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(Use cases dataset 2.3)
(List of resources and relations between them)
 
(19 tussenliggende versies door 2 gebruikers niet weergegeven)
Regel 1: Regel 1:
 
{{DISPLAYTITLE:FHIR Implementation Guide BirthCare v1.1 | FHIR Implementation Guide BirthCare}}
 
{{DISPLAYTITLE:FHIR Implementation Guide BirthCare v1.1 | FHIR Implementation Guide BirthCare}}
 
<imagemap>Bestand:Afsprakenstelsel-functioneel-technisch-banner_00_alle.png|center|500px|alt=Afspraken-Functioneel-Technisch   
 
<imagemap>Bestand:Afsprakenstelsel-functioneel-technisch-banner_00_alle.png|center|500px|alt=Afspraken-Functioneel-Technisch   
circle 241 216 211 [[Gebz:V2.3_Babyconnect | Afsprakenstelsel]]
+
circle 241 216 211 [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/97813647/Afsprakenstelsel+Interoperabiliteit+Geboortezorg | Afsprakenstelsel]
circle 1013 224 212 [[Gebz:V2.3_Ontwerpen | Functioneel]]              
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circle 1013 224 212 [[Gebz:V3.2_Ontwerpen | Functioneel]]    
 
circle 1787 230 212 [[Gebz:V1.0_FHIR_IG | Technisch]]                 
 
circle 1787 230 212 [[Gebz:V1.0_FHIR_IG | Technisch]]                 
 
desc none                     
 
desc none                     
Regel 10: Regel 10:
 
This page details the HL7 FHIR requirements for exchanging the BirthCare (Geboortezorg) data.
 
This page details the HL7 FHIR requirements for exchanging the BirthCare (Geboortezorg) data.
  
The functional view for BirthCare (Geboortezorg) 2.3 is described in [[Gebz:V2.3_Ontwerpen | Functioneel]]. Functional specifications for other datasets will follow.
+
The FHIR Implementation Guide for BirthCare is '''independent of the functional specifications'''. We expect the FHIR BirthCare IG to be compliant with datasets 2.3, 3.1 and 3.2. We do expect backwards compatible additions to the FHIR BirthCare IG for the latter datasets. The FHIR BirthCare IG does contain '''version-specific mappings''' to the various datasets, for now only 2.3 and 3.2 mappings.
  
The FHIR Implementation Guide for BirthCare is '''independent of the functional specifications'''. We expect the FHIR BirthCare IG to be compliant with datasets 2.3, 3.1 and 3.2. We do expect backwards compatible additions to the FHIR BirthCare IG for the latter datasets. The FHIR BirthCare IG does contain '''version-specific mappings''' to the various datasets, for now only 2.3 and 3.2 mappings.
+
The functional view for BirthCare (Geboortezorg) 3.2 is described in [[Gebz:V3.2_Ontwerpen | Functioneel]].  
 +
The functional view for BirthCare (Geboortezorg) 2.3 is described in [[Gebz:V2.3_Ontwerpen | Functioneel]].  
 +
Functional specifications for other datasets will follow.
  
 
Technical details of the FHIR resources and structure definitions described in this Implementation Guide (IG) can be found in the [https://simplifier.net/geboortezorg-stu3 Simplifier Geboortezorg STU3 project]. This IG provides links to the required resources and structure definitions for each use case.
 
Technical details of the FHIR resources and structure definitions described in this Implementation Guide (IG) can be found in the [https://simplifier.net/geboortezorg-stu3 Simplifier Geboortezorg STU3 project]. This IG provides links to the required resources and structure definitions for each use case.
  
A high level overview:
+
==A high level overview==
  
 
[[Bestand:Fhir-model-overview.png]]
 
[[Bestand:Fhir-model-overview.png]]
Regel 22: Regel 24:
 
=FHIR Resources and StructureDefinitions=
 
=FHIR Resources and StructureDefinitions=
 
==Types of resources and relations between them==
 
==Types of resources and relations between them==
For Observations, which are often very similar, we follow patterns: an implementer will only need to implement the pattern and an associated table with codes, and be able to support all Observations. So for Observations pertaining to a particular pregnancy (not to the woman - she may have multiple pregnancies on record, neither to the delivery) all Observations will link to the Pregnancy Condition. So instead of having to inspect StructureDefinitions separately for each pregnancy observations, following a single pattern will do. The pattern has it's own StructureDefinition, so the FHIR profile is still complete. Likewise Observations for the mother, delivery and child follow patterns. See links below.
+
===Pregnancy and maternal record===
 +
A pregnancy (Condition) starts with a pregnant woman (Patient). Her data is registered in a maternal record (EpisodeOfCare). The maternal record contains references to the pregnant woman (subject), the pregnancy (condition), the care manager (careManager:Practitioner) and managing organization (managingOrganization:Organization).
 +
 
 +
[[Bestand:Gebz-pregnancy.PNG]]
 +
 
 +
===Birth and Delivery===
 +
If all goes well a pregnancy ends with a delivery (Procedure). A delivery is related to the mother (subject). It has 3 stages: 1. dilation, 2. birth of one or more children and 3. afterbirth. There are no separate resource for the first and third stages of delivery, but the second stage of delivery is another Procedure, which is related to the child (subject). The Birth Procedure is part of the Delivery Procedure and in case of a multiple pregnancy, multiple Birth Procedures can be part of the same Delivery Procedure.
 +
 
