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| − | {{Vdraft/InformationBox|This IG is currently under development and can not be considered stable and ready for use.}}
| + | <!--__NOINDEX__--> |
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| − | {{DISPLAYTITLE:FHIR Implementation Guide Lab2patient V1.0.0 - beta}} | + | {{DISPLAYTITLE:Technical Design Lab2patient V1.0.0-beta.1}} |
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| | desc none | | desc none |
| | </imagemap> | | </imagemap> |
| | + | |
| | + | <big>For an overview of all current documentation [[Lab:V3.0.0_Ontwerp_Laboverdacht| see information standard lab exchange main page]]</big> |
| | | | |
| | __NUMBEREDHEADINGS__ | | __NUMBEREDHEADINGS__ |
| | | | |
| − | =Introduction= | + | ==Introduction== |
| | [[Bestand:Functioneel-02.png|link=Lab:V1.0_Ontwerp_Lab2Patient|100px|rechts|Functional design|Go to functional design]] | | [[Bestand:Functioneel-02.png|link=Lab:V1.0_Ontwerp_Lab2Patient|100px|rechts|Functional design|Go to functional design]] |
| | | | |
| − | This page describes the technical design of Lab2patient (L2P) as a subset of the '''[[Lab:V3.0.0 Ontwerp Laboverdacht|Information standard lab exchange]]''' (Dutch: Labuitwisseling or abbreviated to LU). This technical specification is implementer centric and complements the '''[[Lab:V1.0_Ontwerp_Lab2Patient|functional design]]'''. This page uses various terms as defined in the [[Lab:V3.0.0 Ontwerp Laboverdacht#Begrippenlijst|glossary]]. | + | This is the technical design (TO) for the information standard (IS) Lab2patient. This TO must be used together with the IS functional design, see [[Lab:V1.0_Ontwerp_Lab2Patient| functional design Lab2patient 1.0.0-beta.1]]. The data exchange format used in this version is: FHIR R4. |
| | | | |
| − | ==Disclaimers== | + | === Support === |
| − | This page implements general principles applicable to FHIR as outlined by a central [[FHIR:V1.0_FHIR_IG_R4|FHIR IG for R4]]. Please make sure you familiarize yourself with both the functional design and the FHIR IG for full appreciation of the context of this page.
| + | For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement]. |
| | | | |
| − | This FHIR Implementation Guide assumes that systems (XIS) are able to make a connection to the right systems. It does not provide information on finding the right XIS nor does it provide information about security including authentication and authorization. Finding the right system, and security aspects of the connection, are dealt with by the infrastructure. Any relevant infrastructure is expected to have a framework in place to deal with this. The only assumption/requirement for an infrastructure is that this allows RESTful FHIR-based exchange as specified here. | + | === 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:V1.0_Ontwerp_Lab2Patient| functional design Lab2patient 1.0.0-beta.1]]. |
| | | | |
| − | =Boundaries and relationships= | + | === Prerequisite knowledge === |
| − | ==Overview of relationships between FHIR resources== | + | The following background information is required for understanding this TO: |
| − | [[Bestand:LaboratoryInFHIRR4Overview.png||Laboratory results in FHIR R4 overview]] | + | * The [[Lab:V1.0_Ontwerp_Lab2Patient| functional design Lab2patient 1.0.0-beta.1]] accompanying this TO. |
| − | ==Mappings between profiles and data set==
| + | * The data exchange format FHIR R4, which you can find here: |
| − | Each transaction starts with links to the [https://decor.nictiz.nl/ad/#/lu-/scenarios/scenarios/2.16.840.1.113883.2.4.3.11.60.25.3.5/2024-09-16T00:00:00 functional definition in an ART-DECOR publication] and references one or several FHIR profiles. Where the functional definition contains all specific data elements for the transaction (prefixed with ‘lu-concept-v2’), the FHIR profiles only contain a mapping to these data elements that do not have a dependency on a zib counterpart. For example: ‘lu-concept-v2-4266’ (Specimen) has a relation with the zib element with id ‘NL-CM-13.1.2’, therefore no mapping with ‘lu-concept-v2-4266’ can be found in the profiles. On the other hand, ‘lu-concept-v2-4296’ (LaboratoryResultIdentification) has no relation with a zib element, therefore a mapping can be found in the relevant FHIR profile.
