uz:V1.0.0-alpha.1 FHIR OBC

This FHIR IG is currently under development and can not be considered stable and ready for use. For questions and change requests regarding this IG, please create a ticket in BITS.

Introduction

This is the implementation guide (IG) for the information standard Outcomebased Care (Dutch: Uitkomstgerichte zorg), version . The functional specification can be found here and is implemented using HL7 FHIR R4. This implementation guide assumes that the reader is familiar with both the functional specification and this version of FHIR.

Apart from this document, the guidelines as specified in the general FHIR Implementation Guide apply. In particular, the reader should take note of the Overarching principles and the use of FHIR packages. Where the general IG uses the term ‘use case’, this IG uses the term ‘transaction’ for the various processes that are described.

This IG first describes the boundaries and relationships in place, after which the implementation is described per transaction.

Boundaries and relationships

Boundaries

• Huidige versie van deze wiki houdt klinische gegevens nog buiten beschouwing.
• Alleen focus op de structuur van de FHIR Questionnaires en antwoordgegevens.

This version of the OBC information standard focuses solely on Questionnaires and Questionnaire Responses, excluding clinical datasets. Technically, this scope is reflected in the terminology used within the FHIR profiles and the naming of the obc-QuestionnaireResponse profile. However, in this IG, we will not elaborate further on this narrower scope. Instead, we will describe the technical implementation of this standard as generally as possible to facilitate the incorporation of a broader scope in subsequent versions of this IG.

Building blocks and profiles

• Geen link met zibs en geen nl-core profielen gebruikt
• What is a FHIR Questionnaire
• QR

The exchange of data within the OBC standard version 1.0.0 is not based on any publication of the Dutch Health and Care Information Models (Dutch: ‘zorginformatiebouwstenen’ or ‘zibs’), as there are no zibs that represent this standard. Therefore, there is no dependency on corresponding nl-core profiles, and mappings to zib concepts are not defined. Currently, there are no plans to replace this standard with a more general nl-core-OutcomeBasedCare profile in the future, as no corresponding zibs exist.

Within the OBC standard, the FHIR Questionnaire focuses on capturing patient-related data in a standardized format. It is used in healthcare settings to collect information from patients, healthcare providers, or other stakeholders. The data captured through a FHIR Questionnaire can include patient demographics, medical history, symptoms, and responses to health-related questions. Within the FHIR Questionnaire, a variety of aspects can be considered, such as sensitive questions whose answers may not be available for every person. Currently, the OBC standard consists of five instances of five different Questionnaires. More information about the content of these Questionnaires can be found in the functional design.

The current OBC standard includes a FHIR QuestionnaireResponse profile. This profile features a structured set of questions and their answers, representing the outcome of a PROMs (Patient Reported Outcome Measures) collection event, as well as the scores. The QuestionnaireResponse contains enough information about the questions asked that it can be interpreted somewhat independently from the Questionnaire it is based on. In other words, you don't need access to the Questionnaire to extract basic information from a QuestionnaireResponse.

=== Main building blocks ===

• tabel met de profielen -> alleen QR dus in dit geval.
• Link naar de r4 Questionnaire profiel
• At the time of writing no nl-core profiles.

As described above, the QuestionnaireResponse profile has no dependency on any zib counterparts, resulting in the so-called ‘obc-QuestionnaireResponse’ profile. Each transaction starts with links to the functional definition in an ART-DECOR publication and references, currently, one FHIR profile. The QuestionnaireResponse profile contains mappings to all data elements that are present in the functional data set (prefixed with ‘obc-dataelement-10-’).

Dit weglaten? Each transaction contains a Patient profile with cardinality 1..1 M. This patient is the subject in the transaction, although no explicit relation exists in the data set. Therefore, a reference to a Patient resource conforming to the nl-core-Patient profile is expected in .subject of each FHIR instance. ?

Building block (EN)	Building block (NL)	FHIR resource	FHIR profile
Responsedata	Antwoordgegevens	QuestionnaireResponse	http://nictiz.nl/fhir/StructureDefinition/obc-QuestionnaireResponse

Mappings between profiles and data set

• Hoe is QR en dataset gelinked
• FHIR Questionnaire worden in transacties gedefinieerd
• mapping code/id