Brontekst bekijken van L2z:v4.0.0 FHIR lab2zorg

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{{DISPLAYTITLE: Information Standard Lab Exchange v3.0.0-beta.3: '''Technical Design Lab2zorg V3.0.0-beta.4'''}}

''The Information Standard Lab Exchange consists of four different components: Lab2Zorg, Lab2Lab, Lab2PublicHealth, and Lab2Patient. These four components were developed independently of each other and are subject to continuous development. This is reflected in the Semantic Versioning (SemVer). Each component undergoes its own development process with its own corresponding numerical publications.'' 

{{IssueBox| The FHIR resource used for one of the use cases described in this technical design is DiagnosticReport. DiagnosticReport is not the preferred FHIR resource for the information standard Laboratory exchange. However, this resource has been chosen as it contains information about the order data. Optimally, order data could be linked directly to the preferred FHIR resource Observation via basedOn element. This will be updated in a future version.}}

<imagemap>Bestand:functioneel-technisch-banner_00_alle.png|center|240px|alt=Functioneel-Technisch   
circle 204 216 215 [[Lab:V3.0.2-b4_Ontwerp_Lab2zorg|Functional]]
circle 990 216 215 [[Lab:V3.0.0-B4_FHIR_Lab2zorg|Technical]]
desc none                         
</imagemap>

<big>For an overview of all current documentation [[Lab:V3.0.0_Ontwerp_Laboverdacht| see information standard lab exchange main page]]</big>

__NUMBEREDHEADINGS__

==Introduction==
[[Bestand:Functioneel-02.png|link=Lab:V3.0.0-b4_Ontwerp_Lab2zorg|100px|rechts|Functional design|Go to functional design]]

This is the technical design (TO) for the information standard (IS) Lab2zorg. This TO must be used together with the IS functional design, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]]. The data exchange format used in this version is: FHIR R4.

=== Support ===
For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement].

=== Boundaries ===
This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]].

=== Prerequisite knowledge ===
The following background information is required for understanding this TO:
* The [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]] accompanying this TO.
* The data exchange format FHIR R4, which you can find here:
** [[FHIR:V1.0 FHIR IG R4|general FHIR R4 Implementation Guide]],
** [[FHIR:V1.0_FHIR_IG_R4#FHIR_Packages|FHIR packages]],
** [[FHIR:V1.0_FHIR_IG_R4#Usage_of_the_.id.2C_.identifier_and_.fullUrl_elements_in_FHIR_instances|usage of the .id, .identifier and .fullUrl]].

== Relationships ==

The diagrams below show the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.

For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.

===Model overview for usecases without the request===

[[Bestand:FHIR-model-overview-L2Z-SLR-BLR.png]]

===Model overview for usecase with the request===

[[Bestand:FHIR-model-overview-L2P-LOA.png]]

==Components==

HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

=== HL7 FHIR R4 ===
{{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.4|p2=nictiz.fhir.nl.r4.nl-core|v2=0.12.0-labtrial.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.12.0-beta.1}}

==== Artifacts ====

The artifacts of the information standard are presented in the following table:
{| style="text-align: left; background-color: white;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! zib 
! FHIR resource
! FHIR profile

|- style="background-color: #fcf0e9;"
| HealthcareProvider
| Organization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthcareProvider-Organization}}

|- style="background-color: #fcf0e9;"
| rowspan="2" | HealthProfessional
| Practitioner
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-Practitioner}}

|- style="background-color: #fcf0e9;"
| PractitionerRole
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-PractitionerRole}}

|- style="background-color: #fcf0e9;"
| rowspan="3" | LaboratoryTestResult
| Device
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.7.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen.Source}}

|- style="background-color: #fcf0e9;"
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-labtrial.1|title=nl-core-LaboratoryTestResult}}

|- style="background-color: #fcf0e9;"
| Specimen
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen}}

|- style="background-color: #fcf0e9;"
| Patient 
| Patient
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-Patient}}

|- style="background-color: #fcf0e9;"
| 
| DiagnosticReport
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-LaboratoryTestResult-DiagnosticReport|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-LaboratoryTestResult-DiagnosticReport}}

|- style="background-color: #fcf0e9;"
| 
| ServiceRequest
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-OrderData|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-OrderData}}
|}

==== Examples of FHIR instances ====
You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: [https://github.com/Nictiz/HL7-mappings/tree/master/ada_2_fhir-r4/lab/l2z-3.0.0 <nowiki>Lab exchange HL7-mappings repository</nowiki>].

== Transactions ==
=== Health professional orders lab tests and receives results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results based on a request
| Send laboratory results based on a request || Client || LAB-LAS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LAO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LAS = Laboratoriumresultaat antwoord sturend (systeem), LAO = Laboratoriumresultaat antwoord ontvangend (systeem).''
|}

=== Health professional retrieves lab results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Retrieve laboratory results (PULL)
| Retrieve laboratory results request || Client || LAB-LRR || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-RetrieveServe|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_RetrieveServe}}

|- style="background-color: #fcf0e9;"
| Retrieve laboratory results response || Server || LAB-LRB

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem).''
|}

==== Search parameters ====
{| style="text-align: left;" cellpadding=5px; 
|- style="color: white; background-color: #e7844b;"
! FHIR Search Parameter || Description || FHIR Resource || Example

|- style="color: white; background-color: #eda778;"
! colspan="5"  | Retrieve laboratory results (Observation search)

|- style="background-color: #fcf0e9;"
| category || Restrict search to laboratory observations || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory</pre>

|- style="background-color: #fcf0e9;"
| patient (with modifier identifier) || Constrain results to a specific patient context || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333</pre>

|- style="background-color: #fcf0e9;"
| code || Filter by laboratory test code (LOINC/NHG) || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="background-color: #fcf0e9;"
| date || Filter results based on observation date || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&date=gt2022-03-12&date=lt2022-06-07</pre>

|- style="color: white; background-color: #eda778;"
! colspan="5" | Retrieve latest laboratory results ($lastn operation)

|- style="background-color: #fcf0e9;"
| $lastn (max=1 is default) || Retrieve most recent lab result using the $lastn operation || Observation || <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7</pre>

|- style="background-color: #fcf0e9;"
| max || Retrieve 5 most recent lab results using the $lastn operation || Observation || <pre>GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! colspan="5" | Retrieve related resources

|- style="background-color: #fcf0e9;"
| _include || Include linked resources (Specimen, Patient, Organization) in the response bundle || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&_include=Observation:specimen&_include=Observation:patient&_include=Observation:performer</pre>

|+ style="align: bottom; caption-side: bottom; text-align: left;" | 
|}

=== Health professional sends lab results to other health professional ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results (PUSH)
| Send laboratory results || Client || LAB-LRS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LRO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRS = Laboratoriumresultaat sturend (systeem), LRO = Laboratoriumresultaat ontvangend (systeem).''
|}