FHIR Implementation Guide: Pregnancy Card

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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 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

Go to Afsprakenstelsel

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

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 Beschikbaarstellen integrale zwangerschapskaart version 2021-04-06T15:01:01

PWD 3.2 to FHIR
Type # Concept Card Profile Mapping
Container.png 1313 Administratief 1 .. 1
Container.png 750    Contact 0 .. * bc-Encounter Encounter
CD.png 751       ContactType 1 .. 1 bc-Encounter Encounter.class
CD.png 3690       ContactSoort 0 .. 1 bc-Encounter Encounter.type
Container.png 752       ContactMet 0 .. 1 bc-Encounter Encounter.participant.individual
Container.png 1868          Zorgverlener 0 .. 1 nl-core-practitioner Practitioner.participant.individual
Container.png 754       Locatie 0 .. 1 bc-Encounter Encounter.serviceProvider
Container.png 1881          Zorgaanbieder 0 .. 1 nl-core-organization Organization
TS.png 756       BeginDatumTijd 1 .. 1 bc-Encounter Encounter.period.start
TS.png 757       EindDatumTijd 1 .. 1 bc-Encounter Encounter.period.end
Container.png 758       RedenContact 1 .. * bc-Encounter Encounter.diagnosis
Container.png 759          Probleem 0 .. 1 zib-Problem Condition
Container.png 1984             Vrouw/ moeder 0 .. 1 zib-Problem Condition.subject
Container.png 3828                Probleem (Algemene anamnese) 0 .. 1 zib-Problem Condition
Container.png 3831                Probleem (Psychiatrie) 0 .. 1 zib-Problem Condition
Container.png 3829                Probleem (Sociale problemen) 0 .. 1 zib-Problem Condition
Container.png 3832                Probleem (Misbruik/ Geweld) 0 .. 1 zib-Problem Condition
Container.png 3830                Probleem (Zwangerschap) 0 .. 1 bc-DisorderOfPregnancy Condition
Container.png 1928                Probleem (Maternaal) 0 .. 1 bc-DisorderPostPartum Condition
Container.png 3833                Probleem (Postpartum complicatie) 0 .. 1 bc-DisorderPostPartum Condition
Container.png 1985             Kind 0 .. 1 bc-DisorderOfChild Condition.subject
Container.png 1981                Probleem (Kindspecifieke maternale problemen) 0 .. 1 bc-DisorderOfChild Condition.code
Container.png 1983                Probleem (ProblematiekKind) 0 .. 1 bc-DisorderOfChild Condition
Container.png 8781                Probleem (Geboortetrauma) 0 .. 1 bc-DisorderOfChild Condition
Container.png 8782                Probleem (Congenitale aandoeningen) 0 .. 1 bc-DisorderOfChild Condition
Container.png 8783                Probleem_Huid 0 .. 1 bc-DisorderOfChild Condition
Container.png 8784                Probleem_Hoofd/Hals 0 .. 1 bc-DisorderOfChild Condition
Container.png 8785                Probleem_Thorax 0 .. 1 bc-DisorderOfChild Condition
Container.png 8786                Probleem_Abdomen 0 .. 1 bc-DisorderOfChild Condition
Container.png 8787                Probleem_Rug 0 .. 1 bc-DisorderOfChild Condition
Container.png 8788                Probleem_Extremiteiten 0 .. 1 bc-DisorderOfChild Condition
Container.png 8789                Probleem_Genitalia 0 .. 1 bc-DisorderOfChild Condition
Container.png 8790                Probleem_Neurologie 0 .. 1 bc-DisorderOfChild Condition
Container.png 10682                Probleem (OpnameIndicatie_LNR) 0 .. 1 nvt
CD.png 10683                   ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfChild Condition.bodySite
CD.png 10684                   ProbleemLateraliteit 0 .. 1 bc-DisorderOfChild Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 10685                   ProbleemType 0 .. 1 bc-DisorderOfChild Condition.category
CD.png 10686                   ProbleemNaam 0 .. 1 bc-DisorderOfChild Condition.code
TS.png 10687                   ProbleemBeginDatum 0 .. 1 bc-DisorderOfChild Condition.onsetDateTime:onsetDateTime
TS.png 10688                   ProbleemEindDatum 0 .. 1 bc-DisorderOfChild Condition.abatementDateTime:abatementDateTime
CD.png 10689                   ProbleemStatus 0 .. 1 bc-DisorderOfChild Condition.clinicalStatus
CD.png 10690                   VerificatieStatus 0 .. 1 bc-DisorderOfChild Condition.verificationStatus
ST.png 10691                   Toelichting 0 .. 1 bc-DisorderOfChild Condition.note
Container.png 769          Verrichting 0 .. 1 zib-Procedure Procedure
Container.png 1986             Vrouw/ moeder 0 .. 1 zib-Procedure Procedure.subject
Container.png 3834                Verrichting (Algemene anamnese) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 3835                Verrichting (Zwangerschap) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 1970                Verrichting (Maternaal) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 3836                Verrichting (Onderzoek) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 3837                Verrichting (Postpartum complicatie) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 1987             Kind 0 .. 1 bc-Birth Procedure.subject
Container.png 1982                Verrichting (Kindspecifieke maternale verrichtingen) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 8791                Verrichting (Ondersteuning opvang) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 8792                Chirurgische ingrepen (Verrichting) 0 .. 1 bc-ObstetricProcedure Procedure
Container.png 8793                Verrichting (Problematiek kind) 0 .. 1 bc-ObstetricProcedure Procedure
ST.png 763          AfwijkendeUitslag 0 .. 1 bc-Encounter Encounter.reason.text
ST.png 8780          Toelichting reden contact 0 .. 1 bc-Encounter Encounter.reason.text
CD.png 764       Herkomst 0 .. 1 bc-Encounter Encounter.hospitalization.admitSource
CD.png 765       Bestemming 0 .. 1 bc-Encounter Encounter.hospitalization.dischargeDisposition
Container.png 675    Patient 1 .. * nl-core-patient Patient*
Container.png 3197       Naamgegevens 1 .. 1 nl-core-patient Patient.name
ST.png 3198          Voornamen 0 .. 1 nl-core-patient Patient.name.given
ST.png 3199          Initialen 0 .. 1 nl-core-patient Patient.name.given
ST.png 3200          Roepnaam 0 .. 1 nl-core-patient Patient.name.given
CD.png 3201          Naamgebruik 0 .. 1 nl-core-patient Patient.name.use
Container.png 3202          Geslachtsnaam 0 .. 1 nl-core-patient Patient.name.family:humannameOwnName
ST.png 3203             Voorvoegsels 0 .. 1 nl-core-patient Patient.name.family:humannameOwnPrefix
ST.png 3204             Achternaam 1 .. 1 nl-core-patient Patient.name.family:humannameOwnName