| + | ** [[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]]. |
| | | | |
| − | Cardinalities in FHIR profiles may be less strict than the ART-DECOR definitions. In this IG, transaction-level cardinalities take precedence. For example: in the nl-core-LaboratoryTestResult profile, {{fhir|.performer}} has a core cardinality of 0..*, while in both the 'Send laboratory results' and ‘Serve laboratory results’ ART-DECOR transactions, the Performer element has a cardinality of 1..1 M. Therefore, {{fhir|.performer}} is expected to be filled with a reference to an nl-core-HealthcareProvider-Organization resource.
| + | == Relationships == |
| | | | |
| − | Each transaction contains a Patient building block with cardinality 1..1 M. This patient is the subject of all other building blocks 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 {{fhir|.subject}} of each FHIR instance of each building block.
| + | The diagram below shows the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship. |
| | | | |
| − | The single zib LaboratoryTestResult consists of objects that in FHIR are represented using different (instances of) resources:
| + | For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource. |
| − | * ''NL-CM:13.1.1 LaboratoryTestResult'' maps into profile {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult}} {{fhir|Observation}} and has {{fhir|.hasMember}} relationships with individual ''NL-CM:13.1.3 LaboratoryTests''.
| |
| − | ** Note that this level only exists when LaboratoryTestResult contains ''NL-CM:13.1.4 PanelOrBattery''. The concepts ''NL-CM:13.1.7 ResultType'', ''NL-CM:13.1.5 Comment'', and ''NL-CM:13.1.6 ResultStatus'' are not mapped in the absence of ''NL-CM:13.1.4 PanelOrBattery''.
| |
| − | * ''NL-CM:13.1.3 LaboratoryTest'' also maps into profile {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult}} {{fhir|Observation}} and MAY be referenced by a different {{fhir|Observation.hasMember}} containing ''NL-CM:13.1.1 LaboratoryTestResult''.
| |
| − | * ''NL-CM:13.1.2 Specimen'' maps into profile {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult.Specimen}} {{fhir|Specimen}}.
| |
| − | ** Note that there could be multiple instances of Specimen: one for the main ''NL-CM:13.1.16 SpecimenMaterial'', and one per isolated ''NL-CM:13.1.22 Microorganism'' with a {{fhir|.parent}} relationship to the main specimen.
| |
| − | * ''NL-CM:13.1.29 SpecimenSource'' maps into profile {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult.Specimen.Source}} {{fhir|Device}}. This is a special case where the specimen did not come from the Patient directly.
| |
| | | | |
| − | ==FHIR relationship structures==
| + | [[Bestand:FHIR-model-overview-L2P.png]] |
| − | Many laboratory results have important relationships to other observations and need to be grouped together. [http://hl7.org/fhir/r4/observation.html#10.1.4.1 The FHIR specification] defines several structures to do this:
| |
| | | | |
| − | * {{fhir|Observation.hasMember}}
| + | ==Components== |
| − | ** Each {{fhir|.hasMember}} element references another Observation and the Observation with {{fhir|.hasMember}} elements thus serves as grouper for all Observations it references. Each Observation can be accessed individually. This is useful for panels and/or batteries of tests.
| |
| − | ** Note that while FHIR Observation also allows references to resource types MolecularSequence and QuestionnaireResponse, there is no identified use case for that at the time of writing.
| |
| − | ** An Observation without {{fhir|.hasMember}} elements is expected to be an individual result and has a value when one can be/is determined.
| |
| − | * {{fhir|Observation.derivedFrom}}
| |
| − | ** Each {{fhir|.derivedFrom}} element references another Observation references related measurements the observation is made from.
| |
| − | ** Note that while FHIR Observation also allows references to resource types DocumentReference, ImagingStudy, Media, QuestionnaireResponse and MolecularSequence, there is no identified use case for those at the time of writing.
| |
| − | * {{fhir|Observation.component}}
| |
| − | ** {{fhir|.component}} elements of an Observation are not accessible individually. Whenever you access the Observation, you also access all its components. This is mostly useful when certain context is provided around the result. For lab observations this is expected to be less common. An example outside of the lab realm could be BloodPressure where systolic, diastolic, and cuff size are all in one Observation with 3 components.
