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=Use case 3A: Send Aanmeldbericht (PUSH)=
 
=Use case 3A: Send Aanmeldbericht (PUSH)=

Versie van 10 apr 2020 om 12:44

{{#customtitle:eOverdracht FHIR Implementation Guide}}

Introduction

This page details the HL7 FHIR requirements for exchanging the data in the eOverdracht Proeftuin pilot described in the functional design.

TODO

Implementation of these transactions is spread over multiple phases. In the first phase of the Proeftuin a simplified version of both the Aanmeldbericht en Overdrachtsbericht are being used. Both messages exist of four HCIMs listed in the table below. The Aanmeldbericht is send to the recieving organisation, which after confirmation of recieving the aanmeldberricht, gets send the Overdrachtbericht. Phase two consists of the complete Aanmeldbericht as well as an incomplete Overdrachtsbericht. The Overdrachtsbericht is a subset of 11 HCIM's (complete set used in Aanmeldbericht) and an unstructured PDF containing the remaining data which are not part of the HCIM's. Phase three is the complete dataset of the Aanmeldbericht, Overdrachtsbericht Volwassenen, Overdrachtsbericht Kinderen 0-1 jaar, Overdrachtsbericht Kinderen 1-18 jaar as PUSH messages.

/TODO

This implementation guide assumes that the reader is familiar with FHIR(STU3).

Overarching FHIR principles

  • This implementation guide does not provide information on finding the right XIS, nor does it provide information about security. It is assumed that the sending XIS is able to make a connection with the receiving XIS.
  • All FHIR resources used within eOverdracht SHALL conform to the profiles listed in this implementation guide and SHALL include the profile canonical URL in their meta.profile element.

Package and dependencies

eOverdracht uses the FHIR Packaging mechanism to conveniently bundle all examples, profiles and other conformance resources you need into a single download. The eOverdracht package has a dependency on the Nictiz Zib2017 package .

Example instances

Example instances of the FHIR messages can be found on Simplifier:

Use case 1A: Send Overdrachtsbericht volwassenen (PUSH)

Introduction

The Send Overdrachtsbericht scenario is used by the sending XIS to send the relevant data for the patient care to the receiving XIS. The structure of the eventual scenario is described in the functional design and additionally in Opbouw Overdrachtsbericht Volwassenen. For the pilot a limited subset is implemented.

Actors

Transaction group Transaction Actor Role
Send Overdrachtbericht (PUSH) Send Overdrachtsbericht Healthcare professional at organization A (using a XIS) Sends Overdrachtsbericht
Healthcare professional at organization B (using a XIS) Receives Overdrachtsbericht

Invocation

The Send Overdrachtsbericht transaction is an HTTP POST method on the target XIS's base, where the body of the POST request is a FHIR document according to #Structure of the Overdrachtsbericht (4 HCIMs + PDF). See #Sending documents for more information.

Trigger events

This transaction is invoked when the sending XIS needs to send the Overdrachtsbericht to the receiving XIS.

Expected response

The document Bundle should be processed as a transaction by the receiving XIS. See #Processing documents for more information.

Structure of the Overdrachtsbericht

The Overdrachtsbericht consists of multiple FHIR resources, which are assembled into a FHIR document. See #Creating documents for information on how to assemble this document.

During phase 1, the Overdrachtsbericht is based on the same 4 HCIMs as the Aanmeldbericht (Patient, Betaler, Contactpersoon en Zorgaanbieder). The table below lists the FHIR profiles[1] that are applicable for the pilot implementation of the Overdrachtsbericht transaction.

