GZ:FHIR Pregnancy Card

Note that this is draft material for use in the pilot of region Northern Netherlands

1 Introduction

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

This Implementation Guide (IG) is a technical representation of the functional design 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 project.

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 Card (Dutch: gegevensdienst Integrale Zwangerschapskaart) has overlap with other standards such as the BgZ (Basisgegevensset Zorg), Medication Process, Vital Signs and Lab Results. The Pregnancy Card uses 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 woman to the (unborn) child.

4 Use case: retrieve pregnancy card

This use case covers the process of retrieving the Pregnancy Card in the Personal Health Record (PHR) of the (pregnant) woman.

4.1 PHR: request message

The PHR system requests the Pregnancy Card using individual search interactions. The Pregnancy Card consists of multiple FHIR resources with certain constraints. To obtain the patient's Pregnancy Card, 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 Card, a client has to execute the following requests.

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

A woman 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
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/{record-id}
GET Encounter?episodeofcare={record-id}&_include=Encounter:practitioner
GET Observation?context=EpisodeOfCare/{record-id}
GET Observation?context:Encounter.episodeofcare=EpisodeOfCare/{record-id}
GET Procedure?context=EpisodeOfCare/{record-id}&_include=Procedure:performer&_include=Procedure:based-on

Step 3: Retrieve data related to the practitioner role

Managing and participating Practitioners are included in the EpisodeOfCare and Encounter requests, but an additional request is necessary to retrieve the PractitionerRole related to these Practitioners.

GET PractitionerRole?practitioner={practitioner-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 MedMij 0.1 Beschikbaarstellen integrale zwangerschapskaart version 2021-04-06T15:01:01