| |
| | | | |
| − | ==Resource identification==
| + | HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS. |
| − | ART-DECOR transactions define a stricter cardinality of 1..1 R for resource identifiers. Therefore:
| |
| − | * A stable identifier SHOULD be provided for each resource.
| |
| − | * If no identifier value is available, [[FHIR:V0.9_FHIR_IG_R4#Missing_information|the DataAbsentReason extension]] SHOULD be used.
| |
| − | * Identifiers SHALL contain both a {{fhir|.system}} and a {{fhir|.value}}.
| |
| | | | |
| − | For compatibility with HL7v3 (CDA), where identifiers can only be represented as [[Hoofdpagina#Object_IDentifiers_.28OIDs.29|OIDs]]:
| + | === HL7 FHIR R4 === |
| − | * The {{fhir|.system}} SHALL be an OID to ensure compatibility in transformations to and from FHIR.
| + | {{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.4|p2=nictiz.fhir.nl.r4.nl-core|v2=0.12.0-beta.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.12.0-beta.1}} |
| − | * The {{fhir|.system}} SHALL have a maximum of 128 characters.
| |
| − | * The {{fhir|.value}} SHALL have a maximum of 64 characters.
| |
| | | | |
| − | Regarding reference handling:
| + | ==== Artifacts ==== |
| − | * Systems that encounter or resolve references, either logical or literal, in resources they receive, SHALL NOT rewrite these references to a copy of these resources (with {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/ext-CopyIndicator|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2}} present) they may store.
| |
| − | * This means that [https://hl7.org/fhir/r4/references.html relative literal references] MAY need to be rewritten to absolute ones.
| |
| − | * The same applies to [[FHIR:V1.0_FHIR_IG_R4#Including_.22secondary.22_resources_when_sending_information|included secondary resources in transactions]].
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| | | | |
| − | ==FHIR Profile Package==
| + | The artifacts of the information standard are presented in the following table: |
| − | <!-- If you change this section title, also change the links to it on the pages ... -->
| + | {| style="text-align: left; background-color: white;" cellpadding=5px; |
| − | All use cases in this specification depend on the same set of FHIR profiles. FHIR profile package for Lab2Patient is currently in development. The table below lists profiles used within the framework of Lab2Zorg (Lab2Healthcare) that represent applicable zibs for laboratory result information exchange.
| |
| | | | |
| − | {{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.2|p2=nictiz.fhir.nl.r4.nl-core|v2=0.8.0-beta.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.6.0-beta.2}}
| + | |- style="color: white; background-color: #e7844b;" |
| | + | ! zib |
| | + | ! FHIR resource |
| | + | ! FHIR profile |
| | | | |
| − | {| class="wikitable"
| + | |- style="background-color: #fcf0e9;" |
| − | ! style="text-align:left;" | FHIR Profile
| + | | HealthcareProvider |
| − | ! style="text-align:left;" | FHIR Resource
| |
| − | ! style="text-align:left;" | Based on zib
| |
| − | |-
| |
| − | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult}}
| |
| − | | Observation
| |
| − | | rowspan="3" | [https://zibs.nl/wiki/LaboratoryTestResult-v4.6(2020EN) LaboratoryTestResult]
| |
| − | |-
| |
| − | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult.Specimen}}
| |
| − | | Specimen | |
| − | |-
| |
| − | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-LaboratoryTestResult.Specimen.Source}}
| |
| − | | Device
| |
| − | |-
| |
| − | | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-patient|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.6.0-beta.2|title=nl-core-Patient}}
| |
| − | | Patient
| |
| − | | [https://zibs.nl/wiki/Patient-v3.2(2020EN) Patient]
| |
| − | |-
| |
| − | | {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|title=nl-core-HealthcareProvider-Organization}}
| |
| | | Organization | | | Organization |
| − | | [https://zibs.nl/wiki/HealthcareProvider-v3.4(2020EN) HealthcareProvider] | + | | {{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}} |
| − | |}
| |
| | | | |
| − | =Actors involved=
| + | |- style="background-color: #fcf0e9;" |
| − | {| class="wikitable"
| + | | rowspan="2" | HealthProfessional |
| − | ! colspan="2" style="text-align:left;font-weight: bold;" | Actors
| + | | Practitioner |
| − | ! colspan="2" style="text-align:left;font-weight: bold;" | Systems
| + | | {{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}} |
| − | ! colspan="2" style="text-align:left;font-weight: bold;" | FHIR CapabilityStatements
| |
| − | |- | |
| − | ! style="text-align:left;" |Name
| |
| − | ! style="text-align:left;" |Description
| |
| − | ! style="text-align:left;" |Name
| |
| − | ! style="text-align:left;" |Description
| |
| − | ! style="text-align:left;" |Name
| |
| − | ! style="text-align:left;" |Description
| |
| − | |-
| |
| − | | Patient
| |
| − | | The user of a personal healthcare environment.
