Bgz:V2.0-beta.3 Technical IG BgZ MSZ

For an overview of all current documentation for BgZ-MSZ see BgZ main page

1 Introduction

This is the FHIR implementation guide (IG) for the information standard BgZ-MSZ. This IG must be used together with the functional specification: see BgZ main page.

In addition, the guidelines as specified in general FHIR STU3 Implementation Guide apply. The guide defines how to implement FHIR STU3 and what rules apply (e.g. how to handle empty reponses etc.). In particular, the reader should take note of the use case overarching principles and the use of FHIR packages.

First, this IG describes the boundaries and relationships that exist. Second, it describes the implementation per transaction.

1.1 Known issues

This version of the information standard has known issues. Please find them in the functional design page.

2 Boundaries and relationships

2.1 Boundaries

Please note that this version of the BgZ-MSZ describes the exchange of all BgZ chapters. This version does not use the MBH identifier from medication process, however systems are encouraged to use the .identifier as stated in the general FHIR STU3 Implementation Guide.

In future versions of the BgZ it is expected that implementation guides will be modularized and that for subsets of the BgZ references will be made to other information standards such as Medication Process, and Lab.

In future versions the gap to the European patient summary will be addressed.

2.2 Building blocks and FHIR profiles

Data exchange of the BgZ is based on the Dutch zibs 2017 (clinical information models). Table 3 contains an overview of all FHIR building blocks, including custom building blocks. Please note that every FHIR profile makes use of mappings towards the baseclass HCIM BasicElements, this is relevant since some parts within a FHIR profile are not mapped in the associated HCIM profile (e.g. effectiveDateTime in livingSituation). The HCIM BasicElements are used primarily for lastn queries that depend on the effectiveDateTime element.

• The Metadata building block is made independently of the nl-core profiles. Metadata contains data that relates to the registration process rather than the medical content. Exchange of metadata for the BgZ-MSZ is designed via a query add-on: BgZ-MSZ sections can be queried with or without metadata. When data with a specific section are exchanged, there may be metadata about the registration process that refer to instances within such a section. In the future, when more information standards will use the Provenance resource to exchange registration data, it is planned to create an nl-core-MetaData profile that will replace the current bgz-MetaData profile.

2.3 Relations between building blocks

Figure 1. Relations between building blocks.

2.4 Mapping between profiles and dataset

Each FHIR profile maps to the functional definition in ART-DECOR. FHIR profiles contain mappings to all data elements that are present in the functional data set. Either HCIM mappings are used (e.g., NL-CM:17.2.1) or BgZ specific mappings are used with prefix: "bgz2017-dataelement-".

Each transaction must contain a Patient building block. Therefore, a reference to a Patient resource conforming to the nl-core-Patient profile is expected in .subject or .patient of each FHIR instance of each main building block with the exception of MetaData, Patient, HealthProvider.

FHIR instances, exchanged as part of a transaction, will contain references to other instances. For example a procedure may reference a problem list item. Implementers SHOULD use literal references (using .reference) instead of logical references (using .identifier) where possible, see the general FHIR IG on the Reference data type.

2.5 Patient identification

This implementation guide assumes that the client system is able to make a connection to the right server that contains the patient's information. It does not provide information on finding the right server nor does it provide information about security. Moreover, each transaction is performed in the context of a specific patient, whose context might have been established using the authentication mechanisms described in external specifications such as the MedMij ‘Afsprakenstelsel’ or through the usage of search parameters for patient identification. Each server is required to perform filtering based on the patient associated with the context for the request or based on the patient identification search parameters, which is a chained search parameter for all resource types except Patient, so only the records associated with the authenticated patient are returned.

An example of a request that retrieves all Condition resources of a patient with a fictional BSN of 111222333: GET [base]/Condition?patient.identifier=http://fhir.nl/fhir/NamingSystem/bsn%7C111222333.

Table 4 defines the FHIR queries for all BgZ chapters. These queries apply for both use cases: "Exchange BgZ for Referral" and "Retrieval of BgZ from previous practitioner". All search parameters used in this table SHALL be supported for processing by servers and MAY be supported by clients.

3 Transactions

3.1 Exchange BgZ for Referral

Actors		Systems		FHIR Capability Statements
Name	Description	Name	Description	Name	Description
Referring (Sending) Medical Specialist	Medical specialist who sends a BgZ along with a referral	EHR	Electronic health record	CapabilityStatement: Client	FHIR Client requirements
Receiving Medical Specialist	Medical specialist receives a BgZ along with a referral	EHR	Electronic health record	CapabilityStatement: Server	FHIR Server requirements

Table 1. Actors in the BgZ exchange for referral.

FHIR instances for the BgZ summary are made available at the sending system using the profiles (table 3), the definition of the ART-DÉCOR publication (see functional specification), and the FHIR query specification (table 4). The FHIR instances will remain available unchanged for as long as the task period is valid.

3.1.1 Exchange Using Notified Pull Transaction

The BgZ-MSZ Notification task profile (table 5) is used by the sending system to invite the receiving system to perform one or more Pull interactions (FHIR requests). The task contains the FHIR-read and FHIR-search interactions that can be performed to retrieve the data that has been made available at the sending system. The valueReference or valueString for a BgZ section is defined in Table 6.

When generating the notification message the restriction.period, during which the data will be available, is set by the sending system. This period is identical to the duration of the referral. Working agreements describe how long queries are valid.

3.1.2 Exchange without Notified Pull Transaction

The sending system pushes a FHIR document with the BgZ to a receiving system. To construct a document, a FHIR Composition resource is created that summarizes and references all the resources that need to be exchanged. This Composition resource is then placed together with all referenced resources in a Bundle with Bundle.type set to "document". The Composition resource SHALL be the first entry.

The Push use case can be used by systems transitioning from HL7 CDA to HL7 FHIR where the CDA based BgZ is replaced by a FHIR Composition.

3.2 Retrieval of BgZ from previous practitioner

Person		System
Name	Description	Name	Description
Requesting Medical Specialist	Medical specialist who queries for a BgZ	EHR	Electronic health record

Table 2. Actors in the retrieval of the BgZ from a previous practitioner.

In the "Retrieval of BgZ from previous practitioner" use case, the current healthcare provider (Requesting Medical Specialist) takes the initiative to retrieve the BgZ from the previous care institution. The Requesting Medical Specialist can retrieve the BgZ (at a suitable time) using the Pull Message and the search/ read queries defined in table 4.

It is assumed that the Requesting Medical Specialist, as person who uses the BgZ sharing infrastructure, is signed on, authenticated and has authorization & consent to access the necessary (patient) information stored in the BgZ sharing infrastructure (or in other words, an authenticated healthcare professional who has an active treatment relationship with the patient).

4 Materials

BgZ-MSZ 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: nictiz.fhir.nl.stu3.bgz, version 2.0.3-beta.2 nictiz.fhir.nl.stu3.zib2017, version 2.1.0 or compatible 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.

4.1 FHIR Profiles

Chapter	HCIM EN	Resource	Profile
1	Patient	Patient	http://nictiz.nl/fhir/StructureDefinition/BgZ-Patient
	MaritalStatus	Patient.maritalStatus
2	Payer	Coverage	http://nictiz.nl/fhir/StructureDefinition/zib-Payer
	Payer.InsuranceCompany	Organization	http://fhir.nl/fhir/StructureDefinition/nl-core-organization
	Payer.PayerPerson	Patient	http://nictiz.nl/fhir/StructureDefinition/BgZ-Patient
3	TreatmentDirective	Consent	http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective
	AdvanceDirective	Consent	http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective
4	ContactPerson	Patient.contact	http://nictiz.nl/fhir/StructureDefinition/BgZ-Patient
5	FunctionalOrMentalStatus	Observation	http://nictiz.nl/fhir/StructureDefinition/BgZ-FunctionalOrMentalStatus
6	Problem	Condition	http://nictiz.nl/fhir/StructureDefinition/BgZ-Problem
7	LivingSituation	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation
	DrugUse	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse
	AlcoholUse	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse
	TobaccoUse	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse
	NutritionAdvice	NutritionOrder	http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice
8	Alert	Flag	http://nictiz.nl/fhir/StructureDefinition/zib-Alert
9	AllergyIntolerance	AllergyIntolerance	http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance
10	MedicationAgreement	MedicationRequest	http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement
	AdministrationAgreement	MedicationDispense	http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement
	MedicationUse2	MedicationStatement	http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse
	PharmaceuticalProduct	Medication	http://nictiz.nl/fhir/StructureDefinition/zib-Product
	InstructionsForUse	Dosage	http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse
11	MedicalDevice	DeviceUseStatement	http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice
	MedicalDevice.Product	Device	http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct
12	Vaccination	Immunization	http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination
	Vaccination.PreferedDateForRevaccination	ImmunizationRecommendation	http://nictiz.nl/fhir/StructureDefinition/zib-VaccinationRecommendation
13	BloodPressure	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure
	BodyWeight	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight
	BodyHeight	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight
14	LaboratoryTestResult	Observation	http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation
15	Procedure	Procedure	http://nictiz.nl/fhir/StructureDefinition/BgZ-Procedure
16	Encounter	Encounter	http://nictiz.nl/fhir/StructureDefinition/zib-Encounter
17	PlannedCareActivity.Procedure	ProcedureRequest	http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest
18	HealthProfessional	Practitioner	http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner
	HealthProfessional.Specialty	PractitionerRole	http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole
	HealthProfessional.HealthProfessionalRole	CareTeam	http://fhir.nl/fhir/StructureDefinition/nl-core-careteam
	HealthcareProvider	Organization	http://fhir.nl/fhir/StructureDefinition/nl-core-organization
	Metadata	Provenance	http://nictiz.nl/fhir/StructureDefinition/bgz-metadata

Table 3. FHIR Profiles used to exchange BgZ MSZ sections. The reader should take note of the 'Relating FHIR profiles with their functional definitions' in the FHIR STU3 Implementation Guide.

4.1.1 Future changes in FHIR BgZ related profiles

Certain BgZ related FHIR profiles are derived from zib and nl-core profiles. In future versions of the standard, BgZ profiles will possibly be replaced by their predaopt zib2020 counterparts.

4.2 FHIR Query Specification

The table below provides an overview of the FHIR queries to exchange all BgZ-MSZ sections.

Query	Description
1 Demographics and identification
1.1 Patient
GET [base]/Patient? _include=Patient:general-practitioner	The patient information available in the source system is exchanged as a FHIR patient instance that conforms to the nl-core-patient profile. The last known marital status available in the source system is exchanged using the patient.maritalStatus field. If available in the source system, the general practitioner (GP) is exchanged (a) as a FHIR Practitioner instance conforming to the nl-core-practitioner profile, where the Practitioner.identifier indicates a GP, and/or (b) as a FHIR Organization instance conforming to the nl-core-organization profile. The specified referenced resources are returned in full. Information regarding the primary partner/contact available in the source system is exchanged using elements of the patient instance. It is not exchanged using the RelatedPerson resource.
1.2 Marital status
see Patient.maritalStatus	Marital status data are exchanged via the patient resource (see 1.1).
2 Financial information
2.1 Payer
GET [base]/Coverage? _include=Coverage:payor	The payer data available in the source system is exchanged as a FHIR coverage instance that conforms to the zib-Payer profile. The specified referenced payor resource instances, that may be of type nl-core-organization, nl-core-patient, or nl-core-relatedperson, are returned in full.
3 Treatment restrictions
3.1 Treatment instructions
GET [base]/Consent? category=http://snomed.info/sct|11291000146105	All treatmentDirectives available in the source system are exchanged as FHIR consent instances, which conform to the zib-TreatmentDirective profile. The consent.category is fixed to ‘treatment instructions’ (code = '11291000146105' in codeSystem 'SNOMED CT').
3.2 Advance directive
GET [base]/Consent? category=http://snomed.info/sct|11341000146107	All AdvanceDirectives available in the source system are exchanged as FHIR consent instances, which conform to the zib-AdvanceDirective profile. The consent.category is fixed to ‘levenstestament en wilsverklaring in dossier’ (code = '11341000146107' in codeSystem 'SNOMED CT'). the document is only exchanged via a pdf.
4 Contact persons
4.1 Contact
Patient.contact	Primary partner/contact data are exchanged via the patient resource (see 1.1).
5 Functional/mental status
5.1 Functional or mental status
GET [base]/Observation? category=http://snomed.info/sct|118228005, http://snomed.info/sct|384821006	All functional or mental status information available in the source system is exchanged as FHIR observation data that conforms to the zib-FunctionalOrMentalStatus profile. Functional status data are exchanged with the observation.category fixed to ‘Functional finding’ (code = '118228005' in codeSystem 'SNOMED CT'). Mental status data are exchanged with the observation.category fixed to ‘Mental state, behavior and/or psychosocial function finding’ (code = '384821006 ' in codeSystem 'SNOMED CT'). please note that as defined in the BgZ dataset, the category may be both a functional and a mental status. The target system may be configured to optimize the use of this information. For example, it may be configured to group and categorize according to StatusName regarding mental, hearing, vision, mobility and language skills.
6 Complaints and diagnoses
6.1 Problem
GET [base]/Condition	All problems available in the source system are returned as zib-Problem instances. The condition.ProblemStatus must be populated when exchanging data. In cases where for legacy data there is no Problem.ProblemStatus recorded in the source system then the Condition.clinicalStatus field must be populated with an assumed state such as “active” if there is no problemEndDate defined. It is a known problem that the data-absent-reason cannot be used. This aspect is under investigation. Note that no Condition.category (e.g. diagnosis or symptom) may be assumed while exchanging data if the condition.category is not known. Note that the condition.code can exchange multiple encodings for the same problem. In the transaction it is defined that a problem may contain an additional more specific problemName that is exchanged using a second condition.code.coding.