PWD 3.2 to FHIR
Type	#	Concept	Card	Profile	Mapping
	1313	Administratief	1 .. 1
	750	Contact	0 .. *	bc-Encounter	Encounter
	751	ContactType	1 .. 1	bc-Encounter	Encounter.class
	3690	ContactSoort	0 .. 1	bc-Encounter	Encounter.type
	752	ContactMet	0 .. 1	bc-Encounter	Encounter.participant.individual
	1868	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner.participant.individual
	754	Locatie	0 .. 1	bc-Encounter	Encounter.serviceProvider
	1881	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	756	BeginDatumTijd	1 .. 1	bc-Encounter	Encounter.period.start
	757	EindDatumTijd	1 .. 1	bc-Encounter	Encounter.period.start
	758	RedenContact	1 .. *	bc-Encounter	Encounter.diagnosis
	759	Probleem	0 .. 1	zib-Problem	Condition
	1984	Vrouw/ moeder	0 .. 1	zib-Problem	Condition.subject
	3828	Probleem (Algemene anamnese)	0 .. 1	zib-Problem	Condition
	3831	Probleem (Psychiatrie)	0 .. 1	zib-Problem	Condition
	3829	Probleem (Sociale problemen)	0 .. 1	zib-Problem	Condition
	3832	Probleem (Misbruik/ Geweld)	0 .. 1	zib-Problem	Condition
	3830	Probleem (Zwangerschap)	0 .. 1	bc-DisorderOfPregnancy	Condition
	1928	Probleem (Maternaal)	0 .. 1	bc-DisorderPostPartum	Condition
	3833	Probleem (Postpartum complicatie)	0 .. 1	bc-DisorderPostPartum	Condition
	769	Verrichting	0 .. 1	nl-core-procedure	Procedure
	1986	Vrouw/ moeder	0 .. 1	nl-core-procedure	Procedure.subject
	3834	Verrichting (Algemene anamnese)	0 .. 1	bc-ObstetricProcedure	Procedure
	3835	Verrichting (Zwangerschap)	0 .. 1	bc-ObstetricProcedure	Procedure
	1970	Verrichting (Maternaal)	0 .. 1	bc-ObstetricProcedure	Procedure
	3836	Verrichting (Onderzoek)	0 .. 1	bc-ObstetricProcedure	Procedure
	3837	Verrichting (Postpartum complicatie)	0 .. 1	bc-ObstetricProcedure	Procedure
	1987	Kind	0 .. 1
	1982	Verrichting (Kindspecifieke maternale verrichtingen)	0 .. 1	bc-ObstetricProcedure	Procedure
	8791	Verrichting (Ondersteuning opvang)	0 .. 1	bc-ObstetricProcedure	Procedure
	8792	Chirurgische ingrepen (Verrichting)	0 .. 1	bc-ObstetricProcedure	Procedure
	8793	Verrichting (Problematiek kind)	0 .. 1	bc-ObstetricProcedure	Procedure
	763	AfwijkendeUitslag	0 .. 1	bc-Encounter	Encounter.reason.text
	8780	Toelichting reden contact	0 .. 1	bc-Encounter	Encounter.reason.text
	764	Herkomst	0 .. 1	bc-Encounter	Encounter.hospitalization.admitSource
	765	Bestemming	0 .. 1	bc-Encounter	Encounter.hospitalization.dischargeDisposition
	675	Patient	1 .. *	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	1 .. 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	1 .. 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 .. *	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 .. *	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
	683	Geboortedatum	0 .. 1	nl-core-patient	Patient.birthDate
	684	Geslacht (administratief)	1 .. 1	nl-core-patient	Patient.gender
	10776	Geslacht (identiteit)	0 .. 1	bc-Woman	Patient.extension:genderIdentity
	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
	3236	Adresgegevens	0 .. 1	nl-core-organization	Organization.address
	3237	Straat	0 .. 1	nl-core-organization	Organization.address.line.streetName
	3238	Huisnummer	0 .. 1	nl-core-organization	Organization.address.line.houseNumber
	3239	Huisnummerletter	0 .. 1	nl-core-organization	Organization.address.line:extension:buildingNumbersuffix
	3240	Huisnummertoevoeging	0 .. 1	nl-core-organization	Organization.address.line:extension:buildingNumbersuffix
	3241	AanduidingBijNummer	0 .. 1	nl-core-organization	Organization.address.line:extension:additionalLocator
	3242	Postcode	0 .. 1	nl-core-organization	Organization.address.postalCode
	3243	Woonplaats	0 .. 1	nl-core-organization	Organization.address.city
	3244	Gemeente	0 .. 1	nl-core-organization	Organization.address.district
	3245	Land	0 .. 1	nl-core-organization	Organization.address.country
	3246	AdditioneleInformatie	0 .. 1	nl-core-organization	Organization.address.line.extension
	3247	AdresSoort	0 .. 1	nl-core-organization	Organization.address.use/.type (via conceptMap)
	965	OrganisatieType	1 .. 1	nl-core-organization	Organization.type
	978	Zorgverlener	1 .. *	nl-core-practitioner	Practitioner
	979	ZorgverlenerIdentificatienummer	1 .. *	nl-core-practitioner	Practitioner.identifier
	3248	Naamgegevens	1 .. 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	1 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannameOwnName
	3254	Voorvoegsels	0 .. 1	nl-core-practitioner	Practitioner.name.family:extension:humannameOwnPrefix
	3255	Achternaam	1 .. 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
	2219	Specialisme	1 .. 1	nl-core-practitionerrole	PractitionerRole.specialty
	3271	Contactgegevens	0 .. 1	nl-core-practitioner	Practitioner.telecom
	3272	Telefoonnummers	0 .. *	nl-core-practitioner	Practitioner.telecom.value
	3273	Telefoonnummer	1 .. 1	nl-core-practitioner	Practitioner.telecom.value
	3274	TelecomType	1 .. 1	nl-core-practitioner	Practitioner.telecom:extension:TelecomType
