BgZ medisch-specialistische zorg Technical Implementation Guide 2.0
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Dit is een tijdelijke pagina met wijzigingen voor issue NICTIZ-14348. De gepubliceerde versie vind je hier. |
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This article or section is in the middle of an expansion or major restructuring and is not yet ready for use. |
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1 Introduction
2 Background
3 About this document
4 Glossary
5 Boundaries and Relationships
6 Systems and System Roles
System roles are further defined through the Healthcare Information Exchange model of "Registratie aan de Bron" ("Register at the source").
BgZ-compliant systems should use HCIMs with appropriate metadata, not only in exchange but also when recording and processing data. Since HCIMs do not have many mandatory items, a sparsely filled BgZ would easily be compliant for exchange. The need however is to be able to record, exchange and process the full HCIMs. Therefore, it is a requirement for a Storing System to register the full HCIMs, for an Exchanging System to provide the full HCIMs and for a Processing System to process the entire zib.
Further requirements are specified in:
- the HCIM definitions and technical artefacts
- the Qualification Scenario's
- in the Metadata see FO (add link)
7 Use Cases
7.1 Verzenden BgZ
7.1.1 Actors
| Persons | Systems | ||
|---|---|---|---|
| Name | Description | Name | Description |
| Referring medical specialist | Medical specialist who sends a BgZ along with a referral | EHR | Electronic health record |
| Receiving medical specialist | Medical specialist receives a BgZ along with a referral | EHR | Electronic health record |
7.1.2 Transactions
7.1.2.1 Send BgZ using Notified Pull communication pattern
7.1.2.2 Send BgZ using Push operation
using NP
7.2 Opvragen BgZ
(out of scope V2.0)
7.2.1 Actors
| Persons | Systems | ||
|---|---|---|---|
| Name | Description | Name | Description |
| to do... Source System that is queried for the BgZ | to do... | EHR | Electronic health record |
| Querying medical specialist | Medical specialist who queries for a BgZ | EHR | Electronic health record |
7.2.2 Transactions
7.2.2.1 Query BgZ using Pull operation
8 Query Coding Schemes
LOINC / SNOMED-CT codes identifying BgZ MSZ items
| HCIM Code System | Code | System |
|---|---|---|
| Patient MaritalStatus ContactPerson HealthProfessional |
79191-3 | http://loinc.org |
| Payer | 48768-6 | http://loinc.org |
| TreatmentDirective | 11291000146105 | http://snomed.info/sct |
| AdvanceDirective | 11341000146107 | http://snomed.info/sct |
| FunctionalOrMentalStatus | 47420-5 | http://loinc.org |
| Problem | 11450-4 | http://loinc.org |
| LivingSituation | 365508006 | http://snomed.info/sct |
| DrugUse | 228366006 | http://snomed.info/sct |
| AlcoholUse | 228273003 | http://snomed.info/sct |
| TobaccoUse | 365980008 | http://snomed.info/sct |
| NutritionAdvice | 11816003 | http://snomed.info/sct |
| Alert | 75310-3 | http://loinc.org |
| AllergyIntolerance | 48765-2 | http://loinc.org |
| MedicationAgreement | 16076005 | http://snomed.info/sct |
| AdministrationAgreement | 422037009 | http://snomed.info/sct |
| MedicationUse2 | 422979000 | http://snomed.info/sct |
| MedicalDevice | 46264-8 | http://loinc.org |
| Vaccination | 11369-6 | http://loinc.org |
| BloodPressure | 85354-9 | http://loinc.org |
| BodyWeight | 29463-7 | http://loinc.org |
| BodyHeight | 8302-2 | http://loinc.org |
| LaboratoryTestResult | 15220000 | http://snomed.info/sct |
| Procedure | 47519-4 | http://loinc.org |
| Encounter | 46240-8 | http://loinc.org |
| PlannedCareActivityForTransfer | 18776-5 | http://loinc.org |
9 FHIR Queries
The XIS requests the BgZ using individual search interactions. The BgZ consists of multiple FHIR resources with certain constraints. To obtain the patient's BgZ, 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]}
The table below shows in the first four columns the BgZ sections, the HCIMs that constitute those sections and the specific content of the BgZ. The last column shows the FHIR search queries to obtain the BgZ information. These queries and expected responses are based on profiles listed in this section.
| # | BgZ Section | HCIM EN | Content | Search URL[1] | ||||
|---|---|---|---|---|---|---|---|---|
| 1 | Patient information | Patient | Identification, birth date, gender, deceased indicator, contact details, last known marital status, and general practitioner (practitioner or organization) | GET [base]/Patient?_include=Patient:general-practitioner | ||||
| 2 | Payment details | Payer | Insurance information | GET [base]/Coverage?_include=Coverage:payor:Patient&_include=Coverage:payor:Organization | ||||
| 3 | Treatment directives | TreatmentDirective | Known treatment directives | GET [base]/Consent?category=http://snomed.info/sct|11291000146105 | ||||
| AdvanceDirective | Known advance directives | GET [base]/Consent?category=http://snomed.info/sct|11341000146107 | ||||||
| 4 | Contact persons | ContactPerson | First relation/contact | see Patient | ||||
| 5 | Functional status | FunctionalOrMentalStatus | Last known functional / mental status | GET [base]/Observation/$lastn?category=http://snomed.info/sct|118228005,http://snomed.info/sct|384821006
| ||||
| 6 | Problems | Concern | All known problems | GET [base]/Condition | ||||
| 7 | Social history | LivingSituation | Current living situation | GET [base]/Observation/$lastn?code=http://snomed.info/sct|365508006 | ||||
| DrugUse | All known drug use | GET [base]/Observation?code=http://snomed.info/sct|228366006 | ||||||
| AlcoholUse | All known alcohol use | GET [base]/Observation?code=http://snomed.info/sct|228273003 | ||||||
| TobaccoUse | All known tobacco use | GET [base]/Observation?code=http://snomed.info/sct|365980008 | ||||||
| NutritionAdvice | All known dietary recommendations | GET [base]/NutritionOrder | ||||||
| 8 | Alerts | Alert | All known alerts | GET [base]/Flag | ||||
| 9 | Allergies | AllergyIntolerance | All known information regarding allergies | GET [base]/AllergyIntolerance | ||||
| 10 | Medication | MedicationUse | Known medication use | todo ref MP9 | ||||
| MedicationAgreement | Known medication agreements | todo ref MP9 | ||||||
| AdministrationAgreement | Known administration agreements | todo ref MP9 | ||||||
| 11 | Medical aids | MedicalDevice | Known medical aids | GET [base]/DeviceUseStatement?_include=DeviceUseStatement:device | ||||
| 12 | Vaccinations | Vaccination | Known vaccinations | GET [base]/Immunization?status=completed | ||||
| 13 | Vital signs | BloodPressure | Last known blood pressure | GET [base]/Observation/$lastn?code=http://loinc.org|85354-9 | ||||
| BodyWeight | Last known body weight | GET [base]/Observation/$lastn?code=http://loinc.org|29463-7 | ||||||
| BodyHeight | Last known body height | GET [base]/Observation/$lastn?code=http://loinc.org|8302-2,http://loinc.org|8306-3,http://loinc.org|8308-9 | ||||||
| 14 | Results | LaboratoryTestResult | Last known laboratory results per type | GET [base]/Observation/$lastn?category=http://snomed.info/sct|275711006&_include=Observation:related-target&_include=Observation:specimen | ||||
| 15 | Procedures | Procedure | Known surgical procedures | GET [base]/Procedure?category=http://snomed.info/sct|387713003 | ||||
| 16 | Encounters | Contact | Known hospital admissions (no outpatient contacts) | GET [base]/Encounter?class=http://hl7.org/fhir/v3/ActCode|IMP,http://hl7.org/fhir/v3/ActCode|ACUTE,http://hl7.org/fhir/v3/ActCode|NONAC | ||||
| 17 | Planned care | PlannedCareActivityForTransfer | Known planned care activities |
GET [base]/ProcedureRequest?status=active GET [base]/ImmunizationRecommendation GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication
GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device GET [base]/Appointment?status=booked,pending,proposed | ||||
| 18 | Care setting | HealthProfessional | General Practitioner of the patient | todo query HealthProfessional |
||||
| HealthProvider | Health provider of the patient | todo query HealthProvider |
10 FHIR Profiles
10.1 Notification Task
10.2 Workflow Task
10.3 Referenced BgZ Resources
The profiles represent their entire respective HCIM, to make them applicable in a broader context than the exchange of BgZ or a MedMij context. An example of reuse of existing profiles is those of the patient administration resources and vital signs.
11 Infrastructure
This standard does not mandate a particular infrastructure, and therefore does not specify details for such an infrastructure.
TODO: Say something about infrastructure and use of generic functions
Useful materials from other parties can be found on:
12 References
| Reference | Document Title | Date, Version, Source |
| [1] | Kwaliteitsstandaard - Uitwisseling Basisgegevensset Zorg tussen instellingen waar medisch-specialistische zorg wordt verleend
Translates as “Exchange of BgZ between institutions where specialist medical care is provided” |
Commentaarfase februari 2023 |
| [2] | NEN 7540:2024 BgZ-uitwisseling tussen instellingen voor medisch specialistische zorg
Translates as “BgZ exchange between institution for specialist medical care” |
ICS 11.020.01;35.240.80 maart 2024 |
| [3] | Technical Agreement - Exchanging FHIR Data using a generic Notified Pull mechanism | Version: 1.0.0 06-03-24 |
13 Release Notes
Changes compared to previous release.
| BITS ticket | Short description |
|---|---|
| NICTIZ-14769 | Ontwikkelen/schrijven van de TO in de wiki |
- ↑ See Search URLs and search parameters for the interpretation of these search URLs
