MedMij:Vissue-MM-5621/FHIR Implementation Guide: Pregnancy Card Ultrasound

Dit is een tijdelijke pagina met wijzigingen voor issue MM-5621. De gepubliceerde versie vind je hier.

Please note that this material is still in development

1 Introduction

This page describes the process of collecting ultrasound data related to a pregnancy in a patient's personal health record (PHR). The process is initiated by the patient (pregnant person).

This Implementation Guide (IG) is a technical representation of the FO Integrale Zwangerschapskaart Echo and follows the principles of the general use case overarching principles.

Technical details of the FHIR resources and structure definitions described in this IG can be found in the birthcare information standard and the Simplifier Geboortezorg STU3 package.

The technical specifications described in this IG are based on the PWD (Perinataal Woordenboek & Dataset) 3.2.

2 Actors involved

The table shows the relevant actors, systems and FHIR CapabilityStatements. The CapabilityStatements demonstrate the minimum conformance requirements for the described use cases.

Actors		Systems		FHIR CapabilityStatements
Name	Description	Name	Description	Name	Description
Patient	The user of a personal healthcare environment	PHR	Personal health record	CapabilityStatement:Receive	FHIR client requirements
Healthcare provider	The user of a XIS	XIS	Healthcare information system	CapabilityStatement:Send	FHIR server requirements

3 Boundaries and relationships

This FHIR implementation guide assumes that the PHR system is able to make a connection with the XIS and create resources. It does not provide information on finding the right XIS nor does it provide information about security. These infrastructure and interface specifications are described in the 'MedMij Afsprakenstelsel'.

The Pregnancy Ultrasound Data Set is an addition to the Pregnancy Card (Dutch: gegevensdienst Integrale Zwangerschapskaart), which has overlap with other standards such as the BgZ (Basisgegevensset Zorg), Medication Process, Vital Signs and Lab Results. The Pregnancy Card and Pregnancy Ultrasound Data Set use the same HCIM based FHIR profiles for exchanging information as used in other standards extended with additional birthcare specific profiles. Most of these birthcare specific profiles are derived from the base HCIM FHIR profiles. For example, the bc-Woman is in fact a nl-core-patient with additional specifications for relating the pregnant person to the (unborn) child.

4 Use case: retrieve pregnancy ultrasound data set

This use case covers the process of retrieving the Pregnancy Ultrasound Data Set in the Personal Health Record (PHR) of the (pregnant) person.

4.1 PHR: request message

The PHR system requests the Pregnancy Ultrasound Data Set using individual search interactions. The Pregnancy Ultrasound Data Set consists of multiple FHIR resources with certain constraints. To obtain the patient's Pregnancy Ultrasound Data Set, the client can use multiple individual search operations based on specified search queries. The interactions are performed by an HTTP GET as shown:

GET [base]/[type]{?[parameters]}

4.1.1 List of requests

To retrieve all known data of the Pregnancy Ultrasound Data Set, a client has to execute the following requests

Step 1: Retrieve patient data and her maternal record(s)

A pregnant person may have data of one or more pregnancies. The data of each pregnancy is captured in a maternal record (EpisodeOfCare). Please note that the status search parameter should be set to active to retrieve the current, active pregnancy, or to finished to retrieve earlier, finished pregnancies. If the status search parameter is not used, both the active pregnancy and earlier pregnancies are retrieved.

GET Patient?_include=RelatedPerson:link
GET Patient
GET Coverage
GET EpisodeOfCare?type=http://snomed.info/sct|364320009{&status=active|finished}&_include=EpisodeOfCare:organization&_include=EpisodeOfCare:care-manager

Step 2: Retrieve data related to each maternal record

For each pregnancy, the related data should be retrieved by using the maternal record id (EpisodeOfCare.id) in the context search parameter.

GET Condition?context=EpisodeOfCare/{episode-id}
GET Encounter?episodeofcare=EpisodeOfCare/{episode-id}&_include=Encounter:practitioner
GET Observation?context=EpisodeOfCare/{episode-id}
GET Observation?context:Encounter.episodeofcare=EpisodeOfCare/{episode-id}
GET Procedure?context=EpisodeOfCare/{episode-id}&_include=Procedure:performer&_include=Procedure:based-on
GET DiagnosticReport?context=EpisodeOfCare/{episode-id}	
GET ReferralRequest?context=EpisodeOfCare/{episode-id}

4.1.2 PWD to FHIR mapping table

The table below shows in the first three columns the PWD 3.2 data elements, in the fifth and sixth column their mapping to the FHIR profiles.

The mapping table below is based on the corresponding ART-DECOR transaction [...]