	1678	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	989	ZorgverlenersRol	0 .. 1	bc-Encounter	Encounter.participant.type.coding:healthProfessionalRole
	1314	Zorgverlening	1 .. *		nvt
	3399	ZorgEpisode	1 .. *	bc-MaternalRecord	EpisodeOfCare
	3400	BeginDatum	0 .. 1	bc-MaternalRecord	EpisodeOfCare.period.start
	3401	EindDatum	0 .. 1	bc-MaternalRecord	EpisodeOfCare.period.end
	674	Vrouw	1 .. 1	bc-Woman	Patient
	1713	Demografische gegevens	1 .. 1	bc-Woman	Patient
	1434	Patient	1 .. 1	bc-Woman	Patient
	1127	Bloedonderzoek	0 .. *	zib-LaboratoryTestResult-Observation	Observation
	1139	LaboratoriumTest_Bloedgroep	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	1151	LaboratoriumTest_Rhesus D	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	1163	LaboratoriumTest_Rhesus c	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	25	Zwangerschapsgegevens	1 .. 1	bc-MaternalRecord	EpisodeOfCare
	1699	Coördinerend zorgverlener	1 .. 1	bc-MaternalRecord	EpisodeOfCare.careManager
	9662	Zorgverlener	1 .. 1	nl-core-practitioner	Practitioner
	3341	Zwangerschap	1 .. 1	zib-Pregnancy	Condition
	3342	Zwangerschapsduur	1 .. 1	zib-Pregnancy-PregnancyDuration	Observation.value[x]:valueQuantity
	3343	Pariteit	1 .. 1	zib-Pregnancy-Parity	Observation.value[x]:valueQuantity
	3344	Graviditeit	1 .. 1	zib-Pregnancy-Gravidity	Observation.value[x]:valueQuantity
	3345	Toelichting	0 .. 1	zib-Pregnancy	Condition.note
	3346	ATermeDatumItems	1 .. *	zib-Pregnancy-TermDate	Observation
	3347	ATermeDatum	1 .. 1	zib-Pregnancy-TermDate	Observation.value[x]:valueDateTime
	3348	BepalingsMethode	1 .. 1	zib-Pregnancy-TermDate	Observation.method
	3349	DatumBepaling	1 .. 1	zib-Pregnancy-TermDate	Observation.effective[x]:effectiveDateTime
	3350	DatumLaatsteMenstruatie	1 .. 1	zib-Pregnancy-DateLastMenstruation	Observation.value[x]:valueDateTime
	1729	Datum einde zwangerschap	0 .. *	bc-PregnancyObservation	Observation.value[x]:valueDateTime
	2220	Definitieve à terme datum (Observatie)	0 .. 1	bc-PregnancyObservation	Observation
	2221	Definitieve à terme DatumTijd	0 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	2223	Definitieve à terme Waarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueDateTime
	2224	Definitieve à terme Methode	0 .. 1	bc-PregnancyObservation	Observation.method
	2225	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1837	Aantal foetussen (Observatie)	1 .. 1	bc-PregnancyObservation	Observation
	1838	AantalFoetussenDatumTijd	0 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	1840	AantalFoetussenWaarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueQuantity
	1841	ObservatieMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	1843	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1711	Meerling zwangerschap (Observatie)	0 .. 1	bc-PregnancyObservation	Observation
	1825	MeerlingZwangerschapDatumTijd	0 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	2231	TyperingGemellizwangerschapWaarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueCodeableConcept
	1845	Aantal foetussen (Observatie)	1 .. 1	bc-PregnancyObservation	Observation.related.target
	1833	ObservatieMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	1826	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1734	Aantal levende kinderen (Observatie)	0 .. 1	bc-PregnancyObservation	Observation
	1735	AantalLevendeKinderenDatumTijd	0 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	1740	AantalLevendeKinderenWaarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueQuantity
	1736	ObservatieMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	1738	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1817	Fetal loss (Observatie)	0 .. 1	bc-PregnancyObservation	Observation
	1818	FetalLossDatumTijd	0 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	1820	FetalLossWaarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueQuantity
	1821	ObservatieMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	1824	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1742	Foliumzuurgebruik (Observatie)	0 .. 1	bc-MaternalObservation	Observation
	1743	FoliumzuurgebruikDatumTijd	0 .. 1	bc-MaternalObservation	Observation.effective[x]:effectiveDateTime
	1745	FoliumzuurgebruikWaarde	1 .. 1	bc-MaternalObservation	Observation.value[x]:valueCodeableConcept
	1746	ObservatieMethode	0 .. 1	bc-MaternalObservation	Observation.method
	1749	Toelichting	0 .. 1	bc-MaternalObservation	Observation.comment
	111	Prenatale controle	0 .. *	bc-Encounter	Encounter
	10520	Contact	0 .. 1	bc-Encounter	Encounter
	7025	Zwangerschapsduur	0 .. 1	zib-Pregnancy-PregnancyDuration	Observation.value[x]:valueQuantity
	2134	Leven voelen (Observatie)	0 .. 1	bc-PregnancyObservation	Observation
	2135	LevenVoelenDatumTijd	1 .. 1	bc-PregnancyObservation	Observation.effective[x]:effectiveDateTime
	2137	LevenVoelenWaarde	1 .. 1	bc-PregnancyObservation	Observation.value[x]:valueCodeableConcept
	2138	ObservatieMethode	0 .. 1	bc-PregnancyObservation	Observation.method
	2141	Toelichting	0 .. 1	bc-PregnancyObservation	Observation.comment