 +
[[Bestand:Gebz-delivery.PNG]]
 +
 
 +
===Obstetric procedures===
 +
Obstetric procedures are procedures related to pregnancy, birth and delivery. These procedures can be part of (partOf) a Birth Procedure (in case of child-related procedures, like a c-section) or a Delivery Procedure (in case of maternal procedures, like a blood transfusion). The partOf element can also be left blank when the procedure is linked to the pregnancy (record), but not to birth and delivery.
 +
 
 +
===Relations between pregnancy, birth and delivery===
 +
A pregnancy (Condition), birth (Procedure) and delivery (Procedure) are all related to a maternal record (EpisodeOfCare) through their context element, either with a direct reference to the EpisodeOfCare or an indirect reference to an Encounter which in itself is linked to the maternal record (EpisodeOfCare). In addition, the Birth and Delivery Procedures both include a reference to the pregnancy (reasonReference).
 +
 
 +
[[Bestand:Gebz-delivery-pregnancy.PNG]]
 +
 
 +
===Patterns===
 +
For Observations and Conditions, which are often very similar, we follow patterns: an implementer will only need to implement the pattern and an associated table with codes, and be able to support all Observations. So for Observations pertaining to a particular pregnancy (not to the woman - she may have multiple pregnancies on record, neither to the delivery) all Observations will link to the Pregnancy Condition. So instead of having to inspect StructureDefinitions separately for each pregnancy observations, following a single pattern will do. The pattern has it's own StructureDefinition, so the FHIR profile is still complete. Likewise Observations for the mother, delivery and child follow patterns.
 +
 
 +
Pattern tables can be found on individual pattern pages, see links below, and on [[Gebz:V2.3_FHIR_mapping_addendum]] for 2.3 mappings and [[Gebz:V3.2_FHIR_mapping_addendum]] for 3.2 mappings.
 +
 
 +
===Observation patterns===
 +
Observations follow patterns based on their subject (either the child or the mother patient) and their ''focal'' subject (either the pregnancy, birth or delivery), see table below. The use of ''focus'' extensions is a pre-adopt of FHIR R4, where it is part of Observation: "What the observation is about, when it is not about the subject of record." Focus is required for all Observations which do not pertain to the Patient. In R4, use of focus permits "reverse include" queries (give me all Observations with focus element X). In STU3, this could be a custom search.
 +
{| class="wikitable"
 +
|-
 +
| '''Pattern'''
 +
| '''Subject'''
 +
| '''Focus'''
 +
|-
 +
| Patient-related Observations
 +
| Mother patient
 +
| x
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-PregnancyObservation|Pregnancy-related Observations]]
 +
| Mother patient
 +
| Pregnancy
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-DeliveryObservation|Delivery-related Observations]]
 +
| Mother patient
 +
| Delivery
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-BirthObservation|Birth-related Observations]]
 +
| Mother patient
 +
| Birth
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-ChildObservation|Child-related Observations]]
 +
| Child patient
 +
| x
 +
|-
 +
|}
 +
 
 +
===Condition patterns===
 +
Conditions follow patterns based on their category (disorders related to either pregnancy, labor and delivery, postpartum or child disorders). Pregnancy, birth and delivery related disorders use partOf to link to these concepts, see table below.
 +
{| class="wikitable"
 +
|-
 +
| '''Pattern'''
 +
| '''Subject'''
 +
| '''Category'''
 +
| '''PartOf'''
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-DisorderOfPregnancy|Pregnancy-related disorder]]
 +
| Mother patient
 +
| 173300003
 +
| Pregnancy
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-DisorderOfLaborAndDelivery|Delivery-and-birth-related disorder]]
 +
| Mother patient
 +
| 362972006
 +
| Delivery
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-DisorderPostPartum|Postpartum disorder]]
 +
| Mother patient
 +
| 362973001
 +
| Delivery
 +
|-
 +
| [[Gebz:V1.1_FHIR_IG_bc-DisorderOfChild|Child-related disorder]]
 +
| Child patient
 +
| 414025005
 +
| x
 +
|-
 +
|}
 +
 
 +
==List of resources and relations between them==
 
{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
| '''Name'''
+
| '''Profile'''
 +
| '''Pattern'''
 
| '''FHIR resource'''
 
| '''FHIR resource'''
 
| '''Description'''
 
| '''Description'''
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-woman|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Woman (Vrouw)}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-woman|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Woman (Vrouw)}}
 +
|
 
|Patient
 
|Patient
 
|The core of each pregnancy is the pregnant woman, a FHIR Patient.
 
|The core of each pregnancy is the pregnant woman, a FHIR Patient.
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-maternalobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Maternal Observation (Bevinding vrouw)}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-maternalobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Maternal Observation (Bevinding vrouw)}}
 +
|
 
|Observation
 
|Observation
 
|Observations and findings related to the woman, before, during or after pregnancy childbirth. Examples are risk status or maternal ultrasound observations.
 
|Observations and findings related to the woman, before, during or after pregnancy childbirth. Examples are risk status or maternal ultrasound observations.
 