5 Addendum MedMij Echo Beschikbaarstellen

Generated code, do not change by hand

Based on ART-DECOR transaction version: 2024-01-16T13:18:30

PWD 3.2 to FHIR
Type	#	Concept	Card	Profile	Mapping
	1313	Administratief	1 .. 1
	1290	Betaler	0 .. 1	zib-Payer	Coverage
	1297	Verzekeraar	1 .. *	zib-Payer	Coverage
	1298	Verzekering	1 .. *	zib-Payer	Coverage.payor
	1299	BeginDatumTijd	0 .. 1	zib-Payer	Coverage.period.start
	1300	EindDatumTijd	0 .. 1	zib-Payer	Coverage.period.end
	1301	Verzekeringssoort	0 .. 1	zib-Payer	Coverage.type
	1302	IdentificatieNummer	0 .. 1	nl-core-organization	Organization.identifier
	1303	OrganisatieNaam	0 .. 1	nl-core-organization	Organization.name
	1304	VerzekerdeNummer	1 .. 1	zib-Payer	Coverage.subscriberId
	675	Patient	0 .. *	nl-core-patient	Patient*
	3197	Naamgegevens	1 .. 1	nl-core-patient	Patient.name
	3198	Voornamen	0 .. 1	nl-core-patient	Patient.name.given
	3199	Initialen	0 .. 1	nl-core-patient	Patient.name.given
	3200	Roepnaam	0 .. 1	nl-core-patient	Patient.name.given
	3201	Naamgebruik	0 .. 1	nl-core-patient	Patient.name.use
	3202	Geslachtsnaam	0 .. 1	nl-core-patient	Patient.name.family:humannameOwnName
	3203	Voorvoegsels	0 .. 1	nl-core-patient	Patient.name.family:humannameOwnPrefix
	3204	Achternaam	0 .. 1	nl-core-patient	Patient.name.family:humannameOwnName
	3205	GeslachtsnaamPartner	0 .. 1	nl-core-patient	Patient.name.family:humannamePartnerName
	3206	VoorvoegselsPartner	0 .. 1	nl-core-patient	Patient.name.family:humannamePartnerPrefix
	3207	AchternaamPartner	0 .. 1	nl-core-patient	Patient.name.family:humannamePartnerName
	3208	Adresgegevens	0 .. *	nl-core-patient	Patient.address
	3209	Straat	0 .. 1	nl-core-patient	Patient.address.line.streetName
	3210	Huisnummer	0 .. 1	nl-core-patient	Patient.address.line.houseNumber
	3211	Huisnummerletter	0 .. 1	nl-core-patient	Patient.address.line.buildingNumbersuffix
	3212	Huisnummertoevoeging	0 .. 1	nl-core-patient	Patient.address.line.additionalLocator
	3213	AanduidingBijNummer	0 .. 1	nl-core-patient	Patient.address.line.additionalLocator
	3214	Postcode	0 .. 1	nl-core-patient	Patient.address.postalCode
	3215	Woonplaats	0 .. 1	nl-core-patient	Patient.address.city
	3216	Gemeente	0 .. 1	nl-core-patient	Patient.address.district
	3217	Land	0 .. 1	nl-core-patient	Patient.address.country
	3218	AdditioneleInformatie	0 .. 1	nl-core-patient	Patient.address
	3219	AdresSoort	0 .. 1	nl-core-patient	Patient.address.use
	3220	Contactgegevens	0 .. 1	nl-core-patient	Patient.telecom
	3221	Telefoonnummers	0 .. 1	nl-core-patient	Patient.telecom.value
	3222	Telefoonnummer	0 .. 1	nl-core-patient	Patient.telecom.value
	3223	TelecomType	0 .. 1	nl-core-patient	Patient.telecom:extension:TelecomType
	3224	NummerSoort	0 .. 1	nl-core-patient	Patient.telecom.use
	3225	EmailAdressen	0 .. 1	nl-core-patient	Patient.telecom.value
	3226	EmailAdres	0 .. 1	nl-core-patient	Patient.telecom.value
	3227	EmailSoort	0 .. 1	nl-core-patient	Patient.telecom.use
	682	Identificatienummer	0 .. *	nl-core-patient	Patient.identifier
	9861	GeborenIndicator	1 .. 1	bc-Child	Patient.extension:fetalStatus.value[x]:valueCodeableConcept
	683	Geboortedatum	0 .. 1	nl-core-patient	Patient.birthDate
	684	Geslacht (administratief)	0 .. 1	nl-core-patient	Patient.gender
	685	MeerlingIndicator	0 .. 1	nl-core-patient	Patient.multipleBirthBoolean
	3358	Rangnummer	0 .. 1	nl-core-patient	Patient.multipleInteger
	686	OverlijdensIndicator	0 .. 1	nl-core-patient	Patient.deceasedBoolean
	687	DatumOverlijden	0 .. 1	nl-core-patient	Patient.deceasedDateTime
	956	Zorgaanbieder	1 .. *	nl-core-organization	Organization
	957	ZorgaanbiederIdentificatienummer	1 .. *	nl-core-organization	Organization.identifier
	958	OrganisatieNaam	1 .. 1	nl-core-organization	Organization.name
	960	AfdelingSpecialisme	0 .. 1	nl-core-organization	Organization.type:departmentSpecialty
	965	OrganisatieType	0 .. 1	nl-core-organization	Organization.type
	978	Zorgverlener	1 .. *	nl-core-practitioner	Practitioner
	979	ZorgverlenerIdentificatienummer	1 .. *	nl-core-practitioner	Practitioner.identifier
	3248	Naamgegevens	0 .. 1	nl-core-practitioner	Practitioner.name
	3249	Voornamen	0 .. 1	nl-core-practitioner	Practitioner.name.given
	3250	Initialen	0 .. 1	nl-core-practitioner	Practitioner.name.given
	3251	Roepnaam	0 .. 1	nl-core-practitioner	Practitioner.name.given