	1078	Lichaamsgewicht	0 .. 1	bc-PregnancyObservation	Observation
	1072	Bloeddruk	0 .. 1	bc-PregnancyObservation	Observation
	121	AlcoholGebruik	0 .. 1	zib-AlcoholUse	Observation
	122	Toelichting	0 .. 1	zib-AlcoholUse	Observation.comment
	123	AlcoholGebruikStatus	0 .. 1	zib-AlcoholUse	Observation.value[x]:valueCodeableConcept
	124	WaarnemingGebruik	0 .. 1	zib-AlcoholUse	Observation.effectivePeriod
	125	StartDatum	0 .. 1	zib-AlcoholUse	Observation.effective[x]:effectivePeriod.start
	126	StopDatum	0 .. 1	zib-AlcoholUse	Observation.effective[x]:effectivePeriod.end
	127	Hoeveelheid	0 .. 1	zib-AlcoholUse	Observation.component:amount.valueQuantity
	112	DrugsGebruik	0 .. *	zib-DrugUse	Observation
	117	Toelichting	0 .. 1	zib-DrugUse	Observation.comment
	119	DrugsGebruikStatus	0 .. 1	zib-DrugUse	Observation.value[x]:valueCodeableConcept
	118	DrugsOfGeneesmiddelSoort	0 .. 1	zib-DrugUse	Observation.component:DrugOrMedicationType.valueCodeableConcept
	120	Toedieningsweg	0 .. 1	zib-DrugUse	Observation.component:RouteOfAdministration.valueCodeableConcept
	113	WaarnemingGebruik	0 .. 1	zib-DrugUse	Observation.effectivePeriod
	114	StartDatum	0 .. 1	zib-DrugUse	Observation.effective[x]:effectivePeriod.start
	115	StopDatum	0 .. 1	zib-DrugUse	Observation.effective[x]:effectivePeriod.end
	116	Hoeveelheid	0 .. 1	zib-DrugUse	Observation.component:amount.valueQuantity
	2243	TabakGebruik	0 .. *	zib-TobaccoUse	Observation
	2244	Toelichting	0 .. 1	zib-TobaccoUse	Observation.comment
	2246	TabakGebruikStatus	0 .. 1	zib-TobaccoUse	Observation.value[x]:valueCodeableConcept
	2245	SoortTabakGebruik	0 .. 1	zib-TobaccoUse	Observation.component:TypeOfTobaccoUsed.valueCodeabelConcet
	2247	WaarnemingGebruik	0 .. 1	zib-TobaccoUse	Observation.effectivePeriod
	2248	StartDatum	0 .. 1	zib-TobaccoUse	Observation.effective[x]:effectivePeriod.start
	2249	StopDatum	0 .. 1	zib-TobaccoUse	Observation.effective[x]:effectivePeriod.end
	2250	Hoeveelheid	0 .. 1	zib-TobaccoUse	Observation.component:amount.valueQuantity
	2251	PackYears	0 .. 1	zib-TobaccoUse	Observation.component:PackYears.valueQuantity
	1775	Uitwendig onderzoek	0 .. *		nvt
	10521	Bevindingen Moeder	0 .. 1	bc-MaternalObservation	Observation
	3415	Fundushoogte (Meting)	0 .. 1	bc-MaternalObservation	Observation
	3417	FundushoogteWaarde	0 .. 1	bc-MaternalObservation	Observation.value[x]:valueQuantity
	3418	MeetMethode	0 .. 1	bc-MaternalObservation	Observation.method
	3421	MeetDatumBeginTijd	0 .. 1	bc-MaternalObservation	Observation.effective[x]:effectivePeriod.start
	3422	MeetDatumEindTijd	0 .. 1	bc-MaternalObservation	Observation.effective[x]:effectivePeriod.end
	3423	Toelichting	0 .. 1	bc-MaternalObservation	Observation.comment
	3424	AnatomischeLocatieMeting	0 .. 1	bc-MaternalObservation	Observation.bodySite
	3425	Locatie	0 .. 1	bc-MaternalObservation	Observation.bodySite
	4048	Fundusstand (Meting)	0 .. 1	bc-FetusObservation	Observation
	4050	FundusstandWaarde	0 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	4051	MeetMethode	0 .. 1	bc-FetusObservation	Observation.method
	4054	MeetDatumBeginTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	4055	MeetDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	4056	Toelichting	0 .. 1	bc-FetusObservation	Observation.comment
	4057	AnatomischeLocatieMeting	0 .. 1	bc-FetusObservation	Observation.bodySite
	4058	Locatie	0 .. 1	bc-FetusObservation	Observation.bodySite
	10522	Bevindingen Foetus	0 .. *	bc-FetusObservation	Observation
	4060	LiggingFoetus (Meting)	1 .. *	bc-FetusObservation	Observation
	4062	LiggingFoetusWaarde	1 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	4066	MeetDatumBeginTijd	1 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	4067	MeetDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	4069	AnatomischeLocatieMeting	1 .. 1	bc-FetusObservation	Observation.bodySite
	4070	Locatie	1 .. 1	bc-FetusObservation	Observation.bodySite
	4072	IndalingFoetus(Meting)	1 .. *	bc-FetusObservation	Observation
	4074	IndalingFoetusWaarde	1 .. 1	bc-FetusObservation	Observation.value[x]:valueCodeableConcept
	4078	MeetDatumBeginTijd	1 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.start
	4079	MeetDatumEindTijd	0 .. 1	bc-FetusObservation	Observation.effective[x]:effectivePeriod.end
	4081	AnatomischeLocatieMeting	1 .. 1	bc-FetusObservation	Observation.bodySite
	4082	Locatie	1 .. 1	bc-FetusObservation	Observation.bodySite
	1776	Foetale hartslag (Hartfrequentie)	0 .. *	bc-FetalHeartRate	Observation
	1778	HartfrequentieDatumTijd	0 .. 1	bc-FetalHeartRate	Observation.effective[x]:effectiveDateTime
	1777	HartfrequentieWaarde	1 .. 1	bc-FetalHeartRate	Observation.value[x]:valueQuantity
	1779	HartslagMeetMethode	0 .. 1	bc-FetalHeartRate	Observation.method
	1781	HartslagRegelmatigheid	1 .. 1	bc-FetalHeartRate	Observation.component:heartRateRegularity.value[x]:valueCodeableConcept
	1782	InterpretatieFrequentie	1 .. 1	bc-FetalHeartRate	Observation.interpretation
	1780	Toelichting	0 .. 1	bc-FetalHeartRate	Observation.comment
	1180	Probleem (Zwangerschap)	0 .. *	bc-DisorderOfPregnancy	Condition