| |
| − | | PHR
| |
| − | | Personal health record
| |
| − | | rowspan="2" | {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-RetrieveServe|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.1|title=CapabilityStatement: Lab2Healthcare-Results-RetrieveServe}}
| |
| − | | rowspan="2" | Retrieve [LAB-LRR-PGO]/serve [LAB-LRB-PGO] lab results requirements.
| |
| − | |-
| |
| − | | Lab Professional
| |
| − | | The user of a LIS
| |
| − | | LIS
| |
| − | | Laboratory information system
| |
| − | |}
| |
| | | | |
| − | =Use cases= | + | |- 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}} |
| | | | |
| − | ==Patient retrieves laboratory results in their PGO== | + | |- style="background-color: #fcf0e9;" |
| − | ===Introduction===
| + | | rowspan="3" | LaboratoryTestResult |
| − | This FHIR Implementation Guide assumes that the PHR system is able to make a connection to the right LIS that contains the patient's information. It does not provide information on finding the right LIS 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 [https://www.medmij.nl/afsprakenstelsel/ '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.
| + | | 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}} |
| | | | |
| − | ===Actors===
| + | |- style="background-color: #fcf0e9;" |
| − | {| class="wikitable"
| + | | Observation |
| − | ! style="text-align:left;" | Transaction group
| + | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-LaboratoryTestResult}} |
| − | ! style="text-align:left;" | Transaction
| |
| − | ! style="text-align:left;" | Actor
| |
| − | ! style="text-align:left;" | Role
| |
| − | |- | |
| − | | rowspan="2" | Retrieve laboratory results (PULL) | |
| − | | Retrieve laboratory results request
| |
| − | | LaboratoriumresultaatResultaatRaadplegend Systeem [LAB-LRR-PGO]
| |
| − | | Send a query to the LAB-LRB-PGO to retrieve lab results | |
| − | |- | |
| − | | Retrieve laboratory results response | |
| − | | LaboratoriumresultaatResultaatBeschikbaarstellend Systeem [LAB-LRB-PGO]
| |
| − | | Respond to a query from the LAB-LRR-PGO to retrieve lab results
| |
| − | |}
| |
| | | | |
| − | ===Invocations=== | + | |- style="background-color: #fcf0e9;" |
| − | ====LAB-LRR-PGO: request message====
| + | | Specimen |
| − | The request message represents an HTTP GET parameterized query from the PHR (LAB-LRR-PGO) to the LIS (LAB-LRB-PGO).
| + | | {{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}} |
| | | | |
| − | =====Trigger events===== | + | |- style="background-color: #fcf0e9;" |
| − | When the PHR wants to obtain laboratory results, it issues a retrieve laboratory results request message.
| + | | 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}} |
| | | | |
| − | =====Message semantics===== | + | |- style="background-color: #fcf0e9;" |
| − | The PHR (LAB-LRR-PGO) executes an HTTP GET conforming to the FHIR [http://hl7.org/fhir/r4/http.html RESTful] and [http://hl7.org/fhir/r4/search.html search] specification against the LIS's Observation endpoint. Laboratory results are all under the {{fhir|.category}} ''observation'', using query parameter {{fhir|category}} as token.
| + | | |
| | + | | 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}} |
| | | | |
| − | '''Basic query syntax'''
| + | |- style="background-color: #fcf0e9;" |
| − | <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory</pre>
| + | | |
| | + | | ServiceRequest |
| | + | | {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-OrderData|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-OrderData}} |
| | + | |} |
| | | | |
| − | '''Examples'''
| + | ==== 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/l2p-1.0.0 <nowiki>Lab exchange HL7-mappings repository</nowiki>]. |
| | | | |
| − | Parameter values have not been uri escaped in these examples for readability. This is likely necessary in practice.