|-
 
|-
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Partner}}
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Partner}}
 +
|
 
|RelatedPerson
 
|RelatedPerson
 
|The partner of the pregnant woman (not necessarily the biological father).
 
|The partner of the pregnant woman (not necessarily the biological father).
 +
|
 
|-
 
|-
|Generic resources
 
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Practitioner}}, {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=PractitionerRole}}, {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Organization}}
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Practitioner}}, {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-practitionerrole|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=PractitionerRole}}, {{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-organization|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Organization}}
|Those are not used differently than in other Dutch projects.
+
|
 +
|Practitioner, PractitionerRole, Organization
 +
|Generic resources. Those are not used differently than in other Dutch projects.
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-referralrequest|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Referral details}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-referralrequest|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Referral details}}
 +
|
 
|ReferralRequest
 
|ReferralRequest
 
|Referral details (such as type of referral, reason code, referrer and target of the referral) are described in ReferralRequest. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare).  
 
|Referral details (such as type of referral, reason code, referrer and target of the referral) are described in ReferralRequest. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare).  
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-careteam|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Involvement pediatrician}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-careteam|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Involvement pediatrician}}
 +
|
 
|CareTeam
 
|CareTeam
 
|A CareTeam describes the involvement of different care providers, such as a pediatrician.  
 
|A CareTeam describes the involvement of different care providers, such as a pediatrician.  
Regel 56: Regel 150:
 
* The reason of involvement is described in CareTeam.reasonCode
 
* The reason of involvement is described in CareTeam.reasonCode
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-pregnancy|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Pregnancy}}, {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-maternalrecord|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Maternity Record}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/zib-pregnancy|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Pregnancy}}, {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-maternalrecord|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Maternity Record}}
 +
|
 
|Condition, EpisodeOfCare
 
|Condition, EpisodeOfCare
 
|Each pregnancy is a Condition. It is also represented as an EpisodeOfCare for each involved Organization. The pregnancy includes references to an Organization and responsible Practitioner. (Practitioners responsible for the actual data may be included there, i.e. in Procedures, Observations.)  
 
|Each pregnancy is a Condition. It is also represented as an EpisodeOfCare for each involved Organization. The pregnancy includes references to an Organization and responsible Practitioner. (Practitioners responsible for the actual data may be included there, i.e. in Procedures, Observations.)  
Regel 64: Regel 159:
 
* Condition.status must be 'active' for ongoing pregnancies and 'inactive' for past ones.
 
* Condition.status must be 'active' for ongoing pregnancies and 'inactive' for past ones.
 
|-
 
|-
 +
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-observation|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Patient-related Observations}}
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-observation|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Patient-related Observations}}
 
|{{Simplifier|http://fhir.nl/fhir/StructureDefinition/nl-core-observation|nictiz.fhir.nl.stu3.zib2017|pkgVersion=2.0.0|title=Patient-related Observations}}
 
|Observation
 
|Observation
Regel 69: Regel 165:
 
* Observations can refer to an EpisodeOfCare with Observation.context.reference
 
* Observations can refer to an EpisodeOfCare with Observation.context.reference
 
|-
 
|-
|[[Gebz:FHIR_bc-PregnancyObservation|Pregnancy-related Observations]]
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-pregnancyobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=PregnancyObservation}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-PregnancyObservation|Pregnancy-related Observations]]
 
|Observation
 
|Observation
 
|Observations such as gravidity and parity do not (only) pertain to the Patient but to a particular pregnancy.  
 
|Observations such as gravidity and parity do not (only) pertain to the Patient but to a particular pregnancy.  
Regel 75: Regel 172:
 
* Pregnancy-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
* Pregnancy-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
|-
 
|-
|[[Gebz:FHIR_bc-DisorderOfPregnancy|Pregnancy-related disorder]]
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderofpregnancy|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Pregnancy-related disorder}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-DisorderOfPregnancy|Pregnancy-related disorder]]
 
|Condition
 
|Condition
 
|Conditions such as cholestasis and hypertension do not (only) pertain to the Patient but to a particular pregnancy.  
 
|Conditions such as cholestasis and hypertension do not (only) pertain to the Patient but to a particular pregnancy.  
Regel 82: Regel 180:
 
* Pregnancy-related Conditions refer to the EpisodeOfCare with Observation.context.reference
 
* Pregnancy-related Conditions refer to the EpisodeOfCare with Observation.context.reference
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-childbirthassistance|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Childbirth Assistance}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-childbirthassistance|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Childbirth Assistance}}
 +
|
 
|Encounter
 
|Encounter
 
|Childbirth Assistance is modeled as an Encounter. The woman Patient is subject of the Encounter.
 
|Childbirth Assistance is modeled as an Encounter. The woman Patient is subject of the Encounter.
Regel 91: Regel 190:
 
* Childbirth Assistance refers to the EpisodeOfCare with Encounter.EpisodeOfCare.reference
 
* Childbirth Assistance refers to the EpisodeOfCare with Encounter.EpisodeOfCare.reference
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-deliveryprocedure|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Delivery (Bevalling)}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-deliveryprocedure|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Delivery (Bevalling)}}
 +
|
 
|Procedure
 
|Procedure
 
|Delivery is modeled with Procedure (even for uncomplicated natural births for consistency). A pregnancy can lead to one DeliveryProcedure even in multiple birth. The Patient is the subject.  
 