	1181	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfPregnancy	Condition.bodySite
	1182	ProbleemLateraliteit	0 .. 1	bc-DisorderOfPregnancy	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	1183	ProbleemType	0 .. 1	bc-DisorderOfPregnancy	Condition.category
	1184	ProbleemNaam	1 .. 1	bc-DisorderOfPregnancy	Condition.code
	8654	Ernst oedeem	1 .. 1	bc-DisorderOfPregnancy	Condition.severity
	7894	Vermoeden iuvd op basis van	1 .. 1	bc-DisorderOfPregnancy	Condition.evidence.code
	1185	ProbleemBeginDatum	0 .. 1	bc-DisorderOfPregnancy	Condition.onsetDateTime:onsetDateTime
	1186	ProbleemEindDatum	0 .. 1	bc-DisorderOfPregnancy	Condition.abatementDateTime:abatementDateTime
	3409	Zwangerschapsduur	1 .. 1	zib-Pregnancy-PregnancyDuration	Observation.value[x]:valueQuantity
	1187	ProbleemStatus	1 .. 1	bc-DisorderOfPregnancy	Condition.clinicalStatus
	1188	VerificatieStatus	0 .. 1	bc-DisorderOfPregnancy	Condition.verificationStatus
	1189	Toelichting	0 .. 1	bc-DisorderOfPregnancy	Condition.note
	1190	Verrichting (Zwangerschap)	0 .. *	bc-ObstetricProcedure	Procedure
	1191	VerrichtingStartDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.start
	1192	VerrichtingEindDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.end
	3408	Zwangerschapsduur	0 .. 1	zib-Pregnancy-PregnancyDuration	Observation.value[x]:valueQuantity
	1193	VerrichtingAnatomischeLocatie	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite
	1194	VerrichtingLateraliteit	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
	1195	Indicatie	0 .. *	bc-ObstetricProcedure	Procedure.reasonReference
	1207	Probleem (Zwangerschap)	0 .. 1	bc-ObstetricProcedure	Procedure.reasonReference
	1197	VerrichtingType	1 .. 1	bc-ObstetricProcedure	Procedure.code
	1198	VerrichtingMethode	0 .. *	bc-ObstetricProcedure	Procedure.extension:procedureMethod
	1199	MedischHulpmiddel	0 .. *	bc-ObstetricProcedure	Procedure.focalDevice.manipulated
	10433	MedischHulpmiddel	0 .. 1	zib-MedicalDeviceProduct	Device
	1201	Locatie	0 .. 1	bc-ObstetricProcedure	Procedure.performer
	1312	Zorgaanbieder	0 .. 1	bc-ObstetricProcedure	Procedure.performer
	1203	Uitvoerder	0 .. *	bc-ObstetricProcedure	Procedure.performer
	1310	Zorgverlener	0 .. 1	bc-ObstetricProcedure	Procedure.performer
	1205	Aanvrager	0 .. *	zib-ProcedureRequest	ProcedureRequest.requester
	1311	Zorgverlener	0 .. 1	zib-ProcedureRequest	ProcedureRequest.requester
	37	Bevalling	0 .. 1	bc-DeliveryProcedure	Procedure
	3411	Partusnummer	0 .. 1	bc-DeliveryProcedure	Procedure.identifier
	10694	Zwangerschapsduur	1 .. 1	zib-Pregnancy-PregnancyDuration	Observation.value[x]:valueQuantity
	1564	Probleem (Maternaal)	0 .. *	bc-DisorderOfLaborAndDelivery	Condition
	1565	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.bodySite
	1566	ProbleemLateraliteit	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition
	1567	ProbleemType	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.category
	1568	ProbleemNaam	1 .. 1	bc-DisorderOfLaborAndDelivery	Condition.code
	7917	Vermoeden iuvd op basis van	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.evidence.code
	1569	ProbleemBeginDatum	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.onsetDateTime:onsetDateTime
	1570	ProbleemEindDatum	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.abatementDateTime:abatementDateTime
	3412	Zwangerschapsduur	1 .. 1	zib-Pregnancy-PregnancyDuration	Observation
	1571	ProbleemStatus	1 .. 1	bc-DisorderOfLaborAndDelivery	Condition.clinicalStatus
	1572	VerificatieStatus	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.verificationStatus
	1573	Toelichting	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.note
	1547	Verrichting (Maternaal)	0 .. *	bc-ObstetricProcedure	Procedure
	1548	VerrichtingStartDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.start
	1549	VerrichtingEindDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.end
	3413	Zwangerschapsduur	0 .. 1	zib-Pregnancy-PregnancyDuration	Observation
	1550	VerrichtingAnatomischeLocatie	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite
	1551	VerrichtingLateraliteit	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
	1552	Indicatie	0 .. *	bc-ObstetricProcedure	Procedure.reasonReference
	1583	Probleem (Maternaal)	0 .. 1	bc-ObstetricProcedure	Procedure.reasonReference
	1554	VerrichtingType	1 .. 1	bc-ObstetricProcedure	Procedure.code
	10280	Moment amniotomie	0 .. 1	bc-ObstetricProcedure	Procedure.extension:partusPhase
	1555	VerrichtingMethode	0 .. *	bc-ObstetricProcedure	Procedure.extension:procedureMethod
	1556	MedischHulpmiddel	0 .. *	bc-ObstetricProcedure	Procedure.focalDevice
	10434	MedischHulpmiddel	0 .. 1	zib-MedicalDeviceProduct	Device
	1558	Locatie	0 .. 1	bc-ObstetricProcedure	Procedure.performer
	10435	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	1560	Uitvoerder	0 .. *	bc-ObstetricProcedure	Procedure.performer
	10436	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	1562	Aanvrager	0 .. *	zib-ProcedureRequest	ProcedureRequest.requester