	3252	Naamgebruik	0 .. 1	nl-core-practitioner	Practitioner.name:extension:humannameAssemblyOrder
	3253	Geslachtsnaam	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannameOwnName
	3254	Voorvoegsels	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannameOwnPrefix
	3255	Achternaam	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humanNameOwnName
	3256	GeslachtsnaamPartner	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannamePartnerName
	3257	VoorvoegselsPartner	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannamePartnerPrefix
	3258	AchternaamPartner	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannamePartnerName
	1314	Zorgverlening	0 .. 1		nvt
	3399	ZorgEpisode	1 .. *	bc-MaternalRecord bc-MultidisciplinaryTeamMeeting	EpisodeOfCare Encounter.episodeOfCare
	3338	Identificatienummer	1 .. *	bc-MaternalRecord	EpisodeOfCare.identifier
	3400	BeginDatum	0 .. 1	bc-MaternalRecord	EpisodeOfCare.period.start
	3401	EindDatum	0 .. 1	bc-MaternalRecord	EpisodeOfCare.period.end
	3402	FocusZorgEpisode	0 .. 1	bc-MaternalRecord	EpisodeOfCare.diagnosis.condition
	8823	Probleem	0 .. 1	zib-Problem	Condition
	8824	ProbleemAnatomischeLocatie	0 .. 1	zib-Problem	Condition.bodySite
	8825	ProbleemLateraliteit	0 .. 1	zib-Problem	Condition.bodySite:Laterality
	8826	ProbleemType	0 .. 1	zib-Problem	Condition.category
	8827	ProbleemNaam	0 .. 1	zib-Problem	Condition.code
	8828	ProbleemBeginDatum	0 .. 1	zib-Problem	Condition.onset[x]:onsetDateTime
	8829	ProbleemEindDatum	0 .. 1	zib-Problem	Condition.abatement[x]:abatementDateTime
	8830	ProbleemStatus	0 .. 1	zib-Problem	Condition.clinicalStatus:ProblemStatusCodelist
	8831	VerificatieStatus	0 .. 1	zib-Problem	Condition.verificationStatus:VerificatieStatusCodelijst
	8832	Toelichting	0 .. 1	zib-Problem	Condition.note
	3404	ZorgEpisodeNaam	0 .. 1	bc-MaternalRecord	EpisodeOfCare.extension:title
	8822	ZorgEpisodeVerantwoordelijke	1 .. 1	bc-MaternalRecord	EpisodeOfCare.careManager
	2163	Zorgverlener	1 .. 1	nl-core-practitioner	Practitioner
	2164	StatusZorgepisode	0 .. 1	bc-MaternalRecord	EpisodeOfCare.status
	3405	Toelichting	0 .. 1	bc-MaternalRecord	EpisodeOfCare.extension:comment
	8877	Verwijsgegevens	1 .. 1	bc-ReferralRequest	ReferralRequest
	8879	Verwijzing van/ afkomstig van	1 .. 1	bc-ReferralRequest	ReferralRequest.requester
	9660	Zorgaanbieder	1 .. 1	bc-ReferralRequest	ReferralRequest.requester.agent
	674	Vrouw	1 .. 1	bc-Woman	Patient
	1713	Demografische gegevens	0 .. 1	bc-Woman	Patient
	1434	Patient	0 .. 1	bc-Woman	Patient
	25	Zwangerschapsgegevens	1 .. 1	bc-MaternalRecord	EpisodeOfCare
	3341	Zwangerschap	1 .. 1	zib-Pregnancy	Condition
	3343	Pariteit	1 .. 1	zib-Pregnancy-Parity	Observation.value[x]:valueQuantity
	3344	Graviditeit	1 .. 1	zib-Pregnancy-Gravidity	Observation.value[x]:valueQuantity
	3346	ATermeDatumItems	1 .. 1	bc-PregnancyObservation	Observation
	3347	ATermeDatum	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueDateTime
	3348	BepalingsMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	3349	DatumBepaling	1 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	1123	Medisch onderzoek	1 .. 1		nvt
	2416	Verrichting (Onderzoek)	1 .. 1	zib-Procedure	Procedure
	2417	VerrichtingStartDatum	1 .. 1	zib-Procedure	Procedure.effectivePeriod.start
	2423	VerrichtingType	1 .. 1	bc-ObstetricProcedure	Procedure.code
	2427	Locatie	0 .. 1	bc-ObstetricProcedure	Procedure.location
	2433	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	2429	Uitvoerder	0 .. 1	bc-ObstetricProcedure	Procedure.performer.actor
	2434	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	8912	Media	0 .. 1		DocumentReference
	8913	Identificatienummer	0 .. 1		DocumentReference.masterIdentifier
	8914	Type beeldmateriaal	0 .. 1		DocumentReference.extension
	8915	Beeldmateriaal	0 .. 1		DocumentReference.extension
blob	8943	Beeld	0 .. 1		Binary
	8916	Datum/Tijd	0 .. 1		DocumentReference.indexed
	8917	Toelichting	0 .. 1		DocumentReference.extension
	1208	Foetusspecifieke onderzoeksgegevens	1 .. *	bc-FetusObservation	Observation
	10283	Patient	1 .. *	bc-FetusObservation bc-FetalHeartRate bc-UmbilicalCord	Observation.subject Observation.subject Observation.subject
	1209	Echoscopie	1 .. 1	bc-PregnancyUltraSound	DiagnosticReport
	8918	Echografische bevindingen algemeen (Observatie)	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation
	8919	ObservatieDatumTijd	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.effective[x]:effectiveDateTime
	8929	ObservatieMethode	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.method
	8921	ConclusieWaarde	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.component:conclusion.value[x]:valueCodeableConcept
	8931	VerdenkingAfwijkingobvWaarde	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.component:suspicionAbnormalities.value[x]:valueCodeableConcept
	8930	AdviesWaarde	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.component:advice.value[x]:valueCodeableConcept
	8927	Toelichting	0 .. 1	bc-PregnancyUltraSoundGeneralFindings	Observation.comment
	1210	Biometrie	0 .. 1	bc-PregnancyUltraSound	DiagnosticReport
	3513	FoetaleBuikomtrek / AC (Meting)	0 .. 1	bc-FetusObservation	Observation
	3515	ACWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3525	ACPercentielWaarde	0 .. 1	bc-FetusObservation	Observation.component:acPercentielWaarde.value[x]
	3516	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3519	ACDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3520	ACDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3521	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3626	FoetaleSchedelomvang	0 .. 1	zib-HeadCircumference	Observation
	3627	SchedelomvangMeetmethode	0 .. 1	zib-HeadCircumference	Observation.method
	3628	Toelichting	0 .. 1	zib-HeadCircumference	Observation.comment
	3629	SchedelomvangWaarde	0 .. 1	zib-HeadCircumference	Observation.value[x]:valueQuantity
	3631	SchedelomvangPercentielWaarde	0 .. 1	zib-HeadCircumference	Observation.component.value[x]:valueQuantity
	3630	SchedelomvangDatumTijd	0 .. 1	zib-HeadCircumference	Observation.effective[x]:effectiveDateTime
	3539	FoetaleFemurlengte / FL (Meting)	0 .. 1	bc-FetusObservation	Observation
	3541	FLWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3551	FLPercentielWaarde	0 .. 1	bc-FetusObservation	Observation.component:flPercentielWaarde.value[x]
	3542	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3545	FLDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3546	FLDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3547	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3552	FoetaleBipariëtaleDiameter / BPD (Meting)	0 .. 1	bc-FetusObservation	Observation
	3554	BPDWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3555	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3558	BPDDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3559	BPDDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3560	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3564	FoetaalLongitudinaleBlaasDiameter / LBD (Meting)	0 .. 1	bc-FetusObservation	Observation
	3566	LBDWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3567	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3570	LBDDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3571	LBDDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3572	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3576	FoetaleKruinRompLengte / CRL (Meting)	0 .. 1	bc-FetusObservation	Observation
	3578	CRLWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3588	CRLPercentielWaarde	0 .. 1	bc-FetusObservation	Observation.component:crlPercentielWaarde.value[x]
	3579	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3582	CRLDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3583	CRLDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3584	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3589	FoetaleTranscerebellarDiameter / TCD (Meting)	0 .. 1	bc-FetusObservation	Observation
	3591	TCDWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3601	TCDPercentielWaarde	0 .. 1	bc-FetusObservation	Observation.component:tcdPercentielWaarde.value[x]
	3592	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3595	TCDDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3596	TCDDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3597	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3602	FoetaleNekplooidikte / NT (Meting)	0 .. 1	bc-FetusObservation	Observation
	3604	NTWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3605	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3608	NTDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3609	NTDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3610	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3614	FoetaalGeschatGewicht / EFW (Meting)	0 .. 1	bc-FetusObservation	Observation