| + | == Transactions == |
| | + | === Patient retrieves laboratory results in their PGO === |
| | + | ==== Involved actors ==== |
| | + | {| style="text-align: left;" cellpadding=5px; |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| + | |- style="color: white; background-color: #e7844b;" |
| − | ! style="text-align: left;" | Get all lab results of type 14683-7 (LOINC) | + | ! Transaction group || Transaction || Actor || System role code |
| − | |- | |
| − | | <pre> | |
| − | GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
| |
| − | </pre>
| |
| − | |} | |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| + | |- style="background-color: #fcf0e9;" |
| − | ! style="text-align: left;" | Get all lab results of type 14683-7 (LOINC) since March 12, 2022
| + | | rowspan="2" | Retrieve laboratory results (PULL) |
| − | |- | + | | Retrieve laboratory results request || Client || LAB-LRR-PGO |
| − | | <pre> | |
| − | GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7&date=gt2022-03-12
| |
| − | </pre>
| |
| − | |}
| |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| + | |- style="background-color: #fcf0e9;" |
| − | ! style="text-align: left;" | Get all lab results of type 14683-7 (LOINC) since March 12, 2022 but before June 7, 2022
| + | | Retrieve laboratory results response || Server || LAB-LRB-PGO |
| − | |- | |
| − | | <pre> | |
| − | GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7&date=gt2022-03-12&date=lt2022-06-07
| |
| − | </pre>
| |
| − | |}
| |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| + | |+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem), PGO = Persoonlijke gezondheidsomgeving.'' |
| − | ! style="text-align: left;" | Get all lab results of type 14683-7 (LOINC) and/or 3583 (NHG)
| |
| − | |-
| |
| − | | <pre>
| |
| − | GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7,https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|3583
| |
| − | </pre>
| |
| | |} | | |} |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed; | + | ==== Search parameters ==== |
| − | ! style="text-align: left;" | Get latest lab result of type 14683-7 (LOINC) | + | {| style="text-align: left;" cellpadding=5px; |
| − | |- | + | |- style="color: white; background-color: #e7844b;" |
| − | | <pre> | + | ! FHIR Search Parameter || Description || FHIR Resource || Example |
| − | GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
| |
| − | </pre>
| |
| − | |} | |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| + | |- style="color: white; background-color: #eda778;" |
| − | ! style="text-align: left;" | Get latest 5 lab results of type 14683-7 (LOINC) | + | ! colspan="4" | Retrieve laboratory results (Observation search) |
| − | |-
| |
| − | | <pre>
| |
| − | GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
| |
| − | </pre>
| |
| − | |}
| |
| − | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;
| |
| − | ! style="text-align: left;" | Get latest lab result of any type
| |
| − | |-
| |
| − | | <pre>
| |
| − | GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
| |
| − | </pre>
| |
| − | |}
| |
| − | | |
| − | ======Expected actions======
| |
| − | The LIS (LAB-LRB-PGO) SHALL process the query to retrieve laboratory results.
| |
| | | | |
| − | ====LAB-LRB-PGO: response message==== | + | |- style="background-color: #fcf0e9;" |
| − | The LIS (LAB-LRB-PGO) returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information. Refer to the generic [[FHIR:V1.0_FHIR_IG_R4|FHIR IG]] for more information on handling errors and status codes. Not finding a match based on stated parameters does not constitute an error.
| + | | category || Restrict search to laboratory observations || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory</pre> |
| | | | |
| − | =====Trigger events===== | + | |- style="background-color: #fcf0e9;" |
| − | The LIS (LAB-LRB-PGO) completed the processing of the retrieve laboratory results request message.
| + | | code || Filter by laboratory test code (LOINC/NHG) || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7</pre> |
| | | | |
| − | =====Message semantics===== | + | |- style="background-color: #fcf0e9;" |
| − | The LIS (LAB-LRB-PGO) SHALL process the request and, unless an error is found, respond with a Bundle resource of type ''searchset''. Each Observation matching the request SHALL be marked with {{fhir|.entry.search.mode}}={{term|match}}. Each otherwise included resource SHALL be marked with {{fhir|.entry.search.mode}}={{term|include}}. If the searchset bundle contains less '''matching''' resources than the actual total set, then:
| + | | date || Filter results based on observation date || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date=gt2022-03-12&date=lt2022-06-07</pre> |
| − | * the {{fhir|Bundle.link}} that holds the self link, SHOULD include the {{fhir|_count}} parameter to inform the client of what max was applied
| |
| − | * an OperationOutcome SHOULD be included marked with {{fhir|.entry.search.mode}}={{term|outcome}}.