	10438	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	38	Ontsluitingsfase	0 .. 1		nvt
	4084	Actieve Ontsluiting (Observatie)	1 .. 1	bc-DeliveryObservation	Observation.code
	4085	ObservatieDatumTijd	0 .. 1	bc-DeliveryObservation	Observation.effective[x]:effectiveDateTime
	4087	BeginActieveOntsluitingWaarde	1 .. 1	bc-DeliveryObservation	Observation.value[x]:valueDateTime
	4088	ObservatieMethode	0 .. 1	bc-DeliveryObservation	Observation.method
	4095	Toelichting	0 .. 1	bc-DeliveryObservation	Observation.comment
	4096	Wijze Begin Baring (Observatie)	1 .. 1	bc-DeliveryObservation	Observation
	4097	ObservatieDatumTijd	0 .. 1	bc-DeliveryObservation	Observation.effective[x]:effectiveDateTime
	4099	BeginBaringWaarde	1 .. 1	bc-DeliveryObservation	Observation.value[x]:valueCodeableConcept
	4100	ObservatieMethode	0 .. 1	bc-DeliveryObservation	Observation.method
	4107	Toelichting	0 .. 1	bc-DeliveryObservation	Observation.comment
	39	Uitdrijvingsfase	0 .. *
	4144	Type Partus (Observatie)	1 .. 1	bc-BirthObservation	Observation
	4145	ObservatieDatumTijd	0 .. 1	bc-BirthObservation	Observation.effective[x]:effectiveDateTime
	4147	TypePartusWaarde	1 .. 1	bc-BirthObservation	Observation.value[x]:valueCodeableConcept
	4148	ObservatieMethode	0 .. 1	bc-BirthObservation	Observation.method
	4155	Toelichting	0 .. 1	bc-BirthObservation	Observation.comment
	4193	Werkelijke plaats baring (type locatie) (Observatie)	1 .. 1	bc-DeliveryObservation	Observation
	4194	ObservatieDatumTijd	0 .. 1	bc-DeliveryObservation	Observation.effective[x]:effectiveDateTime
	4196	WerkelijkePlaatsBaringWaarde	1 .. 1	bc-DeliveryObservation	Observation.value[x]:valueCodeableConcept
	4197	ObservatieMethode	0 .. 1	bc-DeliveryObservation	Observation.method
	4204	Toelichting	0 .. 1	bc-DeliveryObservation	Observation.comment
	1587	Ziekenhuis baring	0 .. 1	bc-DeliveryProcedure	Procedure.performer.actor
	1588	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	1591	Probleem (Kindspecifieke maternale problemen)	0 .. *	bc-DisorderOfLaborAndDelivery	Condition
	1592	ProbleemAnatomischeLocatie	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.bodySite
	1593	ProbleemLateraliteit	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
	1594	ProbleemType	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.category
	1595	ProbleemNaam	1 .. 1	bc-DisorderOfLaborAndDelivery	Condition.code
	1596	ProbleemBeginDatum	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.onsetDateTime:onsetDateTime
	1597	ProbleemEindDatum	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.abatementDateTime:abatementDateTime
	1598	ProbleemStatus	1 .. 1	bc-DisorderOfLaborAndDelivery	Condition.clinicalStatus
	1599	VerificatieStatus	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.verificationStatus
	1600	Toelichting	0 .. 1	bc-DisorderOfLaborAndDelivery	Condition.note
	1603	Verrichting (Kindspecifieke maternale verrichtingen)	0 .. *	bc-ObstetricProcedure	Procedure
	1604	VerrichtingStartDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.start
	1605	VerrichtingEindDatum	0 .. 1	bc-ObstetricProcedure	Procedure.performed[x]:performedPeriod.end
	1606	VerrichtingAnatomischeLocatie	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite
	1607	VerrichtingLateraliteit	0 .. 1	bc-ObstetricProcedure	Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
	1608	Indicatie	0 .. *	bc-ObstetricProcedure	Procedure.reasonReference
	1620	Probleem (Kindspecifieke maternale problemen)	0 .. 1	bc-ObstetricProcedure	Procedure.reasonReference
	1610	VerrichtingType	1 .. 1	bc-ObstetricProcedure	Procedure.code
	7919	Beslismoment sectio caesarea	0 .. 1	bc-ObstetricProcedure	Procedure.extension:decisionMoment
	1611	VerrichtingMethode	0 .. *	bc-ObstetricProcedure	Procedure.extension:procedureMethod
	1612	MedischHulpmiddel	0 .. *	bc-ObstetricProcedure	Procedure.focalDevice
	10452	MedischHulpmiddel	0 .. 1	zib-MedicalDeviceProduct	Device
	1614	Locatie	0 .. 1	bc-ObstetricProcedure	Procedure.performer
	10453	Zorgaanbieder	0 .. 1	nl-core-organization	Organization
	1616	Uitvoerder	0 .. *	bc-ObstetricProcedure	Procedure.performer
	10454	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	10455	Aanvrager	0 .. *	zib-procedurerequest	ProcedureRequest.requester
	10457	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	1123	Medisch onderzoek	0 .. *		nvt
	2416	Verrichting (Onderzoek)	0 .. 1	zib-Procedure	Procedure
	2417	VerrichtingStartDatum	1 .. 1	zib-Procedure	Procedure.effectivePeriod.start
	2418	VerrichtingEindDatum	1 .. 1	zib-Procedure	Procedure.effectivePeriod.end
	2419	VerrichtingAnatomischeLocatie	0 .. 1	zib-Procedure	Procedure.bodySite
	2420	VerrichtingLateraliteit	0 .. 1	zib-Procedure	Procedure.bodySite.extension:ProcedureLaterality.value[x]:valueCodeableConcept
	2421	Indicatie	0 .. 1	zib-Procedure	Procedure.reasonReference
	2422	Probleem	0 .. 1	zib-Problem	Condition
	2423	VerrichtingType	1 .. 1	bc-ObstetricProcedure	Procedure.code
	2424	VerrichtingMethode	0 .. 1	bc-ObstetricProcedure	Procedure.extension:procedureMethod