	3616	EFWWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueQuantity
	3617	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	3620	EFWDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	3621	EFWDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	3622	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	2451	Bevindingen	0 .. 1	bc-FetusObservation	Observation
	1784	Foetale hartslag (Hartfrequentie)	0 .. *	bc-FetalHeartRate	Observation
	10964	HartfrequentieDatumTijd	0 .. 1
	10965	HartfrequentieWaarde	0 .. 1
	10966	HartslagMeetMethode	0 .. 1
	10967	HartslagRegelmatigheid	0 .. 1
	10968	InterpretatieFrequentie	0 .. 1
	10969	Toelichting	0 .. 1
	7789	LiggingFoetus (Meting)	0 .. *	bc-FetusObservation	Observation
	10951	LiggingFoetusWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	10952	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	10953	MeetDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	10954	MeetDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	10955	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	10956	AnatomischeLocatieMeting	0 .. 1	bc-FetusObservation	Observation.bodySite
	10957	Locatie	0 .. 1	bc-FetusObservation	Observation.bodySite
	2404	Beweging foetus (Observatie)	0 .. 1	bc-FetusObservation	Observation
	2405	BewegingFoetusDatumTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectiveDateTime
	2407	BewegingFoetusWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	2408	ObservatieMethode	0 .. 1	bc-FetusObservation	Observation.method
	2409	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	2410	Vruchtwater (Meting)	0 .. 1	bc-AmnioticFluid	Observation
	2411	MeetDatumTijd	0 .. 1	bc-AmnioticFluid	Observation.effective[x]:effectiveDateTime
	2413	HoeveelheidVruchtwaterWaarde	0 .. 1	bc-AmnioticFluid	Observation.component:amnioticFluidQuantity.value[x]:valueCodeableConcept
	2479	VruchtwatercompartimentWaarde	0 .. 1	bc-AmnioticFluid	Observation.component:amnioticFluidCompartment.value[x]:valueCodeableConcept
	2414	MeetMethode	0 .. 1	bc-AmnioticFluid	Observation.method
	2415	Toelichting	0 .. 1	bc-AmnioticFluid	Observation.comment
	2437	PlacentaLokalisatie (Observatie)	1 .. 1	bc-PlacentaLocalization	Observation
	2438	PlacentaLokalisatieDatumTijd	0 .. 1	bc-PlacentaLocalization	Observation.effective[x]:effectiveDateTime
	2449	PlacentalokalisatieWaarde	1 .. 1	bc-PlacentaLocalization	Observation.component:placentaLocalization.value[x]:valueCodeableConcept
	7867	SectioLittekenWaarde	0 .. 1	bc-PlacentaLocalization	Observation.component:sectionScar.extension:valueBoolean
	2448	OstiumWaarde	0 .. 1	bc-PlacentaLocalization	Observation.component:ostium.value[x]:valueCodeableConcept
	2441	ObservatieMethode	0 .. 1	bc-PlacentaLocalization	Observation.method
	2442	Toelichting	0 .. 1	bc-PlacentaLocalization	Observation.comment
	2458	Afwijking placenta	0 .. 1	bc-DisorderOfPregnancy	Condition
	2460	Probleem	0 .. 1	bc-DisorderOfPregnancy	Condition
	2461	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfPregnancy	Condition.bodySite
	2462	ProbleemLateraliteit	0 .. 1	bc-DisorderOfPregnancy	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	2463	ProbleemType	0 .. 1	bc-DisorderOfPregnancy	Condition.category
	2464	ProbleemNaam	0 .. 1	bc-DisorderOfPregnancy	Condition.code
	2465	ProbleemBeginDatum	0 .. 1	bc-DisorderOfPregnancy	Condition.onsetDateTime:onsetDateTime
	2466	ProbleemEindDatum	0 .. 1	bc-DisorderOfPregnancy	Condition.abatementDateTime:abatementDateTime
	2467	ProbleemStatus	0 .. 1	bc-DisorderOfPregnancy	Condition.clinicalStatus
	2468	VerificatieStatus	0 .. 1	bc-DisorderOfPregnancy	Condition.verificationStatus
	2469	Toelichting	0 .. 1	bc-DisorderOfPregnancy	Condition.note
	3635	Cervixlengte (Meting)	0 .. 1	bc-MaternalObservation	Observation
	3637	CervixlengteWaarde	0 .. 1	bc-MaternalObservation	Observation.value[x]:valueQuantity
	3638	MeetMethode	0 .. 1	bc-MaternalObservation	Observation.method
	3641	CervixlengteDatumBeginTijd	0 .. 1	bc-MaternalObservation	Observation.effective[x]:effectivePeriod.start
	3642	CervixlengteDatumEindTijd	0 .. 1	bc-MaternalObservation	Observation.effective[x]:effectivePeriod.end
	3643	Toelichting	0 .. 1	bc-MaternalObservation	Observation.comment