Container.png 3205          GeslachtsnaamPartner 0 .. 1 nl-core-patient Patient.name.family:humannamePartnerName
ST.png 3206             VoorvoegselsPartner 0 .. 1 nl-core-patient Patient.name.family:humannamePartnerPrefix
ST.png 3207             AchternaamPartner 1 .. 1 nl-core-patient Patient.name.family:humannamePartnerName
Container.png 3208       Adresgegevens 0 .. * nl-core-patient Patient.address
ST.png 3209          Straat 0 .. 1 nl-core-patient Patient.address.line.streetName
ST.png 3210          Huisnummer 0 .. 1 nl-core-patient Patient.address.line.houseNumber
ST.png 3211          Huisnummerletter 0 .. 1 nl-core-patient Patient.address.line.buildingNumbersuffix
ST.png 3212          Huisnummertoevoeging 0 .. 1 nl-core-patient Patient.address.line.additionalLocator
CD.png 3213          AanduidingBijNummer 0 .. 1 nl-core-patient Patient.address.line.additionalLocator
ST.png 3214          Postcode 0 .. 1 nl-core-patient Patient.address.postalCode
ST.png 3215          Woonplaats 0 .. 1 nl-core-patient Patient.address.city
ST.png 3216          Gemeente 0 .. 1 nl-core-patient Patient.address.district
CD.png 3217          Land 0 .. 1 nl-core-patient Patient.address.country
ST.png 3218          AdditioneleInformatie 0 .. 1 nl-core-patient Patient.address
CD.png 3219          AdresSoort 0 .. 1 nl-core-patient Patient.address.use
Container.png 3220       Contactgegevens 0 .. 1 nl-core-patient Patient.telecom
Container.png 3221          Telefoonnummers 0 .. * nl-core-patient Patient.telecom.value
ST.png 3222             Telefoonnummer 0 .. 1 nl-core-patient Patient.telecom.value
CD.png 3223             TelecomType 0 .. 1 nl-core-patient Patient.telecom:extension:TelecomType
CD.png 3224             NummerSoort 0 .. 1 nl-core-patient Patient.telecom.use
Container.png 3225          EmailAdressen 0 .. * nl-core-patient Patient.telecom.value
ST.png 3226             EmailAdres 0 .. 1 nl-core-patient Patient.telecom.value
CD.png 3227             EmailSoort 0 .. 1 nl-core-patient Patient.telecom.use
II.png 682       Identificatienummer 0 .. * nl-core-patient Patient.identifier
BL.png 9861       GeborenIndicator 0 .. 1 bc-child Patient.extension.born
TS.png 683       Geboortedatum 0 .. 1 nl-core-patient Patient.birthDate
CD.png 684       Geslacht (administratief) 1 .. 1 nl-core-patient Patient.gender
CD.png 10776       Geslacht (identiteit) 0 .. 1 bc-Woman Patient.extension:genderIdentity
BL.png 685       MeerlingIndicator 0 .. 1 nl-core-patient Patient.multipleBirthBoolean
ANY.png 3358       Rangnummer 0 .. 1 nl-core-patient Patient.multipleInteger
BL.png 686       OverlijdensIndicator 0 .. 1 nl-core-patient Patient.deceasedBoolean
TS.png 687       DatumOverlijden 0 .. 1 nl-core-patient Patient.deceasedDateTime
Container.png 956    Zorgaanbieder 1 .. * nl-core-organization Organization
II.png 957       ZorgaanbiederIdentificatienummer 1 .. * nl-core-organization Organization.identifier
ST.png 958       OrganisatieNaam 1 .. 1 nl-core-organization Organization.name
Container.png 3236       Adresgegevens 0 .. 1 nl-core-organization Organization.address
ST.png 3237          Straat 0 .. 1 nl-core-organization Organization.address.line.streetName
ST.png 3238          Huisnummer 0 .. 1 nl-core-organization Organization.address.line.houseNumber
ST.png 3239          Huisnummerletter 0 .. 1 nl-core-organization Organization.address.line:extension:buildingNumbersuffix
ST.png 3240          Huisnummertoevoeging 0 .. 1 nl-core-organization Organization.address.line:extension:buildingNumbersuffix
CD.png 3241          AanduidingBijNummer 0 .. 1 nl-core-organization Organization.address.line:extension:additionalLocator
ST.png 3242          Postcode 0 .. 1 nl-core-organization Organization.address.postalCode
ST.png 3243          Woonplaats 0 .. 1 nl-core-organization Organization.address.city
ST.png 3244          Gemeente 0 .. 1 nl-core-organization Organization.address.district
CD.png 3245          Land 0 .. 1 nl-core-organization Organization.address.country
ST.png 3246          AdditioneleInformatie 0 .. 1 nl-core-organization Organization.address.line.extension
CD.png 3247          AdresSoort 0 .. 1 nl-core-organization Organization.address.use/.type (via conceptMap)
CD.png 965       OrganisatieType 1 .. 1 nl-core-organization Organization.type
Container.png 978    Zorgverlener 1 .. * nl-core-practitioner Practitioner
II.png 979       ZorgverlenerIdentificatienummer 1 .. * nl-core-practitioner Practitioner.identifier
Container.png 3248       Naamgegevens 1 .. 1 nl-core-practitioner Practitioner.name
ST.png 3249          Voornamen 0 .. 1 nl-core-practitioner Practitioner.name.given
ST.png 3250          Initialen 0 .. 1 nl-core-practitioner Practitioner.name.given
ST.png 3251          Roepnaam 0 .. 1 nl-core-practitioner Practitioner.name.given
CD.png 3252          Naamgebruik 0 .. 1 nl-core-practitioner Practitioner.name:extension:humannameAssemblyOrder
Container.png 3253          Geslachtsnaam 1 .. 1 nl-core-practitioner Practitioner.name.family:extension:humannameOwnName
ST.png 3254             Voorvoegsels 0 .. 1 nl-core-practitioner Practitioner.name.family:extension:humannameOwnPrefix
ST.png 3255             Achternaam 1 .. 1 nl-core-practitioner Practitioner.name.family:extension:humanNameOwnName
Container.png 3256          GeslachtsnaamPartner 0 .. 1 nl-core-practitioner Practitioner.name.family:extension:humannamePartnerName
ST.png 3257             VoorvoegselsPartner 0 .. 1 nl-core-practitioner Practitioner.name.family:extension:humannamePartnerPrefix
ST.png 3258             AchternaamPartner 0 .. 1 nl-core-practitioner Practitioner.name.family:extension:humannamePartnerName
CD.png 2219       Specialisme 1 .. 1 nl-core-practitionerrole PractitionerRole.specialty
Container.png 3271       Contactgegevens 0 .. 1 nl-core-practitioner Practitioner.telecom
Container.png 3272          Telefoonnummers 0 .. * nl-core-practitioner Practitioner.telecom.value
ST.png 3273             Telefoonnummer 1 .. 1 nl-core-practitioner Practitioner.telecom.value
CD.png 3274             TelecomType 1 .. 1 nl-core-practitioner Practitioner.telecom:extension:TelecomType
Container.png 1678       Zorgaanbieder 0 .. 1 nl-core-organization Organization
CD.png 989       ZorgverlenersRol 0 .. 1 bc-Encounter Encounter.participant.type
Container.png 1314 Zorgverlening 1 .. * nvt
Container.png 3399    ZorgEpisode 1 .. * bc-MaternalRecord EpisodeOfCare
TS.png 3400       BeginDatum 0 .. 1 bc-MaternalRecord EpisodeOfCare.period.start