|Delivery is modeled with Procedure (even for uncomplicated natural births for consistency). A pregnancy can lead to one DeliveryProcedure even in multiple birth. The Patient is the subject.  
Regel 97: Regel 197:
 
* Delivery refers to the Pregnancy with Procedure.reasonReference.reference
 
* Delivery refers to the Pregnancy with Procedure.reasonReference.reference
 
|-
 
|-
|[[Gebz:FHIR_bc-DeliveryObservation|Delivery-related Observations]]
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-deliveryobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Delivery-related Observations}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-DeliveryObservation|Delivery-related Observations]]
 
|Observation
 
|Observation
 
|Observations such as onset of labor or blood loss pertain to a delivery Procedure.
 
|Observations such as onset of labor or blood loss pertain to a delivery Procedure.
Regel 103: Regel 204:
 
* Delivery-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
* Delivery-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderoflaboranddelivery|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Disorder of labor and delivery}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderoflaboranddelivery|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Disorder of labor and delivery}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-DisorderOfLaborAndDelivery|Delivery-and-birth-related disorder]]
 
|Condition
 
|Condition
|Disorders occuring during or after delivery are related to either the Delivery (if pertaining to the mother) or to the Birth (if pertaining to (one of) the children).
+
|Disorders occuring during or directly after delivery are related to either the Delivery (if pertaining to the mother) or to the Birth (if pertaining to (one of) the children).
 
* A partOf extension is used to point to the Delivery of the Birth.
 
* A partOf extension is used to point to the Delivery of the Birth.
* context is the Maternal Record or an Encounter.
+
* The context is the Maternal Record or an Encounter.
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-obstetricprocedure|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Obstetric Procedure}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-obstetricprocedure|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Obstetric Procedure}}
 +
|
 
|Procedure
 
|Procedure
|
+
|Obstetric procedures are procedures related to pregnancy, birth and delivery.
 +
* An (optional) partOf extension is used to point to the Delivery (maternal data) or the Birth (child-specific data)
 +
* The context is the Maternal Record or an Encounter.
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderpostpartum|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Post partum disorder}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderpostpartum|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Post partum disorder}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-DisorderPostPartum|Postpartum disorder]]
 
|Condition
 
|Condition
 +
|Disorders occuring after delivery, such as post partum depression, are related to the Delivery.
 +
* A partOf extension is used to point to the Delivery.
 +
* The context is the Maternal Record or an Encounter.
 +
|-
 +
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-birth|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Birth}}
 
|
 
|
|-
 
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-birth|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Birth}}
 
 
|Procedure
 
|Procedure
 
|This groups findings and procedures related to a particular child in a delivery - important in multiple births. A Birth has:
 
|This groups findings and procedures related to a particular child in a delivery - important in multiple births. A Birth has:
* a partOf extension, pointing to the Delivery
+
* A partOf extension, pointing to the Delivery
* subject is the Child
+
* The subject is the Child
* context is the Maternal Record EpisodeOfCare
+
* The context is the Maternal Record EpisodeOfCare
 
|-
 
|-
|[[Gebz:FHIR_bc-BirthObservation|Birth-related Observations]]
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-birthobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Birth-related Observations}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-BirthObservation|Birth-related Observations]]
 
|Observation
 
|Observation
 
|Observations such as parturition type pertain to a birth. They are also about the mother, which still is the subject.
 
|Observations such as parturition type pertain to a birth. They are also about the mother, which still is the subject.
Regel 130: Regel 240:
 
* Birth-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
* Birth-related Observations refer to the EpisodeOfCare with Observation.context.reference
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-child|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Child}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-child|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Child}}
 +
|
 
|Patient
 
|Patient
 
|Child is a separate Patient.  
 
|Child is a separate Patient.  
 
* Procedure-related Observations use focus extension to point to the child Patient they're about.
 
* Procedure-related Observations use focus extension to point to the child Patient they're about.
 
|-
 
|-
|[[Gebz:FHIR_bc-ChildObservation|Child-related Observations]]
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-childobservation|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Child-related Observations}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-ChildObservation|Child-related Observations]]
 
|Observation
 
|Observation
 
|Observations such as Apgar score and birthweight pertain to the child Patient, which is the subject of these Observations.
 
|Observations such as Apgar score and birthweight pertain to the child Patient, which is the subject of these Observations.
 
* Child observations refer to the EpisodeOfCare with Observation.context.reference
 
* Child observations refer to the EpisodeOfCare with Observation.context.reference
 
|-  
 
|-  
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderofchild|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Child disorders}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-disorderofchild|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Child disorders}}
 +
|[[Gebz:V1.1_FHIR_IG_bc-DisorderOfChild|Child disorder]]
 
|Condition
 
|Condition
 
|Child disorders such as chromosomal and congenital abnormalities or other problems are conditions. The child is the subject.
 
|Child disorders such as chromosomal and congenital abnormalities or other problems are conditions. The child is the subject.
Regel 148: Regel 261:
 
|colspan="3"|'''Diagnostic Reports (Onderzoeksverslagen)'''
 
|colspan="3"|'''Diagnostic Reports (Onderzoeksverslagen)'''
 
|-
 
|-
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-combinedtest|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Combined test}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-combinedtest|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Combined test}}
 +
|
 
|DiagnosticReport
 
|DiagnosticReport
 
|Combined test (combinatietest) verslag. The woman Patient is the subject of the report.
 
|Combined test (combinatietest) verslag. The woman Patient is the subject of the report.
 