| |
| | | | |
| − | The resources in the response Bundle SHALL be a valid instance of their stated [[#FHIR_Profile_Package|profile]]. All resources SHALL include their related profile canonical URL in the {{fhir|.meta.profile}} element in order to show compliance. The exception is the OperationOutcome resource for which there is no profile in this specification.
| + | |- style="color: white; background-color: #eda778;" |
| | + | ! colspan="4" | Retrieve latest laboratory results ($lastn operation) |
| | | | |
| − | '''Example searchset Bundle'''
| + | |- style="background-color: #fcf0e9;" |
| | + | | $lastn || Retrieve 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> |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;"
| + | |- style="color: white; background-color: #eda778;" |
| − | ! style="text-align: left;" | XML contents for searchset Bundle
| + | ! colspan="4" | Retrieve related resources |
| − | |-
| |
| − | | <syntaxhighlight lang="xml">
| |
| − | <Bundle xmlns="http://hl7.org/fhir">
| |
| − | <id value="1"/>
| |
| − | <type value="searchset"/>
| |
| − | <total value="3"/>
| |
| − | <link>
| |
| − | <relation value="self"/>
| |
| − | <url value="http://example.org/fhir?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7"/>
| |
| − | </link>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Observation/1"/>
| |
| − | <resource>
| |
| − | <Observation>
| |
| − | <!-- -->
| |
| − | </Observation>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="match"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Observation/2"/>
| |
| − | <resource>
| |
| − | <Observation>
| |
| − | <!-- -->
| |
| − | </Observation>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="match"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Observation/3"/>
| |
| − | <resource>
| |
| − | <resource>
| |
| − | <Observation>
| |
| − | <!-- -->
| |
| − | </Observation>
| |
| − | </resource>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="match"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Specimen/1"/>
| |
| − | <resource>
| |
| − | <Specimen>
| |
| − | <!-- -->
| |
| − | </Specimen>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="include"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Patient/1"/>
| |
| − | <resource>
| |
| − | <Patient>
| |
| − | <!-- -->
| |
| − | </Patient>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="include"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <fullUrl value="https://example.org/fhir/Organization/1"/>
| |
| − | <resource>
| |
| − | <Organization>
| |
| − | <!-- -->
| |
| − | </Organization>
| |
| − | </resource>
| |
| − | <search>
| |
| − | <mode value="include"/>
| |
| − | </search>
| |
| − | </entry>
| |
| − | </Bundle>
| |
| − | </syntaxhighlight>
| |
| − | |} | |
| | | | |
| − | '''Example OperationOutcome'''
| + | |- 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> |
| | | | |
| − | {| class="wikitable mw-collapsible mw-collapsed" style="width:100%; table-layout:fixed;"
| + | |+ style="align: bottom; caption-side: bottom; text-align: left;" | ''All queries are executed in the authenticated patient context as per MedMij Afsprakenstelsel; no patient search parameters are used.'' |
| − | ! style="text-align: left;" | XML contents for OperationOutcome
| |
| − | |-
| |
| − | | <syntaxhighlight lang="xml">
| |
| − | <OperationOutcome xmlns="http://hl7.org/fhir">
| |
| − | <id value="size-exceeded-1"/>
| |
| − | <issue>
| |
| − | <severity value="warning"/>
| |
| − | <code value="too-costly"/>
| |
| − | <details>
| |
| − | <text value="Resultaat was 3000, wat meer is dan het maximum van 1000"/>
| |
| − | </details>
| |
| − | </issue>
| |
| − | </OperationOutcome>
| |
| − | </syntaxhighlight>
| |
| | |} | | |} |
| − |
| |
| − | =====LAB-LRB-PGO: Expected actions=====
| |
| − | The LIS (LAB-LRB-PGO) SHALL process the response Bundle in accordance with the intentions of the trigger event that caused the retrieve. Actions may include discrete rendering on screen or in context with other information, triggering alerts on trends, ordering of (other) tests and more.
| |