7 Social history
7.1 Living Situation
GET [base]/Observation? code=http://snomed.info/sct|365508006	All living situations available in the source system are exchanged as FHIR Observation instances that conform to the zib-LivingSituation profile. The Observation.code is fixed to ‘Residence and accommodation circumstances - finding’ (code = ' 365508006' in codeSystem 'SNOMED CT'). The HouseType cardinality is 1..1R and must be exchanged accordingly.
7.2 Drug Use
GET [base]/Observation? code=http://snomed.info/sct|228366006	All drug use available in the source system is exchanged as a FHIR Observation instances that conform to the zib-DrugUse profile. The Observation.code is fixed to ‘Finding relating to drug misuse behavior’ (code = '228366006' in codeSystem 'SNOMED CT'). The target system may be configured to optimize the use of this information. For example, grouping data according to a specific DrugOrMedicationType.
7.3 Alcohol Use
GET [base]/Observation? code=http://snomed.info/sct|228273003	All known alcohol use, available in the source system, is exchanged as FHIR Observations that conform to the zib-AlcoholUse profile. The Observation.code is fixed to ‘Finding relating to alcohol drinking behavior’ (code = '228273003' in codeSystem 'SNOMED CT').
7.4 Tobacco Use
GET [base]/Observation? code=http://snomed.info/sct|365980008	All known Tobacco Use, available in the source system, is exchanged as FHIR Observation instances that conform to the zib-TobaccoUse profile. The Observation.code is fixed to ‘Finding of tobacco use and exposure’ (code = ' 365980008' in codeSystem 'SNOMED CT').
7.5 Nutrition Advice
GET [base]/NutritionOrder	All Nutrition Advice available in the source system is exchanged as a FHIR NutritionOrder instances that conform to the zib-NutritionAdvice profile. The target system may be configured to optimize the use of this information. For example, grouping data according to a specific NutritionOrder.oralDiet.type.
8 Alerts
8.1 Alert
GET [base]/Flag	All alerts available in the source system are exchanged as a FHIR Flag instances that conform to the zib-Alert profile.
9 Allergies
9.1 Allergy Intolerance
GET [base]/AllergyIntolerance	All allergies and intolerances available in the source system are exchanged as a FHIR AllergyIntolerance instances that conform to the zib-AllergyIntolerance profile. According to the BgZ-MSZ transactions, the AllergyIntolerance.Reaction.Symptom must be exchanged if available. In cases where for legacy data there is no Symptom recorded, then the Reaction.manifestation field MUST be populated with a value from the Valueset-data-absent-reason. "manifestation":{ "extension": [{ "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason", "valueCode": "unknown" }] },
10 Medication
10.1 Medication Agreement
GET [base]/MedicationRequest? category=http://snomed.info/sct|16076005& _include=MedicationRequest:medication	All medication agreements available in the source system are exchanged FHIR MedicationRequest instances that conform to the zib-MedicationAgreement profile. The MedicationRequest.category is fixed to ‘Prescription’ (code = '16076005' in codeSystem 'SNOMED CT') The PharmaceuticalProduct agreed upon to be used is returned in full as FHIR Medication instance according to the zib-Product profile.
10.2 Administration Agreement
GET [base]/MedicationDispense? category=http://snomed.info/sct|422037009& _include=MedicationDispense:medication	All administration agreements available in the source system are exchanged FHIR MedicationDispense instances that conform to the zib-AdministrationAgreement profile. The MedicationDispense.category is fixed to ‘Provider medication administration instructions’ (code = '422037009' in codeSystem 'SNOMED CT') The PharmaceuticalProduct in the agreement is returned in full as FHIR Medication instance according to the zib-Product profile.
10.3 Medication Use
GET [base]/MedicationStatement? category= urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6& _include=MedicationStatement:medication	All medication use available in the source system are exchanged FHIR MedicationStatement instances that conform to the zib-MedicationUse profile. The MedicationStatement.category is fixed to ‘Medicatiegebruik’ (code = '6' in codeSystem ' 2.16.840.1.113883.2.4.3.11.60.20.77.5.3') The PharmaceuticalProduct that is used is returned in full as FHIR Medication instance according to the zib-Product profile.
11 Medical devices
11.1 Medical device