TS.png 3401       EindDatum 0 .. 1 bc-MaternalRecord EpisodeOfCare.period.end
Container.png 674 Vrouw 1 .. 1 bc-Woman Patient
Container.png 1713    Demografische gegevens 1 .. 1 bc-Woman Patient
Container.png 1434       Patient 1 .. 1 bc-Woman Patient
Container.png 1127    Bloedonderzoek 0 .. * zib-LaboratoryTestResult-Observation Observation
Container.png 1139       LaboratoriumTest_Bloedgroep 0 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 1151       LaboratoriumTest_Rhesus D 0 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 1163       LaboratoriumTest_Rhesus c 0 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 25 Zwangerschapsgegevens 1 .. 1 bc-MaternalRecord EpisodeOfCare
Container.png 1699    Coördinerend zorgverlener 1 .. 1 bc-MaternalRecord EpisodeOfCare.careManager
Container.png 9662       Zorgverlener 1 .. 1 nl-core-practitioner Practitioner
Container.png 3341    Zwangerschap 1 .. 1 zib-Pregnancy Condition
PQ.png 3342       Zwangerschapsduur 1 .. 1 zib-Pregnancy-PregnancyDuration Observation.value[x]:valueQuantity
INT.png 3343       Pariteit 1 .. 1 zib-Pregnancy-Parity Observation.value[x]:valueQuantity
INT.png 3344       Graviditeit 1 .. 1 zib-Pregnancy-Gravidity Observation.value[x]:valueQuantity
ST.png 3345       Toelichting 0 .. 1 zib-Pregnancy Condition.note
Container.png 3346       ATermeDatumItems 1 .. * bc-PregnancyObservation Observation
TS.png 3347          ATermeDatum 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueDateTime
CD.png 3348          BepalingsMethode 1 .. 1 bc-PregnancyObservation Observation.method
TS.png 3349          DatumBepaling 1 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
TS.png 3350          DatumLaatsteMenstruatie 1 .. 1 zib-Pregnancy-DateLastMenstruation Observation.value[x]:valueDateTime
TS.png 1729       Datum einde zwangerschap 0 .. * bc-PregnancyObservation Observation.value[x]:valueDateTime
Container.png 2220    Definitieve à terme datum (Observatie) 0 .. 1 bc-PregnancyObservation Observation
TS.png 2221       Definitieve à terme DatumTijd 0 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
TS.png 2223       Definitieve à terme Waarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueDateTime
CD.png 2224       Definitieve à terme Methode 0 .. 1 bc-PregnancyObservation Observation.method.coding:aTermMethod
ST.png 2225       Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1837    Aantal foetussen (Observatie) 1 .. 1 bc-PregnancyObservation Observation
TS.png 1838       AantalFoetussenDatumTijd 0 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
INT.png 1840       AantalFoetussenWaarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueQuantity
CD.png 1841       ObservatieMethode 0 .. 1 bc-PregnancyObservation Observation.method
ST.png 1843       Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1711    Meerling zwangerschap (Observatie) 0 .. 1 bc-PregnancyObservation Observation
TS.png 1825       MeerlingZwangerschapDatumTijd 0 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
CD.png 2231       TyperingGemellizwangerschapWaarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueCodeableConcept
Container.png 1845       Aantal foetussen (Observatie) 1 .. 1 bc-PregnancyObservation Observation
CD.png 1833       ObservatieMethode 0 .. 1 bc-PregnancyObservation Observation.method
ST.png 1826       Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1734    Aantal levende kinderen (Observatie) 0 .. 1 bc-PregnancyObservation Observation
TS.png 1735       AantalLevendeKinderenDatumTijd 0 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
INT.png 1740       AantalLevendeKinderenWaarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueQuantity
CD.png 1736       ObservatieMethode 0 .. 1 bc-PregnancyObservation Observation.method
ST.png 1738       Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1817    Fetal loss (Observatie) 0 .. 1 bc-PregnancyObservation Observation
TS.png 1818       FetalLossDatumTijd 0 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
INT.png 1820       FetalLossWaarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueQuantity
CD.png 1821       ObservatieMethode 0 .. 1 bc-PregnancyObservation Observation.method
ST.png 1824       Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1742    Foliumzuurgebruik (Observatie) 0 .. 1 bc-MaternalObservation Observation
TS.png 1743       FoliumzuurgebruikDatumTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectiveDateTime
CD.png 1745       FoliumzuurgebruikWaarde 1 .. 1 bc-MaternalObservation Observation.value[x]:valueCodeableConcept
CD.png 1746       ObservatieMethode 0 .. 1 bc-MaternalObservation Observation.method
ST.png 1749       Toelichting 0 .. 1 bc-MaternalObservation Observation.comment
Container.png 111    Prenatale controle 0 .. * bc-Encounter Encounter
Container.png 10520       Contact 0 .. 1 bc-Encounter Encounter
PQ.png 7025       Zwangerschapsduur 0 .. 1 zib-Pregnancy-PregnancyDuration Observation.value[x]:valueQuantity
Container.png 2134       Leven voelen (Observatie) 0 .. 1 bc-PregnancyObservation Observation
TS.png 2135          LevenVoelenDatumTijd 1 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
CD.png 2137          LevenVoelenWaarde 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueCodeableConcept
CD.png 2138          ObservatieMethode 0 .. 1 bc-PregnancyObservation Observation.method
ST.png 2141          Toelichting 0 .. 1 bc-PregnancyObservation Observation.comment
Container.png 1078       Lichaamsgewicht 0 .. 1 zib-BodyWeight Observation
Container.png 1072       Bloeddruk 0 .. 1 zib-BloodPressure Observation
Container.png 121       AlcoholGebruik 0 .. 1 zib-AlcoholUse Observation
ST.png 122          Toelichting 0 .. 1 zib-AlcoholUse Observation.comment
CD.png 123          AlcoholGebruikStatus 0 .. 1 zib-AlcoholUse Observation.value[x]:valueCodeableConcept
Container.png 124          WaarnemingGebruik 0 .. 1 zib-AlcoholUse Observation.effectivePeriod
TS.png 125             StartDatum 0 .. 1 zib-AlcoholUse Observation.effective[x]:effectivePeriod.start
TS.png 126             StopDatum 0 .. 1 zib-AlcoholUse Observation.effective[x]:effectivePeriod.end
PQ.png 127             Hoeveelheid 0 .. 1 zib-AlcoholUse Observation.component:amount.valueQuantity
Container.png 112       DrugsGebruik 0 .. * zib-DrugUse Observation
ST.png 117          Toelichting 0 .. 1 zib-DrugUse Observation.comment
CD.png 119          DrugsGebruikStatus 0 .. 1 zib-DrugUse Observation.value[x]:valueCodeableConcept
