following format.
GET [base]/AllergyIntolerance?[parameters]{&_format=[mime-type]}
Search Parameters
The PHR may supply, and the XIS shall be capable of processing, all query parameters listed below. These search parameters are a selection of the defined search parameters by the HL7 FHIR specification search parameters of AllergyIntolerance.
| AllergyIntolerance | ||
|---|---|---|
| Name | Type | Description |
| onset | date | Date(/time) when manifestations showed |
Example search URLs
1. GET https://vonk.test-nictiz.nl/AllergyIntolerance 2. GET https://vonk.test-nictiz.nl/AllergyIntolerance?onset=ge2010-01-01&onset=le2011-12-31
- Retrieves all AllergyIntolerance resources.
- Retrieves all AllergyIntolerance resources that have an onset date(/time) within a 2 year period.
Expected Actions
The XIS shall process the query to discover AllergyIntolerance resources that match the search parameters given.
XIS: response message
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the allergy and intolerance medication information.
Trigger Events
The XIS completed processing of the Retrieve AllergyIntolerance request message.
Message Semantics
Based on the query results, the XIS will either return an error or success. When the XIS needs to report an error, it SHALL use HTTP error response codes and SHOULD include a FHIR OperationOutcome resource with more details on the failure. If the request message is processed successfully, whether or not any AllergyIntolerance resources are found, the HTTP status code SHALL be 200.
The response message shall be a Bundle resource of type "searchset" containing zero or more FHIR resources as entries. If the XIS is sending warnings, the Bundle resource SHALL also contain a FHIR OperationOutcome resource that contains those warnings. The FHIR specification describes the relevant sections:
Message resource content
The returned data to the PHR should conform to the ZIB AllergyIntolerance profile. The table below shows the relevant ZIBs and their profiles. 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.
| ZIB name NL | ZIB name EN | FHIR Resource | URL profile | Reference to section |
| Patient | Patient | Patient | http://fhir.nl/fhir/StructureDefinition/nl-core-patient | Patient
|
| Zorgverlener | HealthProfessional | Practitioner | http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner | HealthProfessional
|
| AllergieIntolerantie | AllergyIntolerance | AllergyIntolerance | http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance | AllergyIntolerance
|
Expected Actions
The PHR processes the results according to application-defined rules. The PHR should be robust as the response may contain medication information resources as mentioned in the former section.
Interactions, operations, search parameters
Interactions
The following logical interactions are needed for the retrieve medication information transaction:
Operations
No operations are defined or needed for this transaction.
Search parameters
The following search parameter types and search result parameters need to be supported for this transaction.
Search parameter types: