L2z:v4.0.0 FHIR lab2zorg: verschil tussen versies

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{{DISPLAYTITLE: Information Standard Lab Exchange v3.0.0-beta.3: '''Technical Design Lab2zorg V3.0.0-beta.4'''}}
  
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''The Information Standard Lab Exchange consists of four different components: Lab2Zorg, Lab2Lab, Lab2PublicHealth, and Lab2Patient. These four components were developed independently of each other and are subject to continuous development. This is reflected in the Semantic Versioning (SemVer). Each component undergoes its own development process with its own corresponding numerical publications.''
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{{IssueBox| The FHIR resource used for one of the use cases described in this technical design is DiagnosticReport. DiagnosticReport is not the preferred FHIR resource for the information standard Laboratory exchange. However, this resource has been chosen as it contains information about the order data. Optimally, order data could be linked directly to the preferred FHIR resource Observation via basedOn element. This will be updated in a future version.}}
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<imagemap>Bestand:functioneel-technisch-banner_00_alle.png|center|240px|alt=Functioneel-Technisch 
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circle 204 216 215 [[Lab:V3.0.2-b4_Ontwerp_Lab2zorg|Functional]]
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circle 990 216 215 [[Lab:V3.0.0-B4_FHIR_Lab2zorg|Technical]]
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desc none                       
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</imagemap>
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<big>For an overview of all current documentation [[Lab:V3.0.0_Ontwerp_Laboverdacht| see information standard lab exchange main page]]</big>
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__NUMBEREDHEADINGS__
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==Introduction==
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[[Bestand:Functioneel-02.png|link=Lab:V3.0.0-b4_Ontwerp_Lab2zorg|100px|rechts|Functional design|Go to functional design]]
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This is the technical design (TO) for the information standard (IS) Lab2zorg. This TO must be used together with the IS functional design, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]]. The data exchange format used in this version is: FHIR R4.
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=== Support ===
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For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement].
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=== Boundaries ===
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This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]].
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=== Prerequisite knowledge ===
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The following background information is required for understanding this TO:
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* The [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]] accompanying this TO.
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* The data exchange format FHIR R4, which you can find here:
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** [[FHIR:V1.0 FHIR IG R4|general FHIR R4 Implementation Guide]],
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** [[FHIR:V1.0_FHIR_IG_R4#FHIR_Packages|FHIR packages]],
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** [[FHIR:V1.0_FHIR_IG_R4#Usage_of_the_.id.2C_.identifier_and_.fullUrl_elements_in_FHIR_instances|usage of the .id, .identifier and .fullUrl]].
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== Relationships ==
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The diagrams below show the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.
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For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.
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===Model overview for usecases without the request===
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[[Bestand:FHIR-model-overview-L2Z-SLR-BLR.png]]
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===Model overview for usecase with the request===
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[[Bestand:FHIR-model-overview-L2P-LOA.png]]
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==Components==
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HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.
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=== HL7 FHIR R4 ===
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{{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.4|p2=nictiz.fhir.nl.r4.nl-core|v2=0.12.0-labtrial.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.12.0-beta.1}}
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==== Artifacts ====
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The artifacts of the information standard are presented in the following table:
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{| style="text-align: left; background-color: white;" cellpadding=5px;
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|- style="color: white; background-color: #e7844b;"
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! zib
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! FHIR resource
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! FHIR profile
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|- style="background-color: #fcf0e9;"
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| HealthcareProvider
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| Organization
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthcareProvider-Organization}}
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|- style="background-color: #fcf0e9;"
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| rowspan="2" | HealthProfessional
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| Practitioner
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-Practitioner}}
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|- style="background-color: #fcf0e9;"
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| PractitionerRole
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-PractitionerRole}}
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|- style="background-color: #fcf0e9;"
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| rowspan="3" | LaboratoryTestResult
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| Device
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.7.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen.Source}}
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|- style="background-color: #fcf0e9;"
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| Observation
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-labtrial.1|title=nl-core-LaboratoryTestResult}}
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|- style="background-color: #fcf0e9;"
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| Specimen
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen}}
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|- style="background-color: #fcf0e9;"
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| Patient
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| Patient
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-Patient}}
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|- style="background-color: #fcf0e9;"
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|
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| DiagnosticReport
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-LaboratoryTestResult-DiagnosticReport|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-LaboratoryTestResult-DiagnosticReport}}
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|- style="background-color: #fcf0e9;"