* This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
 
* This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
 
|-  
 
|-  
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-digitalvaginalexamination|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Digital vaginal examination}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-digitalvaginalexamination|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Digital vaginal examination}}
 +
|
 
|DiagnosticReport
 
|DiagnosticReport
 
|The digital vaginal examination DiagnosticReport groups Observations related to the digital vaginal examination. The woman Patient is the subject of the report.
 
|The digital vaginal examination DiagnosticReport groups Observations related to the digital vaginal examination. The woman Patient is the subject of the report.
 
* This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
 
* This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
 
|-  
 
|-  
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-pregnancyultrasound|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.0.0|title=Ultrasound (Echoverslag)}}
+
|{{Simplifier|http://nictiz.nl/fhir/StructureDefinition/bc-pregnancyultrasound|nictiz.fhir.nl.stu3.geboortezorg|pkgVersion=1.1.0|title=Ultrasound (Echoverslag)}}
 +
|
 
|DiagnosticReport
 
|DiagnosticReport
 
|The ultrasound groups Observations. The woman Patient is the subject of the report.
 
|The ultrasound groups Observations. The woman Patient is the subject of the report.
Regel 164: Regel 280:
 
|-  
 
|-  
 
|}
 
|}
 
The use of ''focus'' extensions is a pre-adopt of FHIR R4, where it is part of Observation: "What the observation is about, when it is not about the subject of record." Focus is required for all Observations which do not pertain to the Patient. In R4, use of focus permits "reverse include" queries (give me all Observations with focus element X). In STU3, this could be a custom search.
 
  
 
The use of ''context'' is encouraged for all resources which have a context element. It is a reference to an EpisodeOfCare or an Encounter. Context should point to an Encounter when appropriate (scheduled maternity checks etc.) and to the EpisodeOfCare in all other cases. Possibly it will be absent in Observations where the source is not birth care, so readers should not rely on it's presence.
 
The use of ''context'' is encouraged for all resources which have a context element. It is a reference to an EpisodeOfCare or an Encounter. Context should point to an Encounter when appropriate (scheduled maternity checks etc.) and to the EpisodeOfCare in all other cases. Possibly it will be absent in Observations where the source is not birth care, so readers should not rely on it's presence.
  
 
Observations should include a performer if known.
 
Observations should include a performer if known.
 
Pattern tables can be found on individual pattern pages and on [[Gebz:V2.3_FHIR_mapping_addendum]] for 2.3 mappings and [[Gebz:V3.2_FHIR_mapping_addendum]] for 3.2 mappings.
 
  
 
The mapping is also available as an XML file: [https://github.com/Nictiz/Geboortezorg-STU3/blob/master/fhirmapping.xml fhirmapping.xml] for 2.3 mappings and [https://github.com/Nictiz/Geboortezorg-STU3/blob/master/fhirmapping.xml fhirmapping-3-2.xml] for 3.2 mappings.
 
The mapping is also available as an XML file: [https://github.com/Nictiz/Geboortezorg-STU3/blob/master/fhirmapping.xml fhirmapping.xml] for 2.3 mappings and [https://github.com/Nictiz/Geboortezorg-STU3/blob/master/fhirmapping.xml fhirmapping-3-2.xml] for 3.2 mappings.
Regel 180: Regel 292:
  
 
=BabyConnect Afsprakenstelsel=
 
=BabyConnect Afsprakenstelsel=
The [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/97813647/VIPP+Babyconnect+Afsprakenstelsel BabyConnect Afsprakenstelsel] describes the BabyConnect architecture, which defines the following modules and transactions.
+
The [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/97813647/VIPP+Babyconnect+Afsprakenstelsel BabyConnect Afsprakenstelsel] describes the BabyConnect architecture.
 
 
==Modules==
 
{| class="wikitable" "cellpadding="10"
 
! style="text-align:left;"| '''Module'''
 
! style="text-align:left;"| '''Name'''
 
! style="text-align:left;"| '''Role'''
 
|-
 
|style="background-color: white;vertical-align:top;"|A
 
|style="background-color: white;vertical-align:top;"|Healthcare information system (XIS)
 
|style="background-color: white;vertical-align:top;"|Send transaction to module B
 
|-
 
|style="background-color: white;vertical-align:top;"|B1
 
|style="background-color: white;vertical-align:top;"|Convertor
 
|style="background-color: white;vertical-align:top;"|Translates ADA transaction to FHIR transaction Bundle which is sent to module B2
 
|-
 
|style="background-color: white;vertical-align:top;"|B2
 
|style="background-color: white;vertical-align:top;"|FHIR server
 
|style="background-color: white;vertical-align:top;"|Receives and stores FHIR data
 
|-
 
|style="background-color: white;vertical-align:top;"|C
 
|style="background-color: white;vertical-align:top;"|Index
 
|style="background-color: white;vertical-align:top;"|Indexes and retrieves FHIR data from module B2
 
|-
 
|style="background-color: white;vertical-align:top;"|D1
 
|style="background-color: white;vertical-align:top;"|Query builder
 
|style="background-color: white;vertical-align:top;"|Translates user query to a FHIR query which is sent to module C
 
|-
 
|style="background-color: white;vertical-align:top;"|D2
 
|style="background-color: white;vertical-align:top;"|Translator
 
|style="background-color: white;vertical-align:top;"|Translates FHIR data retrieved from module C back to ADA format
 
|-
 
|style="background-color: white;vertical-align:top;"|E
 
|style="background-color: white;vertical-align:top;"|Viewer
 
|style="background-color: white;vertical-align:top;"|Collects the data and presents it to the end user
 
|}
 
 
 