GET [base]/DeviceUseStatement? _include=DeviceUseStatement:device	All device use statements available in the source system are exchanged as FHIR DeviceUseStatement instances that conform to the zib-MedicalDevice profile. The actual medical device products are returned in full as FHIR Device instances that conform to the zib-MedicalDevice profile.
12 Vaccinations
12.1 Vaccination
GET [base]/Immunization? status=completed	All administered vaccinations available in the source system are exchanged as FHIR Immunization instances conforming to the zib-Vaccination profile. Only vaccinations that have been administered are exchanged. Effectively, the Immunization.status is always fixed to ‘completed’.
13 vital signs and measurements
13.1 Blood pressure
GET [base]/Observation/$lastn? code=http://loinc.org|85354-9	The last known Blood pressure available in the source system is exchanged as a FHIR Observation instance that conforms to the zib-BloodPressure profile. The Observation.category is fixed to ‘Blood pressure panel with all children optional’ (code = '85354-9' in codeSystem 'LOINC'). The Observation.effectiveDateTime is used to determine the last known Observation.
13.2 Body weight
GET [base]/Observation/$lastn? code=http://loinc.org|29463-7	The last known Body Weight available in the source system is exchanged as a FHIR Observation instance that conforms to the zib-BodyWeight profile. The Observation.category is fixed to ‘Body weight’ (code = ' 29463-7' in codeSystem 'LOINC'). The Observation.effectiveDateTime is used to determine the last known Observation.
13.3 Body height
GET [base]/Observation/$lastn? code=http://loinc.org|8302-2, http://loinc.org|8306-3, http://loinc.org|8308-9	The last known Body Height available in the source system is exchanged as a FHIR Observation instance that conforms to the zib-BodyHeight profile. By default, the Observation.category is fixed to ‘Body height’ (code = ' 29463-7' in codeSystem 'LOINC'). If it is recorded that a measurement is taken while the patient is lying or standing, ‘Body height --lying’ (code = ‘8306-3’ in CodeSystem ‘LOINC’) or ‘Body height --standing’ (code = ‘8308-9’ in CodeSystem ‘LOINC’) are used. The Observation.effectiveDateTime is used to determine the last known Observation.
14 Results
14.1 Laboratory test result
GET [base]/Observation/$lastn? category=http://snomed.info/sct|49581000146104 &_include=Observation:related-target	All last known Laboratory results, with the most recent test result for each PanelOrBattery, are exchanged as FHIR observations conforming to the zib-LaboratoryTestResult-Observation profile. Per PanelOrBattery, all known laboratory tests are exchanged, regardless of their TestDateTime. They are exchanged as related observations with the PanelOrBattery-observation. The optional ResultType is not used when selecting Laboratory results for exchange. The resultStatus cardinality is 1..1R in contract to the zib and must be exchanged accordingly. The LaboratoryTestResult has a DateTime property that is used by the lastn algorithm.
15 Procedures
15.1 Procedure
GET [base]/Procedure? category=http://snomed.info/sct|387713003, http://snomed.info/sct|258174001	All operative and image-guided procedures available in the source system are exchanged as FHIR Procedure instances that conform to the zib-Procedure profile. Surgical procedures are exchanged via an instance with the Procedure.category fixed to ‘Surgical procedure’ (code = ‘387713003’ in CodeSystem ‘SNOMED CT’). Image-guided procedures are exchanged via an instance where the procedure category is fixed to ‘Imaging guidance’ (code = ‘258174001’ in CodeSystem ‘SNOMED CT’). Procedure instances with any other category than the two specified above are not exchanged. The default category for the BgZ MSZ is ‘procedure’ (code = ‘71388002’ in CodeSystem ‘SNOMED CT’).
16 Encounters
16.1 Encounter
GET [base]/Encounter	All Encounters available in the source system are exchanged as FHIR Encounter instances that conform to the zib-Encounter profile.
17 Planned care activity
17.1 Procedure
GET [base]/ProcedureRequest?status=active	All planned procedures available in the source system are exchanged as FHIR ProcedureRequest instances according to the zib-ProcedureRequest profile.
18 Care Setting
18.1 Health professional
GET [base]/CareTeam?status=active&_include=CareTeam:participant	All health professionals available in the source system are exchanged as part of a CareTeam instance according to the nl-core-careteam profile. Practitioners are returned in full as FHIR Practitioner instances according to the nl-core-practitioner profile.
18.2 Healthcare provider
see Procedure.performer see Encounter.serviceProvider	Providers are exchanged as part of the BgZ information elements according to the nl-core-organization profile. There is no specific query to retrieve Healthcare Providers.