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|
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| ServiceRequest
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| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-OrderData|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-OrderData}}
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|}
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==== Examples of FHIR instances ====
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You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: [https://github.com/Nictiz/HL7-mappings/tree/master/ada_2_fhir-r4/lab/l2z-3.0.0 <nowiki>Lab exchange HL7-mappings repository</nowiki>].
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== Transactions ==
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=== Health professional orders lab tests and receives results ===
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==== Involved actors ====
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{| style="text-align: left;" cellpadding=5px;
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|- style="color: white; background-color: #e7844b;"
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! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement
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|- style="background-color: #fcf0e9;"
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| rowspan="2" | Send laboratory results based on a request
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| Send laboratory results based on a request || Client || LAB-LAS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}
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|- style="background-color: #fcf0e9;"
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| Receive laboratory results || Server || LAB-LAO
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|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LAS = Laboratoriumresultaat antwoord sturend (systeem), LAO = Laboratoriumresultaat antwoord ontvangend (systeem).''
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|}
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=== Health professional retrieves lab results ===
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==== Involved actors ====
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{| style="text-align: left;" cellpadding=5px;
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|- style="color: white; background-color: #e7844b;"
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! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement
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|- style="background-color: #fcf0e9;"
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| rowspan="2" | Retrieve laboratory results (PULL)
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| Retrieve laboratory results request || Client || LAB-LRR || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-RetrieveServe|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_RetrieveServe}}
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|- style="background-color: #fcf0e9;"
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| Retrieve laboratory results response || Server || LAB-LRB
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|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem).''
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|}
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==== Search parameters ====
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{| style="text-align: left;" cellpadding=5px;
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|- style="color: white; background-color: #e7844b;"
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! FHIR Search Parameter || Description || FHIR Resource || Example
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|- style="color: white; background-color: #eda778;"
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! colspan="5"  | Retrieve laboratory results (Observation search)
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|- style="background-color: #fcf0e9;"
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| category || Restrict search to laboratory observations || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory</pre>
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|- style="background-color: #fcf0e9;"
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| patient (with modifier identifier) || Constrain results to a specific patient context || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333</pre>
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|- style="background-color: #fcf0e9;"
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| code || Filter by laboratory test code (LOINC/NHG) || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>
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|- style="background-color: #fcf0e9;"
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| date || Filter results based on observation date || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&date=gt2022-03-12&date=lt2022-06-07</pre>
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|- style="color: white; background-color: #eda778;"
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! colspan="5" | Retrieve latest laboratory results ($lastn operation)
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|- style="background-color: #fcf0e9;"
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| $lastn (max=1 is default) || Retrieve most recent lab result using the $lastn operation || Observation || <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7</pre>
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|- style="background-color: #fcf0e9;"
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| max || Retrieve 5 most recent lab results using the $lastn operation || Observation || <pre>GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7</pre>
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|- style="color: white; background-color: #eda778;"
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! colspan="5" | Retrieve related resources
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|- style="background-color: #fcf0e9;"
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| _include || Include linked resources (Specimen, Patient, Organization) in the response bundle || Observation || <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&_include=Observation:specimen&_include=Observation:patient&_include=Observation:performer</pre>
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|+ style="align: bottom; caption-side: bottom; text-align: left;" |
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|}
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=== Health professional sends lab results to other health professional ===
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==== Involved actors ====
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{| style="text-align: left;" cellpadding=5px;
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|- style="color: white; background-color: #e7844b;"
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! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement
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|- style="background-color: #fcf0e9;"
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| rowspan="2" | Send laboratory results (PUSH)
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| Send laboratory results || Client || LAB-LRS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}
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|- style="background-color: #fcf0e9;"
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| Receive laboratory results || Server || LAB-LRO
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|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRS = Laboratoriumresultaat sturend (systeem), LRO = Laboratoriumresultaat ontvangend (systeem).''
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|}