CD.png 118          DrugsOfGeneesmiddelSoort 0 .. 1 zib-DrugUse Observation.component:DrugOrMedicationType.valueCodeableConcept
CD.png 120          Toedieningsweg 0 .. 1 zib-DrugUse Observation.component:RouteOfAdministration.valueCodeableConcept
Container.png 113          WaarnemingGebruik 0 .. 1 zib-DrugUse Observation.effectivePeriod
TS.png 114             StartDatum 0 .. 1 zib-DrugUse Observation.effective[x]:effectivePeriod.start
TS.png 115             StopDatum 0 .. 1 zib-DrugUse Observation.effective[x]:effectivePeriod.end
ST.png 116             Hoeveelheid 0 .. 1 zib-DrugUse Observation.component:amount.valueQuantity
Container.png 2243       TabakGebruik 0 .. * zib-TobaccoUse Observation
ST.png 2244          Toelichting 0 .. 1 zib-TobaccoUse Observation.comment
CD.png 2246          TabakGebruikStatus 0 .. 1 zib-TobaccoUse Observation.value[x]:valueCodeableConcept
CD.png 2245          SoortTabakGebruik 0 .. 1 zib-TobaccoUse Observation.component:TypeOfTobaccoUsed.valueCodeabelConcet
Container.png 2247          WaarnemingGebruik 0 .. 1 zib-TobaccoUse Observation.effectivePeriod
TS.png 2248             StartDatum 0 .. 1 zib-TobaccoUse Observation.effective[x]:effectivePeriod.start
TS.png 2249             StopDatum 0 .. 1 zib-TobaccoUse Observation.effective[x]:effectivePeriod.end
PQ.png 2250             Hoeveelheid 0 .. 1 zib-TobaccoUse Observation.component:amount.valueQuantity
INT.png 2251             PackYears 0 .. 1 zib-TobaccoUse Observation.component:PackYears.valueQuantity
Container.png 1775       Uitwendig onderzoek 0 .. * nvt
Container.png 10521          Bevindingen Moeder 0 .. 1 bc-MaternalObservation Observation
Container.png 3415             Fundushoogte (Meting) 0 .. 1 bc-MaternalObservation Observation
PQ.png 3417                FundushoogteWaarde 0 .. 1 bc-MaternalObservation Observation.value[x]:valueQuantity
CD.png 3418                MeetMethode 0 .. 1 bc-MaternalObservation Observation.method
TS.png 3421                MeetDatumBeginTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 3422                MeetDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
ST.png 3423                Toelichting 0 .. 1 bc-MaternalObservation Observation.comment
Container.png 3424                AnatomischeLocatieMeting 0 .. 1 bc-MaternalObservation Observation.bodySite
CD.png 3425                   Locatie 0 .. 1 bc-MaternalObservation Observation.bodySite
Container.png 4048             Fundusstand (Meting) 0 .. 1 bc-MaternalObservation Observation
CD.png 4050                FundusstandWaarde 0 .. 1 bc-MaternalObservation Observation.value[x]:valueCodeableConcept
CD.png 4051                MeetMethode 0 .. 1 bc-MaternalObservation Observation.method
TS.png 4054                MeetDatumBeginTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 4055                MeetDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
ST.png 4056                Toelichting 0 .. 1 bc-MaternalObservation Observation.comment
Container.png 4057                AnatomischeLocatieMeting 0 .. 1 bc-MaternalObservation Observation.bodySite
CD.png 4058                   Locatie 0 .. 1 bc-MaternalObservation Observation.bodySite
Container.png 10522          Bevindingen Foetus 0 .. * bc-MaternalObservation Observation
Container.png 4060             LiggingFoetus (Meting) 1 .. * bc-MaternalObservation Observation
CD.png 4062                LiggingFoetusWaarde 1 .. 1 bc-MaternalObservation Observation.value[x]:valueCodeableConcept
TS.png 4066                MeetDatumBeginTijd 1 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 4067                MeetDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
Container.png 4069                AnatomischeLocatieMeting 1 .. 1 bc-MaternalObservation Observation.bodySite
CD.png 4070                   Locatie 1 .. 1 bc-MaternalObservation Observation.bodySite
Container.png 4072             IndalingFoetus(Meting) 1 .. * bc-MaternalObservation Observation
CD.png 4074                IndalingFoetusWaarde 1 .. 1 bc-MaternalObservation Observation.value[x]:valueCodeableConcept
TS.png 4078                MeetDatumBeginTijd 1 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 4079                MeetDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
Container.png 4081                AnatomischeLocatieMeting 1 .. 1 bc-MaternalObservation Observation.bodySite
CD.png 4082                   Locatie 1 .. 1 bc-MaternalObservation Observation.bodySite
Container.png 1776             Foetale hartslag (Hartfrequentie) 0 .. * bc-FetalHeartRate Observation
TS.png 1778                HartfrequentieDatumTijd 0 .. 1 bc-FetalHeartRate Observation.effective[x]:effectiveDateTime
PQ.png 1777                HartfrequentieWaarde 1 .. 1 bc-FetalHeartRate Observation.value[x]:valueQuantity
CD.png 1779                HartslagMeetMethode 0 .. 1 bc-FetalHeartRate Observation.method
CD.png 1781                HartslagRegelmatigheid 1 .. 1 bc-FetalHeartRate Observation.component:heartRateRegularity.value[x]:valueCodeableConcept
CD.png 1782                InterpretatieFrequentie 1 .. 1 bc-FetalHeartRate Observation.interpretation
ST.png 1780                Toelichting 0 .. 1 bc-FetalHeartRate Observation.comment
Container.png 1180    Probleem (Zwangerschap) 0 .. * bc-DisorderOfPregnancy Condition
CD.png 1181       ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfPregnancy Condition.bodySite
CD.png 1182       ProbleemLateraliteit 0 .. 1 bc-DisorderOfPregnancy Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 1183       ProbleemType 0 .. 1 bc-DisorderOfPregnancy Condition.category
CD.png 1184       ProbleemNaam 1 .. 1 bc-DisorderOfPregnancy Condition.code
CD.png 8654       Ernst oedeem 1 .. 1 bc-DisorderOfPregnancy Condition.severity
CD.png 7894       Vermoeden iuvd op basis van 1 .. 1 bc-DisorderOfPregnancy Condition.evidence.code
TS.png 1185       ProbleemBeginDatum 0 .. 1 bc-DisorderOfPregnancy Condition.onsetDateTime:onsetDateTime
TS.png 1186       ProbleemEindDatum 0 .. 1 bc-DisorderOfPregnancy Condition.abatementDateTime:abatementDateTime
PQ.png 3409       Zwangerschapsduur 1 .. 1 zib-Pregnancy-PregnancyDuration Observation.value[x]:valueQuantity
CD.png 1187       ProbleemStatus 1 .. 1 bc-DisorderOfPregnancy Condition.clinicalStatus
CD.png 1188       VerificatieStatus 0 .. 1 bc-DisorderOfPregnancy Condition.verificationStatus
ST.png 1189       Toelichting 0 .. 1 bc-DisorderOfPregnancy Condition.note
Container.png 1190    Verrichting (Zwangerschap) 0 .. * bc-ObstetricProcedure Procedure
