BgZ:V2.0 Beta 2 BgZ 2017 Technical IG: verschil tussen versies

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k (Building blocks and FHIR profiles)
k (Exchange Using Notified Pull Transaction)
Regel 92: Regel 92:
  
 
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. Typically, the referral to a second specialist medical care setting is completed within hours or days.
 
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. Typically, the referral to a second specialist medical care setting is completed within hours or days.
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The Workflow Task message is optional in the BgZ MSZ exchange. In terms of system support the following rules apply:
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# The Sending System can support either a standalone Notification Task message or the combined use of the Notification Task and Workflow Task messages. If the Notified Pull is part of a workflow managed by the Sending System, then the Sending System will create a Workflow Task locally and indicate its use in the Notification Task message sent to the Receiving System.
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# The Receiving System must support both the use of a standalone Notification Task message and the combined Notification / Workflow Tasks messages, depending on which option is indicated for use in the Notification Task message. When a Workflow Task is indicated then the Receiving System must retrieve the Worklow Task message from the Sending System using a separate GET operation.
  
 
=== Exchange without Notified Pull Transaction ===
 
=== Exchange without Notified Pull Transaction ===

Versie van 8 nov 2024 om 01:39


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.

2 Boundaries and relationships

2.1 Boundaries

Please note that this version of the BgZ-MSZ describes the exchange of all BgZ chapters. In future versions of the BgZ it is expected that implementation guides will be modularized and that for subsets of the BgZ reference will be made to other information standards such as Medication Process, and Lab.

2.2 Building blocks and FHIR profiles

Data exchange of the BgZ is partly based on the Dutch zib 2017. Table 3 contains an overview of all FHIR building blocks, including custom building blocks.

  • 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. Metadata is designed as an add-on and is not part of any other BgZ section. 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

ChaptersAndRelationsBgZ2 v1.png

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 fake BSN of 111222333: GET [base]/Condition?patient.identifier=http://fhir.nl/fhir/NamingSystem/bsn%7C111222333.

Table 5.1 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

Person System
Name Description Name Description
Referring (Sending) Medical Specialist Medical specialist who sends a BgZ along with a referral EHR Electronic health record
Receiving Medical Specialist Medical specialist receives a BgZ along with a referral EHR Electronic health record

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 5). 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. The type.coding for these sections is defined in table 7.

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. Typically, the referral to a second specialist medical care setting is completed within hours or days.


The Workflow Task message is optional in the BgZ MSZ exchange. In terms of system support the following rules apply:

  1. The Sending System can support either a standalone Notification Task message or the combined use of the Notification Task and Workflow Task messages. If the Notified Pull is part of a workflow managed by the Sending System, then the Sending System will create a Workflow Task locally and indicate its use in the Notification Task message sent to the Receiving System.
  2. The Receiving System must support both the use of a standalone Notification Task message and the combined Notification / Workflow Tasks messages, depending on which option is indicated for use in the Notification Task message. When a Workflow Task is indicated then the Receiving System must retrieve the Worklow Task message from the Sending System using a separate GET operation.

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 5.

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

4.1 FHIR Profiles

Chapter HCIM EN Resource Profile
1 Patient Patient http://fhir.nl/fhir/StructureDefinition/nl-core-patient
MaritalStatus Patient.maritalStatus
2 Payer Coverage http://nictiz.nl/fhir/StructureDefinition/zib-Payer
Organization http://fhir.nl/fhir/StructureDefinition/nl-core-organization
Patient http://fhir.nl/fhir/StructureDefinition/nl-core-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://fhir.nl/fhir/StructureDefinition/nl-core-patient
5 FunctionalOrMentalStatus Observation http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus
6 Problem Condition http://nictiz.nl/fhir/StructureDefinition/zib-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
11 MedicalDevice Device http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct
DeviceUseStatement http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDevice
12 Vaccination Immunization http://nictiz.nl/fhir/StructureDefinition/zib-Vaccination
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
Specimen http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Specimen
15 Procedure Procedure http://nictiz.nl/fhir/StructureDefinition/zib-Procedure
16 Encounter Encounter http://nictiz.nl/fhir/StructureDefinition/zib-Encounter
17 HealthProfessional Practitioner http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner
PractitionerRole http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole
HealthcareProvider Organization http://fhir.nl/fhir/StructureDefinition/nl-core-organization
CareTeam http://fhir.nl/fhir/StructureDefinition/nl-core-careteam
16 Provenance 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.

Resource Profile
Task http://nictiz.nl/fhir/StructureDefinition/BgZ-NotificationTask
Task http://nictiz.nl/fhir/StructureDefinition/BgZ-WorkflowTask

Table 4. BgZ-MSZ Notification task profile required 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 5. The type.coding for these sections 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 itself. Typically, the referral to a second specialized care setting is completed within hours or days (top row). BgZ-MSZ Workflow task profile used to create the Task instance on the sending system if the NP is part of a managed workflow (bottom row).

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, 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.category 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.category 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.category 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.category 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 the ‘unknown’ 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:medicationReference

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:medicationReference

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:medicationReference

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 procedure 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 that 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 Health Providers.

19 Meta data
19.1 Meta data
GET [base]/Provenance

All provenance data available in the source system for a specific BgZ summary is exchanged as FHIR provenance instances according to the BgZ-metadata profile.

Table 5. Header.

4.3 FHIR Task.input 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. The same Task.input parameters are applicable to the Notification Task or the Workflow Task depending on which is used to specify the BgZ MSZ retrieval operation.

Chapter Section FHIR Task type.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.
19 Meta data 19.1 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