	2425	MedischHulpmiddel	0 .. 1	bc-ObstetricProcedure	Procedure.focalDevice
	10474	MedischHulpmiddel	0 .. 1	zib-MedicalDeviceProduct	Device
	2427	Locatie	0 .. 1	bc-ObstetricProcedure	Procedure.performer.actor
	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
	2431	Aanvrager	0 .. 1	zib-ProcedureRequest	Procedure.Requestrequester
	2435	Zorgverlener	0 .. 1	nl-core-practitioner	Practitioner
	1124	Maternale onderzoeksgegevens	1 .. 1	bc-MaternalObservation	Observation
	1125	Urine-, bloed- en aanvullende onderzoeken	1 .. *	zib-LaboratoryTestResult-Observation	Observation
	1126	PSIE	0 .. *	zib-LaboratoryTestResult-Observation	Observation
	1128	LaboratoriumTest_Bloedgroep	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	1129	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	1132	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	1140	LaboratoriumTest_Rhesus D	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	1141	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	1144	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	1152	LaboratoriumTest_Rhesus c	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	1153	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	1156	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	1640	LaboratoriumTest_ HBsAg	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2367	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	1644	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	1649	InterpretatieVlaggen	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.interpretation
	2356	LaboratoriumTest_HIV	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2357	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2360	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	2368	LaboratoriumTest_Lues	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2369	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2372	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2377	InterpretatieVlaggen	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.interpretation
	3501	Irregulaire antistoffen (Observatie)	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	3502	IrregulaireAntistoffenDatumTijd	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.effective[x]:effectiveDateTime
	3503	IrregulaireAntistoffenWaarde	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueBoolean
	3504	WelkeAntistoffenWaarde	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueCodeableConcept
	3505	Toelichting	0 .. 1	zib-LaboratoryTestResult-Observation	Observation.comment
	2379	LaboratoriumTest_Hb	0 .. *	zib-LaboratoryTestResult-Observation	Observation
	2380	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2383	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2401	Hb typering	0 .. *	zib-LaboratoryTestResult-Observation	Observation
	2491	LaboratoriumTest_MCV	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2492	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2495	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2513	LaboratoriumTest_Vitamine B12	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2514	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2517	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2545	LaboratoriumTest_Actief-B12	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2546	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2549	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2524	LaboratoriumTest_Ferritine	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2525	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2528	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2502	LaboratoriumTest_Foliumzuur	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2503	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2506	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	2535	Probleem_Hb-pathie	0 .. *	zib-Problem	Condition
	2538	ProbleemType	0 .. 1	zib-Problem	Condition.category
	2539	ProbleemNaam	0 .. 1	zib-Problem	Condition.code
	2540	ProbleemBeginDatum	0 .. 1	zib-Problem	Condition.onset[x]:onsetDateTime
	2541	ProbleemEindDatum	0 .. 1	zib-Problem	Condition.abatement[x]:abatementDateTime
	2542	ProbleemStatus	1 .. 1	zib-Problem	Condition.clinicalStatus
	2543	VerificatieStatus	0 .. 1	zib-Problem	Condition.verificationStatus
	2544	Toelichting	0 .. 1	zib-Problem	Condition.note
	1651	Schildklierdiagnostiek	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	1652	LaboratoriumTest_VrijT4, TSH & TSH receptor antistoffen	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	1653	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	1656	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity
	1663	TORCH	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2390	LaboratoriumTest_TORCH	0 .. 1	zib-LaboratoryTestResult-Observation	Observation
	2391	TestCode	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.code
	2394	TestUitslag	1 .. 1	zib-LaboratoryTestResult-Observation	Observation.value[x]:valueQuantity