TS.png 1191       VerrichtingStartDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.start
TS.png 1192       VerrichtingEindDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.end
PQ.png 3408       Zwangerschapsduur 0 .. 1 zib-Pregnancy-PregnancyDuration Observation.value[x]:valueQuantity
CD.png 1193       VerrichtingAnatomischeLocatie 0 .. 1 bc-ObstetricProcedure Procedure.bodySite
CD.png 1194       VerrichtingLateraliteit 0 .. 1 bc-ObstetricProcedure Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
Container.png 1195       Indicatie 0 .. * bc-ObstetricProcedure Procedure.reasonReference
Container.png 1207          Probleem (Zwangerschap) 0 .. 1 bc-ObstetricProcedure Procedure.reasonReference
CD.png 1197       VerrichtingType 1 .. 1 bc-ObstetricProcedure Procedure.code
CD.png 1198       VerrichtingMethode 0 .. * bc-ObstetricProcedure Procedure.extension:procedureMethod
Container.png 1199       MedischHulpmiddel 0 .. * bc-ObstetricProcedure Procedure.focalDevice.manipulated
Container.png 10433          MedischHulpmiddel 0 .. 1 zib-MedicalDeviceProduct Device
Container.png 1201       Locatie 0 .. 1 bc-ObstetricProcedure Procedure.performer
Container.png 1312          Zorgaanbieder 0 .. 1 bc-ObstetricProcedure Procedure.performer
Container.png 1203       Uitvoerder 0 .. * bc-ObstetricProcedure Procedure.performer
Container.png 1310          Zorgverlener 0 .. 1 bc-ObstetricProcedure Procedure.performer
Container.png 1205       Aanvrager 0 .. * zib-ProcedureRequest ProcedureRequest.requester
Container.png 1311          Zorgverlener 0 .. 1 zib-ProcedureRequest ProcedureRequest.requester
Container.png 37 Bevalling 0 .. 1 bc-DeliveryProcedure Procedure
II.png 3411    Partusnummer 0 .. 1 bc-DeliveryProcedure Procedure.identifier
PQ.png 10694    Zwangerschapsduur 1 .. 1 zib-Pregnancy-PregnancyDuration Observation.value[x]:valueQuantity
Container.png 1564    Probleem (Maternaal) 0 .. * bc-DisorderOfLaborAndDelivery Condition
CD.png 1565       ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.bodySite
CD.png 1566       ProbleemLateraliteit 0 .. 1 bc-DisorderOfLaborAndDelivery Condition
CD.png 1567       ProbleemType 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.category
CD.png 1568       ProbleemNaam 1 .. 1 bc-DisorderOfLaborAndDelivery Condition.code
CD.png 7917       Vermoeden iuvd op basis van 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.evidence.code
TS.png 1569       ProbleemBeginDatum 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.onsetDateTime:onsetDateTime
TS.png 1570       ProbleemEindDatum 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.abatementDateTime:abatementDateTime
PQ.png 3412       Zwangerschapsduur 1 .. 1 zib-Pregnancy-PregnancyDuration Observation
CD.png 1571       ProbleemStatus 1 .. 1 bc-DisorderOfLaborAndDelivery Condition.clinicalStatus
CD.png 1572       VerificatieStatus 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.verificationStatus
ST.png 1573       Toelichting 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.note
Container.png 1547    Verrichting (Maternaal) 0 .. * bc-ObstetricProcedure Procedure
TS.png 1548       VerrichtingStartDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.start
TS.png 1549       VerrichtingEindDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.end
PQ.png 3413       Zwangerschapsduur 0 .. 1 zib-Pregnancy-PregnancyDuration Observation
CD.png 1550       VerrichtingAnatomischeLocatie 0 .. 1 bc-ObstetricProcedure Procedure.bodySite
CD.png 1551       VerrichtingLateraliteit 0 .. 1 bc-ObstetricProcedure Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
Container.png 1552       Indicatie 0 .. * bc-ObstetricProcedure Procedure.reasonReference
Container.png 1583          Probleem (Maternaal) 0 .. 1 bc-ObstetricProcedure Procedure.reasonReference
CD.png 1554       VerrichtingType 1 .. 1 bc-ObstetricProcedure Procedure.code
CD.png 10280       Moment amniotomie 0 .. 1 bc-ObstetricProcedure Procedure.extension:partusPhase
CD.png 1555       VerrichtingMethode 0 .. * bc-ObstetricProcedure Procedure.extension:procedureMethod
Container.png 1556       MedischHulpmiddel 0 .. * bc-ObstetricProcedure Procedure.focalDevice
Container.png 10434          MedischHulpmiddel 0 .. 1 zib-MedicalDeviceProduct Device
Container.png 1558       Locatie 0 .. 1 bc-ObstetricProcedure Procedure.performer
Container.png 10435          Zorgaanbieder 0 .. 1 nl-core-organization Organization
Container.png 1560       Uitvoerder 0 .. * bc-ObstetricProcedure Procedure.performer
Container.png 10436          Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 1562       Aanvrager 0 .. * zib-ProcedureRequest ProcedureRequest.requester
Container.png 10438          Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 38    Ontsluitingsfase 0 .. 1 nvt
Container.png 4084       Actieve Ontsluiting (Observatie) 1 .. 1 bc-DeliveryObservation Observation
TS.png 4085          ObservatieDatumTijd 0 .. 1 bc-DeliveryObservation Observation.effective[x]:effectiveDateTime
TS.png 4087          BeginActieveOntsluitingWaarde 1 .. 1 bc-DeliveryObservation Observation.value[x]:valueDateTime
CD.png 4088          ObservatieMethode 0 .. 1 bc-DeliveryObservation Observation.method
ST.png 4095          Toelichting 0 .. 1 bc-DeliveryObservation Observation.comment
Container.png 4096       Wijze Begin Baring (Observatie) 1 .. 1 bc-DeliveryObservation Observation
TS.png 4097          ObservatieDatumTijd 0 .. 1 bc-DeliveryObservation Observation.effective[x]:effectiveDateTime
CD.png 4099          BeginBaringWaarde 1 .. 1 bc-DeliveryObservation Observation.value[x]:valueCodeableConcept
CD.png 4100          ObservatieMethode 0 .. 1 bc-DeliveryObservation Observation.method
ST.png 4107          Toelichting 0 .. 1 bc-DeliveryObservation Observation.comment
Container.png 39    Uitdrijvingsfase 0 .. * bc-Birth Procedure
Container.png 9685       Patient 0 .. 1 bc-Woman Patient
Container.png 4144       Type Partus (Observatie) 1 .. 1 bc-BirthObservation Observation
TS.png 4145          ObservatieDatumTijd 0 .. 1 bc-BirthObservation Observation.effective[x]:effectiveDateTime
CD.png 4147          TypePartusWaarde 1 .. 1 bc-BirthObservation Observation.value[x]:valueCodeableConcept
CD.png 4148          ObservatieMethode 0 .. 1 bc-BirthObservation Observation.method
ST.png 4155          Toelichting 0 .. 1 bc-BirthObservation Observation.comment
Container.png 4193       Werkelijke plaats baring (type locatie) (Observatie) 1 .. 1 bc-DeliveryObservation Observation