Table 4. FHIR queries used to retrieve BgZ MSZ components.

Meta data
Query	Description	Example
GET [base]/[FHIR resource]?_revinclude=Provenance:target	When metadata may be required, provenance data available in the source system for a specific BgZ summary should be exchanged according to the BgZ-metadata profile as FHIR Provenance instances.	14.1 Laboratory test result incl. meta data GET [base]/Observation/$lastn?_revinclude=Provenance:target&category=http://snomed.info/sct|49581000146104&_include=Observation:related-target

Table 5. The FHIR query and explanation to retrieve metadata.

4.3 Notified Pull Query Specification

The following table provides the overview of codings needed to retrieve all the BgZ MSZ sections. The coding column defines codedConcepts that identify the BgZ MSZ section (HCIM) to retrieve.

Chapter	Section	Notified Pull coding
1 Demographics and identification	1.1 Patient	http://loinc.org/79191-3
	1.2 Marital status	Data are exchanged as part of the patient.
2 Financial information	2.1 Payer	http://loinc.org/48768-6
3 Treatment restrictions	3.1 Treatment instructions	http://snomed.info/sct/11291000146105
	3.2 Advance directive	http://snomed.info/sct/11341000146107
4 Contact persons	4.1 Contact	Data are exchanged as part of the patient.
5 Functional/mental status	5.1 Functional or mental status	http://loinc.org/47420-5
6 Complaints and diagnoses	6.1 Problem	http://loinc.org/11450-4
7 Social history	7.1 Living Situation	http://snomed.info/sct/365508006
	7.2 Drug Use	http://snomed.info/sct/228366006
	7.3 Alcohol Use	http://snomed.info/sct/228273003
	7.4 Tobacco Use	http://snomed.info/sct/365980008
	7.5 Nutrition Advice	http://snomed.info/sct/11816003
8 Alerts	8.1 Alert	http://loinc.org/75310-3
9 Allergies	9.1 Allergy Intolerance	http://loinc.org/48765-2
10 Medication	10.1 Medication Agreement	http://snomed.info/sct/422979000
	10.2 Administration Agreement	http://snomed.info/sct/422037009
	10.3 Medication Use	http://snomed.info/sct/16076005
11 Medical devices	11.1 Medical device	http://loinc.org/46264-8
12 Vaccinations	12.1 Vaccination	http://loinc.org/11369-6
13 vital signs and measurements	13.1 Blood pressure	http://loinc.org/85354-9
	13.2 Body weight	http://loinc.org/29463-7
	13.3 Body height	http://loinc.org/8302-2
14 Results	14.1 Laboratory test result	http://snomed.info/sct/15220000
15 Procedures	15.1 Procedure	http://loinc.org/47519-4
16 Encounters	16.1 Encounter	http://loinc.org/46240-8
17 Planned care activity	17.1 Procedure	http://loinc.org/18776-5
18 Care Setting	18.1 Health professional	http://snomed.info/sct/229774002
	18.2 Healthcare provider	Data are exchanges as part of other BgZ components.
Meta data	Meta data	http://snomed.info/sct/257733005

Table 6. FHIR Task.input Query Specification.

4.4 Glossary

Term	Description
HCIM	Health and Care Information models (HCIM) or Zorginformatiebouwstenen (ZIB's) are used to capture functional, semantic (non-technical) agreements for the standardization of information used in the care process.

Table 7. Glossary.

5 Release notes

Please find the release notes on the functional design page.

6 Support

For questions and change requests regarding the information on this page, please create a ticket in Servicedesk Portal.