Module B and D are added to make it easier for XIS and viewer vendors to connect to BabyConnect. XIS and viewer vendors are however encouraged to implement their own FHIR API as module B and D will phase out eventually.
 
  
 
==Transactions==
 
==Transactions==
BabyConnect defines the following transactions:
+
The transactions defined by BabyConnect can be found [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/102498694/Zorgproces#2.-Use-Cases here]
* [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/102465714/Proces+Publiceren Publish]
 
* [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/102564283/Proces+Raadplegen Retrieve]
 
* [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/102596965/Proces+Geven+toestemming Authorize]
 
* [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/102596948/Proces+Delen Share]
 
* [https://babyconnect.atlassian.net/wiki/spaces/VBC/pages/103088166/Proces+Verzamelen Collect]
 
  
 
=Actors=
 
=Actors=
Regel 276: Regel 346:
  
 
== Examples ==
 
== Examples ==
Example FHIR resources can be found here: [https://simplifier.net/geboortezorg-stu3/~resources?category=Example&sortBy=RankScore_desc]
+
Example FHIR resources can be found here: [https://simplifier.net/geboortezorg-stu3/~resources?category=Example&sortBy=RankScore_desc Simplifier.net/geboortezorg-stu3/~resources?category=Example]
  
 
== Search ==
 
== Search ==
Regel 286: Regel 356:
  
 
==Use cases dataset 3.2==
 
==Use cases dataset 3.2==
[[Gebz:FHIR_IG_use_cases_3.2|Use cases 3.2]]
+
[[Gebz:V1.1_FHIR_IG_use_cases_3.2|Use cases 3.2]]

Huidige versie van 3 dec 2021 om 16:07

| AfsprakenstelselFunctioneelTechnischAfspraken-Functioneel-Technisch

Introduction

This page details the HL7 FHIR requirements for exchanging the BirthCare (Geboortezorg) data.

The FHIR Implementation Guide for BirthCare is independent of the functional specifications. We expect the FHIR BirthCare IG to be compliant with datasets 2.3, 3.1 and 3.2. We do expect backwards compatible additions to the FHIR BirthCare IG for the latter datasets. The FHIR BirthCare IG does contain version-specific mappings to the various datasets, for now only 2.3 and 3.2 mappings.

The functional view for BirthCare (Geboortezorg) 3.2 is described in Functioneel. The functional view for BirthCare (Geboortezorg) 2.3 is described in Functioneel. Functional specifications for other datasets will follow.

Technical details of the FHIR resources and structure definitions described in this Implementation Guide (IG) can be found in the Simplifier Geboortezorg STU3 project. This IG provides links to the required resources and structure definitions for each use case.

A high level overview

Fhir-model-overview.png

FHIR Resources and StructureDefinitions

Types of resources and relations between them

Pregnancy and maternal record

A pregnancy (Condition) starts with a pregnant woman (Patient). Her data is registered in a maternal record (EpisodeOfCare). The maternal record contains references to the pregnant woman (subject), the pregnancy (condition), the care manager (careManager:Practitioner) and managing organization (managingOrganization:Organization).

Gebz-pregnancy.PNG

Birth and Delivery

If all goes well a pregnancy ends with a delivery (Procedure). A delivery is related to the mother (subject). It has 3 stages: 1. dilation, 2. birth of one or more children and 3. afterbirth. There are no separate resource for the first and third stages of delivery, but the second stage of delivery is another Procedure, which is related to the child (subject). The Birth Procedure is part of the Delivery Procedure and in case of a multiple pregnancy, multiple Birth Procedures can be part of the same Delivery Procedure.

Gebz-delivery.PNG

Obstetric procedures

Obstetric procedures are procedures related to pregnancy, birth and delivery. These procedures can be part of (partOf) a Birth Procedure (in case of child-related procedures, like a c-section) or a Delivery Procedure (in case of maternal procedures, like a blood transfusion). The partOf element can also be left blank when the procedure is linked to the pregnancy (record), but not to birth and delivery.

Relations between pregnancy, birth and delivery

A pregnancy (Condition), birth (Procedure) and delivery (Procedure) are all related to a maternal record (EpisodeOfCare) through their context element, either with a direct reference to the EpisodeOfCare or an indirect reference to an Encounter which in itself is linked to the maternal record (EpisodeOfCare). In addition, the Birth and Delivery Procedures both include a reference to the pregnancy (reasonReference).