TS.png 4194          ObservatieDatumTijd 0 .. 1 bc-DeliveryObservation Observation.effective[x]:effectiveDateTime
CD.png 4196          WerkelijkePlaatsBaringWaarde 1 .. 1 bc-DeliveryObservation Observation.value[x]:valueCodeableConcept
CD.png 4197          ObservatieMethode 0 .. 1 bc-DeliveryObservation Observation.method
ST.png 4204          Toelichting 0 .. 1 bc-DeliveryObservation Observation.comment
Container.png 1587       Ziekenhuis baring 0 .. 1 bc-DeliveryProcedure Procedure.performer.actor
Container.png 1588          Zorgaanbieder 0 .. 1 nl-core-organization Organization
Container.png 1591       Probleem (Kindspecifieke maternale problemen) 0 .. * bc-DisorderOfLaborAndDelivery Condition
CD.png 1592          ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.bodySite
CD.png 1593          ProbleemLateraliteit 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 1594          ProbleemType 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.category
CD.png 1595          ProbleemNaam 1 .. 1 bc-DisorderOfLaborAndDelivery Condition.code
TS.png 1596          ProbleemBeginDatum 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.onsetDateTime:onsetDateTime
TS.png 1597          ProbleemEindDatum 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.abatementDateTime:abatementDateTime
CD.png 1598          ProbleemStatus 1 .. 1 bc-DisorderOfLaborAndDelivery Condition.clinicalStatus
CD.png 1599          VerificatieStatus 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.verificationStatus
ST.png 1600          Toelichting 0 .. 1 bc-DisorderOfLaborAndDelivery Condition.note
Container.png 1603       Verrichting (Kindspecifieke maternale verrichtingen) 0 .. * bc-ObstetricProcedure Procedure
TS.png 1604          VerrichtingStartDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.start
TS.png 1605          VerrichtingEindDatum 0 .. 1 bc-ObstetricProcedure Procedure.performed[x]:performedPeriod.end
CD.png 1606          VerrichtingAnatomischeLocatie 0 .. 1 bc-ObstetricProcedure Procedure.bodySite
CD.png 1607          VerrichtingLateraliteit 0 .. 1 bc-ObstetricProcedure Procedure.bodySite.extension:ProcedureLaterality.valueCodeableConcept:valueCodeableConcept
Container.png 1608          Indicatie 0 .. * bc-ObstetricProcedure Procedure.reasonReference
Container.png 1620             Probleem (Kindspecifieke maternale problemen) 0 .. 1 bc-ObstetricProcedure Procedure.reasonReference
CD.png 1610          VerrichtingType 1 .. 1 bc-ObstetricProcedure Procedure.code
CD.png 7919          Beslismoment sectio caesarea 0 .. 1 bc-ObstetricProcedure Procedure.extension:decisionMoment
CD.png 1611          VerrichtingMethode 0 .. * bc-ObstetricProcedure Procedure.extension:procedureMethod
Container.png 1612          MedischHulpmiddel 0 .. * bc-ObstetricProcedure Procedure.focalDevice
Container.png 10452             MedischHulpmiddel 0 .. 1 zib-MedicalDeviceProduct Device
Container.png 1614          Locatie 0 .. 1 bc-ObstetricProcedure Procedure.performer
Container.png 10453             Zorgaanbieder 0 .. 1 nl-core-organization Organization
Container.png 1616          Uitvoerder 0 .. * bc-ObstetricProcedure Procedure.performer
Container.png 10454             Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 10455          Aanvrager 0 .. * zib-procedurerequest ProcedureRequest.requester
Container.png 10457             Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 1404 Kind 0 .. * bc-Child Patient
Container.png 1754    Demografische gegevens 1 .. 1 bc-Child Patient
Container.png 1378       Patient 1 .. 1 bc-Child Patient
Container.png 1407    Lichamelijk onderzoek kind 0 .. 1 nvt
Container.png 1418       Geboortegewicht (Lichaamsgewicht) 0 .. 1 bc-ChildObservation Observation
PQ.png 1419          GewichtWaarde 1 .. 1 bc-ChildObservation Observation.value[x]:valueQuantity
PQ.png 1423          PercentielGeboortegewicht 0 .. 1 bc-ChildObservation Observation.interpretation
ST.png 1420          Toelichting 0 .. 1 bc-ChildObservation Observation.comment
TS.png 1421          GewichtDatumTijd 0 .. 1 bc-ChildObservation Observation.effective[x]:effectiveDateTime
CD.png 1422          Kleding 0 .. 1 bc-ChildObservation Observation.component:clothing.value[x]:valueCodeableConcept
Container.png 1424       Lichaamslengte 0 .. * zib-BodyHeight Observation
PQ.png 1425          LengteWaarde 1 .. 1 zib-BodyHeight Observation.value[x]:valueQuantity
TS.png 1426          LengteDatumTijd 0 .. 1 zib-BodyHeight Observation.effective[x]:effectiveDateTime
ST.png 1427          Toelichting 0 .. 1 zib-BodyHeight Observation.comment
Container.png 1429       Schedelomvang 0 .. * zib-HeadCircumference Observation
CD.png 1430          SchedelomvangMeetmethode 0 .. 1 zib-HeadCircumference Observation.method
ST.png 1431          Toelichting 0 .. 1 zib-HeadCircumference Observation.comment
PQ.png 1432          SchedelomvangWaarde 1 .. 1 zib-HeadCircumference Observation.value[x]:valueQuantity
TS.png 1433          SchedelomvangDatumTijd 0 .. 1 zib-HeadCircumference Observation.effective[x]:effectiveDateTime
Container.png 1765       Bevindingen 0 .. 1 bc-ChildObservation Observation
Container.png 2706          Algemene indruk 1 .. 1 bc-ChildObservation Observation
Container.png 1408             ApgarScore1min 1 .. 1 zib-ApgarScore Observation
INT.png 1410                ApgarScoreTotaal 1 .. 1 zib-ApgarScore Observation.value[x]:valueQuantity
Container.png 9663             ApgarScore5min 1 .. 1 zib-ApgarScore Observation
INT.png 9665                ApgarScoreTotaal 1 .. 1 zib-ApgarScore Observation.value[x]:valueQuantity
Container.png 9672             ApgarScore10min 0 .. 1 zib-ApgarScore Observation
INT.png 9674                ApgarScoreTotaal 1 .. 1 zib-ApgarScore Observation.value[x]:valueQuantity
Container.png 1123 Medisch onderzoek 0 .. * nvt
Container.png 2416    Verrichting (Onderzoek) 0 .. 1 zib-Procedure Procedure
2417       VerrichtingStartDatum 1 .. 1 zib-Procedure Procedure.effectivePeriod.start
TS.png 2418       VerrichtingEindDatum 1 .. 1 zib-Procedure Procedure.effectivePeriod.end
CD.png 2419       VerrichtingAnatomischeLocatie 0 .. 1 zib-Procedure Procedure.bodySite
CD.png 2420       VerrichtingLateraliteit 0 .. 1 zib-Procedure Procedure.bodySite.extension:ProcedureLaterality.value[x]:valueCodeableConcept
Container.png 2421       Indicatie 0 .. 1 zib-Procedure Procedure.reasonReference
Container.png 2422          Probleem 0 .. 1 zib-Problem Condition
CD.png 2423       VerrichtingType 1 .. 1 bc-ObstetricProcedure Procedure.code