	7790	Navelstreng (Observatie)	0 .. 1	bc-UmbilicalCord	Observation
	7791	NavelstrengDatumTijd	0 .. 1	bc-UmbilicalCord	Observation.effective[x]:effectiveDateTime
	7846	NavelstrengWaarde	0 .. 1	bc-UmbilicalCord	Observation.value[x]:valueCodeableConcept
	7793	NavelstrengVatenWaarde	0 .. 1	bc-UmbilicalCord	Observation.component:umbilicalCordVessels.value[x]:valueCodeableConcept
	7794	ObservatieMethode	0 .. 1	bc-UmbilicalCord	Observation.method
	7799	Toelichting	0 .. 1	bc-UmbilicalCord	Observation.comment
	7836	OrgaansysteemFoetus (Observatie)	0 .. 1	bc-FetusObservation	Observation
	7837	OrgaansysteemFoetusDatumTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectiveDateTime
	7887	ObservatieNaam	0 .. 1	bc-FetusObservation	Observation.code
	7839	OrgaansysteemFoetusWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	7840	ObservatieMethode	0 .. 1	bc-FetusObservation	Observation.method
	7845	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	3920	Probleem (Hart & perifeer vaatstelsel)	0 .. 1	bc-DisorderOfChild	Condition
	3921	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfChild	Condition.bodySite
	3922	ProbleemLateraliteit	0 .. 1	bc-DisorderOfChild	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	3923	ProbleemType	0 .. 1	bc-DisorderOfChild	Condition.category
	3924	ProbleemNaam	0 .. 1	bc-DisorderOfChild	Condition.code
	3925	ProbleemBeginDatum	0 .. 1	bc-DisorderOfChild	Condition.onsetDateTime:onsetDateTime
	3926	ProbleemEindDatum	0 .. 1	bc-DisorderOfChild	Condition.abatementDateTime:abatementDateTime
	3927	ProbleemStatus	0 .. 1	bc-DisorderOfChild	Condition.clinicalStatus
	3928	VerificatieStatus	0 .. 1	bc-DisorderOfChild	Condition.verificationStatus
	3929	Toelichting	0 .. 1	bc-DisorderOfChild	Condition.note
	3930	Probleem (Hersenen, hersenstructuren, intracranieel)	0 .. 1	bc-DisorderOfChild	Condition
	3931	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfChild	Condition.bodySite
	3932	ProbleemLateraliteit	0 .. 1	bc-DisorderOfChild	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	3933	ProbleemType	0 .. 1	bc-DisorderOfChild	Condition.category
	3934	ProbleemNaam	0 .. 1	bc-DisorderOfChild	Condition.code
	3935	ProbleemBeginDatum	0 .. 1	bc-DisorderOfChild	Condition.onsetDateTime:onsetDateTime
	3936	ProbleemEindDatum	0 .. 1	bc-DisorderOfChild	Condition.abatementDateTime:abatementDateTime
	3937	ProbleemStatus	0 .. 1	bc-DisorderOfChild	Condition.clinicalStatus
	3938	VerificatieStatus	0 .. 1	bc-DisorderOfChild	Condition.verificationStatus
	3939	Toelichting	0 .. 1	bc-DisorderOfChild	Condition.note
	3940	Probleem (Wervelkolom, ruggenmerg)	0 .. 1	bc-DisorderOfChild	Condition
	3941	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfChild	Condition.bodySite
	3942	ProbleemLateraliteit	0 .. 1	bc-DisorderOfChild	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	3943	ProbleemType	0 .. 1	bc-DisorderOfChild	Condition.category
	3944	ProbleemNaam	0 .. 1	bc-DisorderOfChild	Condition.code
	3945	ProbleemBeginDatum	0 .. 1	bc-DisorderOfChild	Condition.onsetDateTime:onsetDateTime
	3946	ProbleemEindDatum	0 .. 1	bc-DisorderOfChild	Condition.abatementDateTime:abatementDateTime
	3947	ProbleemStatus	0 .. 1	bc-DisorderOfChild	Condition.clinicalStatus
	3948	VerificatieStatus	0 .. 1	bc-DisorderOfChild	Condition.verificationStatus
	3949	Toelichting	0 .. 1	bc-DisorderOfChild	Condition.note
	7847	Sonomarkers (Observatie)	0 .. 1	bc-FetusObservation	Observation
	7848	ObservatieDatumTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectiveDateTime
	7886	SonomarkerNaam	0 .. 1	bc-FetusObservation	Observation.code
	7850	SonomarkerWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	7851	ObservatieMethode	0 .. 1	bc-FetusObservation	Observation.method
	7856	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	7868	TekstUitslag	0 .. 1	zib-TextResult	DiagnosticReport
	7869	TekstUitslagDatumTijd	0 .. 1	zib-TextResult	DiagnosticReport.effectiveDateTime
	7870	Verrichting	0 .. 1	bc-ObstetricProcedure	Procedure.report
	7875	Verrichting (Onderzoek)	0 .. 1	bc-ObstetricProcedure	Procedure
	7872	TekstUitslagStatus	0 .. 1	zib-TextResult	DiagnosticReport.status.extension:TextResultStatus
	7873	TekstResultaat	0 .. 1	zib-TextResult	DiagnosticReport.conclusion
	7874	TekstUitslagType	0 .. 1	zib-TextResult	DiagnosticReport.code
	9885	Media	0 .. 1		Binary