Versie van 2 jun 2026 om 09:17


The Information Standard Lab Exchange consists of four different components: Lab2Zorg, Lab2Lab, Lab2PublicHealth, and Lab2Patient. These four components were developed independently of each other and are subject to continuous development. This is reflected in the Semantic Versioning (SemVer). Each component undergoes its own development process with its own corresponding numerical publications.

Issue icon.png 

The FHIR resource used for one of the use cases described in this technical design is DiagnosticReport. DiagnosticReport is not the preferred FHIR resource for the information standard Laboratory exchange. However, this resource has been chosen as it contains information about the order data. Optimally, order data could be linked directly to the preferred FHIR resource Observation via basedOn element. This will be updated in a future version.
FunctionalTechnicalFunctioneel-Technisch

For an overview of all current documentation see information standard lab exchange main page


1 Introduction

Go to functional design

This is the technical design (TO) for the information standard (IS) Lab2zorg. This TO must be used together with the IS functional design, see functional design Lab2zorg 3.0.0-beta.4. The data exchange format used in this version is: FHIR R4.

1.1 Support

For questions, feedback, or change requests, please contact our support team at Nictiz Servicemanagement.

1.2 Boundaries

This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see functional design Lab2zorg 3.0.0-beta.4.

1.3 Prerequisite knowledge

The following background information is required for understanding this TO:

2 Relationships

The diagrams below show the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.

For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.

2.1 Model overview for usecases without the request

FHIR-model-overview-L2Z-SLR-BLR.png

2.2 Model overview for usecase with the request

FHIR-model-overview-L2P-LOA.png

3 Components

HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

3.1 HL7 FHIR R4

Em.png

Nictiz 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:

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.

3.1.1 Artifacts

The artifacts of the information standard are presented in the following table:

zib FHIR resource FHIR profile
HealthcareProvider Organization nl-core-HealthcareProvider-Organization
HealthProfessional Practitioner nl-core-HealthProfessional-Practitioner
PractitionerRole nl-core-HealthProfessional-PractitionerRole
LaboratoryTestResult Device nl-core-LaboratoryTestResult.Specimen.Source
Observation nl-core-LaboratoryTestResult
Specimen nl-core-LaboratoryTestResult.Specimen
Patient Patient nl-core-Patient
DiagnosticReport lu-LaboratoryTestResult-DiagnosticReport
ServiceRequest lu-OrderData

3.1.2 Examples of FHIR instances

You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: Lab exchange HL7-mappings repository.

4 Transactions

4.1 Health professional orders lab tests and receives results

4.1.1 Involved actors

Transaction group Transaction Actor System role code FHIR CapabilityStatement
Send laboratory results based on a request Send laboratory results based on a request Client LAB-LAS Lab2Healthcare_Results_SendReceive
Receive laboratory results Server LAB-LAO
Abbreviations: LAB = Laboratorium, LAS = Laboratoriumresultaat antwoord sturend (systeem), LAO = Laboratoriumresultaat antwoord ontvangend (systeem).

4.2 Health professional retrieves lab results

4.2.1 Involved actors

Transaction group Transaction Actor System role code FHIR CapabilityStatement
Retrieve laboratory results (PULL) Retrieve laboratory results request Client LAB-LRR Lab2Healthcare_Results_RetrieveServe
Retrieve laboratory results response Server LAB-LRB
Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem).

4.2.2 Search parameters

FHIR Search Parameter Description FHIR Resource Example
Retrieve laboratory results (Observation search)
category Restrict search to laboratory observations Observation 
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
patient (with modifier identifier) Constrain results to a specific patient context Observation 
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333
code Filter by laboratory test code (LOINC/NHG) Observation 
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7
date Filter results based on observation date Observation 
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&date=gt2022-03-12&date=lt2022-06-07
Retrieve latest laboratory results ($lastn operation)
$lastn (max=1 is default) Retrieve most recent lab result using the $lastn operation Observation 
GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
max Retrieve 5 most recent lab results using the $lastn operation Observation 
GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
Retrieve related resources
_include Include linked resources (Specimen, Patient, Organization) in the response bundle Observation 
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&_include=Observation:specimen&_include=Observation:patient&_include=Observation:performer

4.3 Health professional sends lab results to other health professional

4.3.1 Involved actors

Transaction group Transaction Actor System role code FHIR CapabilityStatement
Send laboratory results (PUSH) Send laboratory results Client LAB-LRS Lab2Healthcare_Results_SendReceive
Receive laboratory results Server LAB-LRO
Abbreviations: LAB = Laboratorium, LRS = Laboratoriumresultaat sturend (systeem), LRO = Laboratoriumresultaat ontvangend (systeem).
Overgenomen van "https://informatiestandaarden.nictiz.nl/index.php?title=L2z:v4.0.0_FHIR_lab2zorg&oldid=313912"