L2z:v4.0.0 FHIR lab2zorg: verschil tussen versies
(→FHIR Search parameters: aligning the format of the query parameter table with TO template [PAT-179]) |
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| Regel 155: | Regel 155: | ||
Value # = number of value occurrences per occurrence of the parameter. Results shall match at least of the value occurrences | Value # = number of value occurrences per occurrence of the parameter. Results shall match at least of the value occurrences | ||
| − | Example: | + | Example: /Patient?language=FR,NL&language=EN would refer to any patient who speaks English, as well as either French or Dutch. language may thus repeat, and may have more than one value. |
The table below lists search parameters for Observation resource. | The table below lists search parameters for Observation resource. | ||
Versie van 10 jun 2026 om 14:48
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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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. |
For an overview of all current documentation see information standard lab exchange main page
Inhoud
1 Introduction
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. 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.
1.3 Prerequisite knowledge
The following background information is required for understanding this TO:
- The functional design Lab2zorg accompanying this TO.
- The data exchange format FHIR R4, which you can find here:
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
2.2 Model overview for usecase with the request
3 Components
HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.
3.1 HL7 FHIR R4
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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 |
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 |
4.2.2 FHIR Search parameters
The search interaction is performed by an HTTP GET in agreement with the FHIR specification.
Unless stated otherwise, all (repetitions of) parameters and their values SHALL be supported by servers. Parameters with minimum of 1 or up SHALL be supported by clients.
- = number of occurrences of the parameter. Results shall match all occurrences
Value # = number of value occurrences per occurrence of the parameter. Results shall match at least of the value occurrences
Example: /Patient?language=FR,NL&language=EN would refer to any patient who speaks English, as well as either French or Dutch. language may thus repeat, and may have more than one value.
The table below lists search parameters for Observation resource.
| Name | # | Value # | Type | Description |
|---|---|---|---|---|
| category | 1..1 | 1..1 | token | Search for laboratory observation. Fixed value: https://terminology.hl7.org/CodeSystem/observation-category|laboratory
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| patient | 0..1 | 1..1 | token | Limit results to this patient based on their national identifier as burgerservicenummer (BSN). Note that this parameter may be replaced with a different mechanism like an OAuth token, which is why this parameter is not required. http://fhir.nl/fhir/NamingSystem/bsn|[BSN]
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| code | 0..* | 1..* | token | Limit results to observations containing a LOINC or an NHG test code. http://loinc.org|[test code], https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|[test code]
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| date | 0..2 | 1..1 | date | Search on observation date earlier or later than the value. To be used with prefixes lt or gt.
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| _include | 0..* | 1..1 | reference | Include linked resource, can be used in conjunction with modifier iterate which includes resources iteratively.
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4.2.3 FHIR Operations
Clients may invoke $lastn to retrieve the most recent Observation(s). The parameter max can optionally be provided to specify the number of observations to be returned. For more information on $lastn, consult $lastn operation.
4.2.4 FHIR Search examples
| Examples |
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| Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 |
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7 |
| Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 from 12 March 2022 |
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03 |
| Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 between 12 March 2022 and 7 June 2022 |
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03&date=lt2022-07-06 |
| Show all laboratory results with test code 14683-7 (LOINC) or 3583 (NHG) of the patient with BSN 111222333 |
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7,https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|3583 |
| Show the most recent laboratory result with test code 14683-7 (LOINC) of the patient with BSN 111222333 |
GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7 |
| Show the five most recent laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 |
GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7 |
| Show the most recent laboratory result of the patient with BSN 111222333 |
GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333 |
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 |
5 Additional guidance
5.1 Translations
When multiple codings are used for the same laboratory test, they should be represented as translations of the same concept within one CodeableConcept (FHIR specification). This means that the codes do not represent different test results. Instead, they are alternative codes for the same laboratory test.
Observation.code may contain multiple coding elements:
Observation.code coding[0]: LOINC code coding[1]: NHG-45 code coding[2]: internal laboratory code
The following code systems may be used:
http://loinc.orgfor LOINC codeshttps://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingenfor NHG-45 table codes- a laboratory specific system URL for internal codes.
The use of translations is to be supported predominantly for purposes of duplicate detection, when the same resource comes from various sources into one system.