Gebz-delivery-pregnancy.PNG

Patterns

For Observations and Conditions, which are often very similar, we follow patterns: an implementer will only need to implement the pattern and an associated table with codes, and be able to support all Observations. So for Observations pertaining to a particular pregnancy (not to the woman - she may have multiple pregnancies on record, neither to the delivery) all Observations will link to the Pregnancy Condition. So instead of having to inspect StructureDefinitions separately for each pregnancy observations, following a single pattern will do. The pattern has it's own StructureDefinition, so the FHIR profile is still complete. Likewise Observations for the mother, delivery and child follow patterns.

Pattern tables can be found on individual pattern pages, see links below, and on Gebz:V2.3_FHIR_mapping_addendum for 2.3 mappings and Gebz:V3.2_FHIR_mapping_addendum for 3.2 mappings.

Observation patterns

Observations follow patterns based on their subject (either the child or the mother patient) and their focal subject (either the pregnancy, birth or delivery), see table below. The use of focus extensions is a pre-adopt of FHIR R4, where it is part of Observation: "What the observation is about, when it is not about the subject of record." Focus is required for all Observations which do not pertain to the Patient. In R4, use of focus permits "reverse include" queries (give me all Observations with focus element X). In STU3, this could be a custom search.

Pattern Subject Focus
Patient-related Observations Mother patient x
Pregnancy-related Observations Mother patient Pregnancy
Delivery-related Observations Mother patient Delivery
Birth-related Observations Mother patient Birth
Child-related Observations Child patient x

Condition patterns

Conditions follow patterns based on their category (disorders related to either pregnancy, labor and delivery, postpartum or child disorders). Pregnancy, birth and delivery related disorders use partOf to link to these concepts, see table below.

Pattern Subject Category PartOf
Pregnancy-related disorder Mother patient 173300003 Pregnancy
Delivery-and-birth-related disorder Mother patient 362972006 Delivery
Postpartum disorder Mother patient 362973001 Delivery
Child-related disorder Child patient 414025005 x

List of resources and relations between them

Profile Pattern FHIR resource Description
Woman (Vrouw) Patient The core of each pregnancy is the pregnant woman, a FHIR Patient.
Maternal Observation (Bevinding vrouw) Observation Observations and findings related to the woman, before, during or after pregnancy childbirth. Examples are risk status or maternal ultrasound observations.
Partner RelatedPerson The partner of the pregnant woman (not necessarily the biological father).
Practitioner, PractitionerRole, Organization Practitioner, PractitionerRole, Organization Generic resources. Those are not used differently than in other Dutch projects.
Referral details ReferralRequest Referral details (such as type of referral, reason code, referrer and target of the referral) are described in ReferralRequest. The pregnant woman is the subject, the context is the pregnancy file (EpisodeOfCare).
Involvement pediatrician CareTeam A CareTeam describes the involvement of different care providers, such as a pediatrician.
  • These care providers are included as participants in the CareTeam using the CareTeam.participant.member element. Participants may either be Practitioners or Organizations.
  • Their role and period of involvement are described at the participant level (that is CareTeam.participant.role and CareTeam.participant.period).
  • The reason of involvement is described in CareTeam.reasonCode
Pregnancy, Maternity Record Condition, EpisodeOfCare Each pregnancy is a Condition. It is also represented as an EpisodeOfCare for each involved Organization. The pregnancy includes references to an Organization and responsible Practitioner. (Practitioners responsible for the actual data may be included there, i.e. in Procedures, Observations.)
  • 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.
Patient-related Observations Patient-related Observations Observation Observations such as blood type pertain to the Patient.
  • Observations can refer to an EpisodeOfCare with Observation.context.reference
PregnancyObservation Pregnancy-related Observations Observation Observations such as gravidity and parity do not (only) pertain to the Patient but to a particular pregnancy.
  • Pregnancy-related Observations use focus extension to point to Condition they're about. Without this, all gravidities would only be Observations about a Patient.
  • Pregnancy-related Observations refer to the EpisodeOfCare with Observation.context.reference
Pregnancy-related disorder Pregnancy-related disorder Condition 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
Childbirth Assistance Encounter Childbirth Assistance is modeled as an Encounter. The woman Patient is subject of the Encounter.
  • The place of birth is described in Encounter.class using a ConceptMap to map values to available FHIR codes
  • The Encounter.diagnosis element refers to the Pregnancy (Condition)
  • The Encounter.participant element containts a list of care providers that were present during delivery. Family members and even the woman Patient could also be included in this list.
  • Additional details can be defined at participant level, such as participant type and time of arrival. The latter uses an extension at participant level with a coded list of time of arrival.
  • Childbirth Assistance refers to the EpisodeOfCare with Encounter.EpisodeOfCare.reference
Delivery (Bevalling) Procedure Delivery is modeled with Procedure (even for uncomplicated natural births for consistency). A pregnancy can lead to one DeliveryProcedure even in multiple birth. The Patient is the subject.
  • Delivery refers to the EpisodeOfCare with Procedure.context.reference
  • Delivery refers to the Pregnancy with Procedure.reasonReference.reference
Delivery-related Observations Delivery-related Observations Observation 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
Disorder of labor and delivery Delivery-and-birth-related disorder Condition Disorders occuring during or directly after delivery are related to either the Delivery (if pertaining to the mother) or to the Birth (if pertaining to (one of) the children).
  • A partOf extension is used to point to the Delivery of the Birth.
  • The context is the Maternal Record or an Encounter.
Obstetric Procedure Procedure Obstetric procedures are procedures related to pregnancy, birth and delivery.
  • An (optional) partOf extension is used to point to the Delivery (maternal data) or the Birth (child-specific data)
  • The context is the Maternal Record or an Encounter.
Post partum disorder Postpartum disorder Condition Disorders occuring after delivery, such as post partum depression, are related to the Delivery.
  • A partOf extension is used to point to the Delivery.
  • The context is the Maternal Record or an Encounter.
Birth Procedure This groups findings and procedures related to a particular child in a delivery - important in multiple births. A Birth has:
  • A partOf extension, pointing to the Delivery
  • The subject is the Child
  • The context is the Maternal Record EpisodeOfCare
Birth-related Observations Birth-related Observations Observation Observations such as parturition type pertain to a birth. They are also about the mother, which still is the subject.
  • Birth-related Observations use focus extension to point to a birth.
  • Birth-related Observations refer to the EpisodeOfCare with Observation.context.reference
Child Patient Child is a separate Patient.
  • Procedure-related Observations use focus extension to point to the child Patient they're about.
Child-related Observations Child-related Observations Observation Observations such as Apgar score and birthweight pertain to the child Patient, which is the subject of these Observations.
  • Child observations refer to the EpisodeOfCare with Observation.context.reference
Child disorders Child disorder Condition Child disorders such as chromosomal and congenital abnormalities or other problems are conditions. The child is the subject.
  • Child disorders can refer to the EpisodeOfCare with Condition.context.reference
  • A ConceptMap is available to map verification status to accepted FHIR codes
Diagnostic Reports (Onderzoeksverslagen)
Combined test DiagnosticReport Combined test (combinatietest) verslag. The woman Patient is the subject of the report.
  • This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
Digital vaginal examination DiagnosticReport The digital vaginal examination DiagnosticReport groups Observations related to the digital vaginal examination. The woman Patient is the subject of the report.
  • This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
Ultrasound (Echoverslag) DiagnosticReport The ultrasound groups Observations. The woman Patient is the subject of the report.
  • This report refers to the EpisodeOfCare with DiagnosticReport.context.reference