CD.png 2424       VerrichtingMethode 0 .. 1 bc-ObstetricProcedure Procedure.extension:procedureMethod
Container.png 2425       MedischHulpmiddel 0 .. 1 bc-ObstetricProcedure Procedure.focalDevice
Container.png 10474          MedischHulpmiddel 0 .. 1 zib-MedicalDeviceProduct Device
Container.png 2427       Locatie 0 .. 1 bc-ObstetricProcedure Procedure.performer.actor
Container.png 2433          Zorgaanbieder 0 .. 1 nl-core-organization Organization
Container.png 2429       Uitvoerder 0 .. 1 bc-ObstetricProcedure Procedure.performer.actor
Container.png 2434          Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 2431       Aanvrager 0 .. 1 zib-ProcedureRequest Procedure.Requestrequester
Container.png 2435          Zorgverlener 0 .. 1 nl-core-practitioner Practitioner
Container.png 1124    Maternale onderzoeksgegevens 1 .. 1 bc-MaternalObservation Observation
Container.png 1125       Urine-, bloed- en aanvullende onderzoeken 1 .. * zib-LaboratoryTestResult-Observation Observation
Container.png 1126          PSIE 0 .. * zib-LaboratoryTestResult-Observation Observation
Container.png 1128             LaboratoriumTest_Bloedgroep 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 1129                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
CD.png 1132                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 1140             LaboratoriumTest_Rhesus D 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 1141                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
CD.png 1144                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 1152             LaboratoriumTest_Rhesus c 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 1153                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
CD.png 1156                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 1640             LaboratoriumTest_ HBsAg 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2367                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 1644                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
CD.png 1649                InterpretatieVlaggen 0 .. 1 zib-LaboratoryTestResult-Observation Observation.interpretation
Container.png 2356             LaboratoriumTest_HIV 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2357                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
CD.png 2360                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
Container.png 2368             LaboratoriumTest_Lues 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2369                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2372                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
CD.png 2377                InterpretatieVlaggen 0 .. 1 zib-LaboratoryTestResult-Observation Observation.interpretation
Container.png 3501             Irregulaire antistoffen (Observatie) 0 .. 1 zib-LaboratoryTestResult-Observation Observation
TS.png 3502                IrregulaireAntistoffenDatumTijd 0 .. 1 zib-LaboratoryTestResult-Observation Observation.effective[x]:effectiveDateTime
BL.png 3503                IrregulaireAntistoffenWaarde 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueBoolean
CD.png 3504                WelkeAntistoffenWaarde 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueCodeableConcept
ST.png 3505                Toelichting 0 .. 1 zib-LaboratoryTestResult-Observation Observation.comment
Container.png 2379          LaboratoriumTest_Hb 0 .. * zib-LaboratoryTestResult-Observation Observation
CD.png 2380             TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2383             TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2401          Hb typering 0 .. * zib-LaboratoryTestResult-Observation Observation
Container.png 2491             LaboratoriumTest_MCV 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2492                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2495                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2513             LaboratoriumTest_Vitamine B12 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2514                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2517                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2545             LaboratoriumTest_Actief-B12 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2546                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2549                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2524             LaboratoriumTest_Ferritine 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2525                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2528                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2502             LaboratoriumTest_Foliumzuur 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2503                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2506                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 2535             Probleem_Hb-pathie 0 .. * zib-Problem Condition
CD.png 2538                ProbleemType 0 .. 1 zib-Problem Condition.category
CD.png 2539                ProbleemNaam 0 .. 1 zib-Problem Condition.code
TS.png 2540                ProbleemBeginDatum 0 .. 1 zib-Problem Condition.onset[x]:onsetDateTime
TS.png 2541                ProbleemEindDatum 0 .. 1 zib-Problem Condition.abatement[x]:abatementDateTime
CD.png 2542                ProbleemStatus 1 .. 1 zib-Problem Condition.clinicalStatus
CD.png 2543                VerificatieStatus 0 .. 1 zib-Problem Condition.verificationStatus
ST.png 2544                Toelichting 0 .. 1 zib-Problem Condition.note
Container.png 1651          Schildklierdiagnostiek 0 .. 1 zib-LaboratoryTestResult-Observation Observation
Container.png 1652             LaboratoriumTest_VrijT4, TSH & TSH receptor antistoffen 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 1653                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 1656                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png 1663          TORCH 0 .. 1 zib-LaboratoryTestResult-Observation Observation
Container.png 2390             LaboratoriumTest_TORCH 0 .. 1 zib-LaboratoryTestResult-Observation Observation
CD.png 2391                TestCode 1 .. 1 zib-LaboratoryTestResult-Observation Observation.code
PQ.png 2394                TestUitslag 1 .. 1 zib-LaboratoryTestResult-Observation Observation.value[x]:valueQuantity
Container.png