6 FHIR profiles

MedMij 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.geboortezorg version 1.3.3 or compatible nictiz.fhir.nl.stu3.zib2017 version 2.2.20 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.

6.1 Generic HCIM profiles

Profile name	FHIR Resource	HCIM EN	Canonical URL
nl core Patient	Patient	Patient	http://nictiz.nl/fhir/StructureDefinition/nl-core-patient
nl core Organization	Organization	HealthcareProvider	http://nictiz.nl/fhir/StructureDefinition/nl-core-organization
nl core Practitioner	Practitioner	HealthProfessional	http://nictiz.nl/fhir/StructureDefinition/nl-core-practitioner
nl core PractitionerRole	PractitionerRole		http://nictiz.nl/fhir/StructureDefinition/nl-core-practitionerrole
zib HeadCircumference	Observation	HeadCircumference	http://nictiz.nl/fhir/StructureDefinition/zib-HeadCircumference
zib HeartRate	Observation	HeartRate	http://nictiz.nl/fhir/StructureDefinition/zib-HeartRate
zib Payer	Coverage	Payer	http://nictiz.nl/fhir/StructureDefinition/zib-Payer
zib Pregnancy	Condition	Pregnancy	http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy
zib Pregnancy-Gravidity	Observation		http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy-Gravidity
zib Pregnancy-Parity	Observation		http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy-Parity
zib Procedure	Procedure	Procedure	http://nictiz.nl/fhir/StructureDefinition/zib-Procedure
zib TextResult	DiagnosticReport	TextResult	http://nictiz.nl/fhir/StructureDefinition/zib-TextResult