The use of context is encouraged for all resources which have a context element. It is a reference to an EpisodeOfCare or an Encounter. Context should point to an Encounter when appropriate (scheduled maternity checks etc.) and to the EpisodeOfCare in all other cases. Possibly it will be absent in Observations where the source is not birth care, so readers should not rely on it's presence.

Observations should include a performer if known.

The mapping is also available as an XML file: fhirmapping.xml for 2.3 mappings and fhirmapping-3-2.xml for 3.2 mappings.

Terminology, NamingSystems, Mappings

Terminology

Relevant value sets can be found here. All resources can be downloaded in a .zip in XML or JSON format. In the .zip, the value sets are stored in the directory 'value sets'.

BabyConnect Afsprakenstelsel

The BabyConnect Afsprakenstelsel describes the BabyConnect architecture.

Transactions

The transactions defined by BabyConnect can be found here

Actors

Transaction group Transaction Actor Role
Publish transaction (PUSH) Publish transaction Healthcare professional (using a XIS) Sends transaction to registry
Retrieve transaction (PULL) Retrieve transaction Healthcare professional (using a XIS and/or viewer software) Retrieves transaction from registry

Module A and E can either directly interact with the FHIR server (which they are encouraged to do) or use the convertor and translator software of module B and D.

Invocations

Publishing XIS: request message

Message Semantics

The publishing XIS or convertor executes a HTTP POST request of a Bundle with Bundle.type = transaction to the target's base endpoint. The first Bundle.entry contains a Composition resource, and each subsequent entry contains a resource that is referenced from the Composition resource.

POST [base]{&_format=[mime-type]}

As a result, all FHIR resources included in the Bundle will be stored individually in the FHIR server.

To persist a Document Bundle at the FHIR server (e.g. to preserve the clinical context), the publishing XIS or convertor should execute a HTTP GET request to the Composition endpoint of the FHIR server, handling the createDocumentOperation with persist=true. The response is a FHIR Document Bundle, which is generated from the Composition resource and stored to the FHIR server's Bundle endpoint.

GET [base]/Composition/[id]/$document?persist=true{&_format=[mime-type]}

Retrieving XIS: request message

When persisted at the FHIR server, FHIR Document Bundles can be retrieved by a HTTP GET request to the FHIR server's Bundle endpoint. Note that FHIR Document Bundles are immutable and its entries refer to a time-related version of a resource which is not necessarily its latest version.

GET [base]/Bundle/[id]{&_format=[mime-type]}

Individual resources can be retrieved by HTTP GET requests to specific resource endpoints, see the Search section and list of StructureDefinitions below.

Examples

Example FHIR resources can be found here: Simplifier.net/geboortezorg-stu3/~resources?category=Example

Search

Example search URLs can be found in the list of StructureDefinitions in each use case section. Some searches require the implementation of custom search parameters. These parameters can be found here: https://simplifier.net/geboortezorg-stu3/~resources?category=SearchParameter

Use cases

Use cases dataset 2.3

Use cases 2.3

Use cases dataset 3.2

Use cases 3.2