4.2 XIS: response message

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

5 FHIR profiles

Em.png

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:

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.

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 ApgarScore Observation ApgarScore http://nictiz.nl/fhir/StructureDefinition/zib-ApgarScore
zib BloodPressure Observation BloodPressure http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure
zib BodyHeight Observation BodyHeight http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight
zib BodyWeight Observation BodyWeight http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight
zib DrugUse Observation DrugUse http://nictiz.nl/fhir/StructureDefinition/zib-DrugUse
zib HeadCircumference Observation HeadCircumference http://nictiz.nl/fhir/StructureDefinition/zib-HeadCircumference
zib LaboratoryTestResult-Observation Observation LaboratotoryTestResult http://nictiz.nl/fhir/StructureDefinition/zib-LaboratoryTestResult-Observation
zib MedicalDeviceProduct Observation MedicalDevice http://nictiz.nl/fhir/StructureDefinition/zib-MedicalDeviceProduct
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 Pregnancy-PregnancyDuration Observation http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy-PregnancyDuration
zib Pregnancy-TermDate Observation http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy-TermDate
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-Birth Procedure Procedure http://nictiz.nl/fhir/StructureDefinition/bc-Birth A Procedure profile describing the birth of a child as defined by BabyConnect.

This groups findings and procedures related to a particular child in a delivery - important in multiple births. A pregnancy can lead to one delivery Procedure and one or multiple birth Procedures. In multiple birth, multiple birth instances point to the same delivery Procedure. A birth also provides the relation between a child and its mother: The mother Patient is the subject of the delivery Procedure and the child Patient is the subject of the birth Procedure.

A Birth has:

  • A partOf extension, pointing to the Delivery
  • The subject is the Child
  • The context is the Maternal Record EpisodeOfCare
  • The pregnancy is captured in the reasonReference
bc-Child Patient Patient http://nictiz.nl/fhir/StructureDefinition/bc-Child A Patient profile for the child Patient as defined by BabyConnect.

Child is a separate Patient.

bc-ChildObservation Child-related Observation Observation http://nictiz.nl/fhir/StructureDefinition/bc-ChildObservation An Observation profile describing child-related Observations (not captured in other existing profiles), as defined by BabyConnect. Child-related Observations, such as Apgar score and birthweight, pertain to the child Patient, which is the subject of the Observation. If the child is unborn and no patient record exists for the child, bc-FetusObservation should be used instead.
  • Child observations refer to the EpisodeOfCare with Observation.context.reference
bc-DeliveryObservation Pregnancy-related disorder 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 focus extension to point to the delivery Procedure they're about.
  • Delivery-related Observations refer to the EpisodeOfCare with Observation.context.reference
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 refers to the EpisodeOfCare with Procedure.context.reference
  • Delivery refers to the Pregnancy with 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-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 with Condition.context.reference
  • A ConceptMap is available to map verification status to accepted FHIR codes
bc-DisorderOfLaborAndDelivery 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 part of extension.
  • Delivery-related Disorders use partOf extension to point to Condition they're about.
  • Delivery-related Conditions refer to the EpisodeOfCare with 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 partOf extension to point to 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 with Observation.context.reference
bc-DisorderPostPartum 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 optional other Conditions)
  • Encounter.serviceProvider points to the responsible Organization for the Encounter
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:
  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 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-MaternalObservation 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-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:

  1. The (overarching) maternal record groups all data related to one pregnancy (.type = 364320009)
  2. 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 a EpisodeOfCare.context.reference element. (Note: different providers may each have their own Condition resource.)
  • EpisodeOfCare points to the Condition through a EpisodeOfCare.diagnosis.condition element.
  • Condition points to the Patient with Condition.subject.reference
  • Condition.status must be 'active' for ongoing pregnancies and 'inactive' for past ones.
bc-MotherOf 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 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-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 with 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.

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.

Overgenomen van "https://informatiestandaarden.nictiz.nl/index.php?title=MedMij:Vissue-GZ-1423-1443/FHIR_Pregnancy_Card&oldid=192006"