6.2 Birthcare specific profiles

Profile	Pattern	Base profile	FHIR Resource	HCIM EN	Canonical URL	Description
bc-DisorderOfChild	Child disorder	zib-Problem	Condition	Problem	http://nictiz.nl/fhir/StructureDefinition/bc-DisorderOfChild	A Condition profile describing child disorders as defined by BabyConnect. Child disorders, such as chromosomal and congenital abnormalities or other problems are disorders of the child. The subject is either the child Patient (in case the child is born or a fetal patient record is in place) or the woman Patient (in case the child is unborn and there is no fetal patient record in place). In the second case, use the bodySite reference extension to refer to the fetus. Child disorders can refer to the EpisodeOfCare with Condition.context.reference A ConceptMap is available to map verification status to accepted FHIR codes
bc-DisorderOfPregnancy	Pregnancy-related disorder	zib-Problem	Condition	Problem	http://nictiz.nl/fhir/StructureDefinition/bc-DisorderOfPregnancy	A Condition profile describing disorders related to a pregnancy as defined by BabyConnect. For example, Conditions such as cholestasis and hypertension do not (only) pertain to the Patient but to a particular pregnancy. Pregnancy-related Disorders use the partOf extension to point to the Condition they're about. In some cases the partOf Condition may not be available. The BGZ for instance does not relate Conditions to particular pregnancies. Pregnancy-related Disorders refer to the EpisodeOfCare through Condition.context.reference
bc-Encounter		zib-Encounter	Encounter	Encounter	http://nictiz.nl/fhir/StructureDefinition/bc-Encounter	An Encounter profile describing birthcare related encounters as defined by BabyConnect. The woman Patient is the subject of the Encounter. Encounter.type specifies the type of encounter, e.g. prenatal visit, postnatal follow up or counseling. Encounter.episodeOfCare points to the maternal record that is the context of the Encounter Encounter.diagnosis points to the pregnancy (and optional other Conditions) Encounter.serviceProvider points to the responsible Organization for the Encounter
bc-FetalHeartRate		nl-core-observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-FetalHeartRate	An Observation profile describing fetal heart rate as defined by BabyConnect. The base definition is a fetus-related Observation. Fetus-related Observations are Observations about a fetus, which is the focus of the Observation (extension). Fetus identification is necessary in these Observations, especially in multiple pregnancy. There are two ways of using this profile depending on the presence of a patient / fetus record for the unborn child: 1. A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension must be left blank. 2. A patient / fetus record is not present. The subject of the Observation is the woman Patient. The focus extension refers to the fetus BodySite.
bc-Fetus		BodySite	BodySite		http://nictiz.nl/fhir/StructureDefinition/bc-Fetus	A BodySite profile as defined by BabyConnect. This BodySite profile refers to the unborn fetus in case no fetal record (yet) exists. In case a fetal record is created the unborn fetus will be registered as a (child) Patient.
bc-FetusObservation		nl-core-observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-FetusObservation	An Observation profile describing fetus-related Observations in a pregnancy, such as movement and heart action, as defined by BabyConnect. Fetus-related Observations are Observations about a fetus, which is the focus of the Observation (extension). Fetus identification is necessary in these Observations, especially in multiple pregnancy. There are two ways of using this profile depending on the presence of a patient / fetus record for the unborn child: 1. A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension must be left blank. 2. A patient / fetus record is not present. The subject of the Observation is the woman Patient. The focus extension refers to the fetus BodySite.
bc-MaternalObservation	Patient-related Observation	nl-core-observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-MaternalObservation	An Observation profile describing patient-related Observations, which are not captured in other existing profiles, as defined by BabyConnect. Patient-related Observations are findings related to the (pregnant) woman, before, during or after pregnancy childbirth. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare). Examples are risk status or maternal ultrasound observations.
bc-MaternalRecord		nl-core-episodeofcare	EpisodeOfCare		http://nictiz.nl/fhir/StructureDefinition/bc-MaternalRecord	An EpisodeOfCare profile describing a maternal record (or pregnancy file) as defined by BabyConnect. Each pregnancy is a Condition. It is also represented as an EpisodeOfCare (maternal record) for each involved Organization. The maternal record defines care responsibility for a specific period of time and groups all data related to this period of care. The maternal record has a fixed type (.type = 364320009). Additional types may be provided to indicate a specific period of care. The maternal record includes references to a managing Organization and responsible Practitioner. The maternal record defines care responsibility for a specific period of time and groups all data related to this period of care: 1. The maternal record groups all data related to one pregnancy for the managing Organization 2. The groupIdentifier (.extension:groupIdentifier) is a unique identifier of the pregnancy which can be used to group all data related to one pregnancy across Organizations Relations between the pregnancy (Condition) and the maternal record (EpisodeOfCare): Condition points to the EpisodeOfCare through a EpisodeOfCare.context.reference element. EpisodeOfCare points to the Condition through a EpisodeOfCare.diagnosis.condition element. Condition and EpisodeOfCare both point to the Patient with .subject.reference Condition.clinicalStatus and EpisodeOfCare.status must be 'active' for ongoing pregnancies Condition.clinicalStatus must be 'inactive' and EpisodeOfCare.status must be 'finished' for past pregnancies
bc-MotherOf		RelatedPerson	RelatedPerson		http://nictiz.nl/fhir/StructureDefinition/bc-MotherOf	A RelatedPerson profile describing the relation between mother and child as defined by BabyConnect. The RelatedPerson is the mother, which is a related person of the child Patient. The RelatedPerson.patient refers to the child Patient The RelatedPerson.link refers to the mother Patient, RelatedPerson.link.type is set to seealso
bc-ObstetricProcedure		zib-Procedure	Procedure	Procedure	http://nictiz.nl/fhir/StructureDefinition/bc-ObstetricProcedure	A Procedure profile describing obstetric procedures, as defined by BabyConnect. Obstetric procedures are procedures related to pregnancy, birth and delivery, such as vacuum delivery. For obstetric procedures related to the pregnancy, use Procedure.reasonReference For obstetric procedures related to birth and delivery, use the (optional) partOf extension to point to the Delivery (maternal data) or the Birth (child-specific data) The context is the Maternal Record or an Encounter
bc-PlacentaLocalization		bc-FetusObservation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-PlacentaLocalization	An Observation profile describing the localization of the placenta as defined by BabyConnect. Fetus-related Observations are Observations about a fetus, which is the focus of the Observation (extension). Fetus identification is necessary in these Observations, especially in multiple pregnancy. There are two ways of using this profile depending on the presence of a patient / fetus record for the unborn child: 1. A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension can be left blank. 2. A patient / fetus record is not present. The subject of the Observation is the woman Patient. The focus extension refers to the fetus BodySite.
bc-PregnancyObservation	Pregnancy-related Observation	nl-core-observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyObservation	An Observation profile describing pregnancy-related Observations, as defined by BabyConnect. Observations such as gravidity and parity do not (only) pertain to the Patient but also to a particular pregnancy. Pregnancy-related Observations use the focus extension to point to the Condition they are about. Without this, all gravidities would only be Observations about a Patient. Pregnancy-related Observations refer to the EpisodeOfCare with Observation.context.reference
bc-PregnancyUltraSound		DiagnosticReport	DiagnosticReport		http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyUltraSound	A DiagnosticReport profile describing a pregnancy ultrasound as defined by BabyConnect. The ultrasound DiagnosticReport groups Observations related to the pregnancy ultrasound. The woman Patient is the subject of the report. This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
bc-PregnancyUltraSoundGeneralFindings		bc-FetusObservation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyUltraSoundGeneralFindings	An Observation profile describing general ultrasound findings for the fetus as defined by BabyConnect. Fetus-related Observations are Observations about a fetus, which is the focus of the Observation (extension). Fetus identification is necessary in these Observations, especially in multiple pregnancy. There are two ways of using this profile depending on the presence of a patient / fetus record for the unborn child: 1. A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension can be left blank. 2. A patient / fetus record is not present. The subject of the Observation is the woman Patient. The focus extension refers to the fetus BodySite.
bc-ReferralRequest		ReferralRequest	ReferralRequest		http://nictiz.nl/fhir/StructureDefinition/bc-ReferralRequest	A ReferralRequest profile describing referral details as defined by BabyConnect. Referral details (such as type of referral, reason code, referrer and target of the referral) are described in ReferralRequest. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare).
bc-UmbilicalCord		nl-core-observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-UmbilicalCord	An Observation profile describing the umbilical cord a as defined by BabyConnect. Fetus-related Observations are Observations about a fetus, which is the focus of the Observation (extension). Fetus identification is necessary in these Observations, especially in multiple pregnancy. There are two ways of using this profile depending on the presence of a patient / fetus record for the unborn child: 1. A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension can be left blank. 2. A patient / fetus record is not present. The subject of the Observation is the woman Patient. The focus extension refers to the fetus BodySite.
bc-Woman		nl-core-patient	Patient	Patient	http://nictiz.nl/fhir/StructureDefinition/bc-Woman	A Patient profile describing the woman who is or was pregnant as defined by BabyConnect. The pregnant woman, a FHIR patient, is the core of each pregnancy.

7 Release notes

Release notes can be found on the functional design page.

8 Support

For questions and change requests regarding the information on this page, a ticket can be created in the Servicedesk Portal.