4.2 XIS: response message

The returned data to the PHR should conform to the profiles listed in FHIR profiles.

5 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 1.1.0 or compatible (latest is ) 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.

Note: although version 1.1.0 is minimally required, it works best to use the latest version (1.2.2) containing the latest fixes and improvements.

5.1 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 AlcoholUse	Observation	AlcoholUse	http://nictiz.nl/fhir/StructureDefinition/zib-AlcoholUse
zib DrugUse	Observation	DrugUse	http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse
zib LaboratoryTestResult-Observation	Observation	LaboratotoryTestResult	http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation
zib Pregnancy	Condition	Pregnancy	http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy
zib Pregnancy-DateLastMenstruation	Observation		http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy-DateLastMenstruation
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 Problem	Condition	Problem	http://nictiz.nl/fhir/StructureDefinition/zib-Problem
zib Procedure	Procedure	Procedure	http://nictiz.nl/fhir/StructureDefinition/zib-Procedure
zib ProcedureRequest	ProcedureRequest	PlannedCareActivityForTransfer	http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest
zib TobaccoUse	Observation	TobaccoUse	http://nictiz.nl/fhir/StructureDefinition/zib-TobaccoUse

5.2 Birthcare specific profiles

Profile name	Pattern	FHIR Resource	HCIM EN	Canonical URL	Description
bc Fetus		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 DisorderOfChild	Child disorder	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 through Condition.context.reference. A ConceptMap is available to map verification status to accepted FHIR codes.
bc DisorderOfLaborAndDelivery	Delivery-and-birth-related disorder	Condition	Problem	http://nictiz.nl/fhir/StructureDefinition/bc-DisorderOfLaborAndDelivery	A Condition profile describing disorders and complications related to labor and delivery as defined by BabyConnect. These disorders are part of the delivery, which is defined in the partOf extension. Delivery-related Conditions use the partOf extension to point to the Condition they're about. Delivery-related Conditions refer to the EpisodeOfCare through Observation.context.reference.
bc DisorderOfPregnancy	Pregnancy-related disorder	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 Observations 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 Conditions refer to the EpisodeOfCare through Observation.context.reference.
bc DisorderPostPartum	Post partum disorder	Condition	Problem	http://nictiz.nl/fhir/StructureDefinition/bc-DisorderPostPartum	A Condition profile describing post partum disorders or complications as defined by BabyConnect. Post partum disorders, such as post partum depression, occur after delivery and are related to the Delivery Procedure. A partOf extension is used to point to the Delivery. The context is the maternal record or an Encounter.
bc 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 optionally other Conditions). Encounter.serviceProvider points to the responsible Organization for the Encounter.
bc MaternalRecord		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. It includes references to an 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: The (overarching) maternal record groups all data related to one pregnancy (.type = 364320009) A sub record groups all data related to a specific perinatal period within the pregnancy (.type contains a code for the perinatal period and .partOf contains a reference to the overarching maternal record) Relations between the pregnancy (Condition) and the overarching maternal record (EpisodeOfCare): Condition points to the EpisodeOfCare through an EpisodeOfCare.context.reference element. (Note: different providers may each have their own Condition resource.) EpisodeOfCare points to the Condition through an EpisodeOfCare.diagnosis.condition element. Condition points to the Patient through Condition.subject.reference. Condition.status must be 'active' for ongoing pregnancies and 'inactive' for past ones.
bc DeliveryObservation	Delivery-related observation	Observation		http://nictiz.nl/fhir/StructureDefinition/bc-DeliveryObservation	An Observation profile describing delivery-related Observations, as defined by BabyConnect. Observations such as onset of labor or blood loss pertain to a delivery Procedure. Delivery-related Observations use the focus extension to point to the delivery Procedure they're about. Delivery-related Observations refer to the EpisodeOfCare through Observation.context.reference.
bc FetalHeartRate		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: A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension can be left blank. 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 FetusObservation	Fetus-related 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: A patient / fetus record is present. The subject of the Observation is the (unborn) child Patient. The focus extension can be left blank. 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-Maternal Observation	Patient-related 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 Pregnancy PregnancyDuration		Observation	Pregnancy	http://nictiz.nl/fhir/StructureDefinition/bc-Pregnancy-PregnancyDuration	An Observation profile describing pregnancy duration as defined by BabyConnect. Pregnancy duration does not (only) pertain to the Patient but also to a particular pregnancy. Use the focus extension to point to the Condition it is about. Without this, pregnancy durations would only be Observations about a Patient. Use Observation.context.reference to point to the EpisodeOfCare. Use the supportingInfo extension to point to other problems and procedures that are relevant in the context of the pregnancy duration.
bc PregnancyObservation	Pregnancy-related 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 through Observation.context.reference.
bc Woman		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.
bc DeliveryProcedure		Procedure	Procedure	http://nictiz.nl/fhir/StructureDefinition/bc-DeliveryProcedure	A Procedure profile describing the delivery (including uncomplicated natural births for consistency), as defined by BabyConnect. A pregnancy can lead to one delivery Procedure, even in multiple birth. The mother Patient is the subject of the delivery Procedure. Delivery-related Procedures refer to the EpisodeOfCare through Procedure.context.reference. Delivery-related Procedures refer to the Pregnancy through Procedure.reasonReference.reference. A delivery Procedure is related to one or more birth Procedures. The child Patient is the subject of the birth Procedure. In case of multiple birth, multiple birth Procedures will point to the same delivery Procedure.
bc ObstetricProcedure		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.

6 Release notes

Release notes can be found on the functional design page.

7 Support

For questions and change requests regarding this IG, please create a ticket in BITS.