Section FHIR profile FHIR resource HCIM name HCIM version Remarks
- aanmeldbericht@ http://nictiz.nl/fhir/StructureDefinition/eOverdracht-aanmeldbericht Composition - - Declaration of the Send Aanmeldbericht transaction.
Datum overplaatsing http://nictiz.nl/fhir/StructureDefinition/eOverdracht-TransferDate - - - DateTime extension used in eOverdracht composition profiles
Persoonsgegevens http://fhir.nl/fhir/StructureDefinition/nl-core-patient Patient Patient v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-Payer Coverage Betaler v3.1(2017NL) -
http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson RelatedPerson Contactpersoon v3.1(2017NL) -
Sturende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-organization Organization Zorgaanbieder v3.1.1(2017NL) -
Ontvangende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-organization
Zorgverlener sturende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner Practitioner Zorgverlener v3.1.1(2017NL) -
Zorgverlener ontvangende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner
Gezinssituatie http://nictiz.nl/fhir/StructureDefinition/zib-FamilySituation FamilySituation Gezinssituatie v3.1(2017NL) -
Woonomgeving http://nictiz.nl/fhir/StructureDefinition/zib-LivingSituation Woonsituatie LivingSituation v3.1 (2017NL) -
Levensovertuiging http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance Levensovertuiging LifeStance v3.1 (2017NL) LifeStance is still in draft version, so the simplifier link might change
http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective Wilsverklaring AdvanceDirective v3.1 (2017NL) -
Sociale omgeving http://nictiz.nl/fhir/StructureDefinition/zib-ParticipationInSociety ParticipatieInMaatschappij ParticipationInSociety v3.1 (2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-HelpFromOthers HulpVanAnderen HelpFromOthers v3.0 (2017NL) -
Communicatie http://nictiz.nl/fhir/StructureDefinition/patient-proficiency Taalvaardigheid LanguageProfeciency v3.1(2017NL)
Medische diagnose http://nictiz.nl/fhir/StructureDefinition/zib-Problem Condition Probleem v4.1(2017NL -
Voorgeschiedenis http://nictiz.nl/fhir/StructureDefinition/zib-Problem Condition Probleem v4.1(2017NL -
Let op http://nictiz.nl/fhir/StructureDefinition/zib-Alert Flag Alert v3.2(2017NL) -
Vrijheidsbeperking http://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures Procedure VrijheidsBeperkendeMaatregelen v3.1(2017NL) -
Meetwaarden http://nictiz.nl/fhir/StructureDefinition/zib-BloodPressure Observation Bloeddruk v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-PulseRate Observation PolsFrequentie v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-BodyTemperature Observation Lichaamstemperatuur v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-Respiration Observation Ademhaling v3.1(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-BodyWeight Observation Lichaamsgewicht v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-BodyHeight Observation Lichaamslengte v3.1(2017NL) -
AlgemeneMeting Observation AlgemeneMeting v3.0(2017NL) No fhir profile is available yet for this HCIM.
Pijnscore http://nictiz.nl/fhir/StructureDefinition/zib-PainScore Observation Pijnscore v3.1(2017NL) The FHIR profile is still in draft in package 2.x
Actuele patiëntenproblemen http://nictiz.nl/fhir/StructureDefinition/zib-Problem Condition Probleem v4.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentObjective Goal Behandeldoel v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention Procedure VerpleegkundigeInterventie v3.2(2018NL) -
Zorgresultaat http://nictiz.nl/fhir/StructureDefinition/zib-OutcomeOfCare DiagnisticReport UitkomstVanZorg v3.1(2017NL) This FHIR profile is still in draft in package 2.x
Afspraken patiënt http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest ProcedureRequest OverdrachtGeplandeZorgActiviteit v3.1(2017NL) -
Wensen en behoeften patiënt en/of naasten - - - - Declared as a text section. See aanmeldbericht profile@ http://nictiz.nl/fhir/StructureDefinition/eOverdracht-aanmeldbericht.
Zelfzorg http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToDrink Observation VermogenTotDrinken v3.1(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToEat Observation VermogenTotEten v3.1(2017NL) This FHIR profile is still in draft in package 2.x
MedicalDevice&scope=zib-AbilityToPerformMouthcareActivities MedicalDevice@ http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToPerformMouthcareActivities MedicalDevice Observation VermogenTotMondverzorging v3.1(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToWashOneSelf Observation VermogenTotZichWassen v3.1(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToDressOneself Observation VermogenTotZichKleden v3.1(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToGroome Observation VermogenTotUiterlijkeVerzorging v1.0(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToUseToilet Observation VermogenTotToiletgang v1.0(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToManageMedication Observation VermogenTotZelfstandigMedicatiegebruik v1.0(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-AbilityToPerformNursingActivities Observation VermogenTotVerpleegtechnischeHandelingen v1.0(2017NL) This FHIR profile is still in draft in package 2.x
toelichting zelfzorg - Explanation selfcare - Free text
Mobiliteit http://nictiz.nl/fhir/StructureDefinition/zib-Mobility Observation Mobiliteit v3.1(2017NL) This FHIR profile is still in draft in package 2.x
Voeding/vocht http://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice NutritionOrder Voedingsadvies v3.2(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-SNAQScore

http://nictiz.nl/fhir/StructureDefinition/zib-SNAQrcScore

http://nictiz.nl/fhir/StructureDefinition/zib-SNAQrcScore

http://nictiz.nl/fhir/StructureDefinition/zib-MUSTScore

Observation SNAQScore

SNAQrcScore

SNAQ65+Score

MUSTScore

v3.1(2017NL)

v1.0(2017NL)

v1.0(2017NL)

v3.1(2017NL)

These FHIR profile are still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-FluidBalance Observation Vochtbalans v1.0(2017NL) This FHIR profile is still in draft in package 2.x
http://nictiz.nl/fhir/StructureDefinition/zib-FeedingTubeSystem DeviceUseStatement SondeSysteem v3.2(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-FeedingTubeSystem DeviceUseStatement Infuus v3.2(2017NL) -
Uitscheiding http://nictiz.nl/fhir/StructureDefinition/zib-BladderFunction Observation Blaasfunctie v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-BowelFunction Observation Darmfunctie v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-Stoma Observation Stoma v3.2(2017NL) -
Huid http://nictiz.nl/fhir/StructureDefinition/zib-BurnWound Condition Brandwond v3.2(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-PressureUlcer Condition DecubitusWond v3.2(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-SkinDisorder Condition Huidaandoening v3.2(2017NL) -
TODO geen WOUND Profile? Condition Wond v3.1(2017NL) -
Zintuigen http://nictiz.nl/fhir/StructureDefinition/zib-HearingFunction Observation FunctieHoren v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-VisualFunction Observation FunctieZien v3.1(2017NL) -
Ziektebeleving http://nictiz.nl/fhir/StructureDefinition/zib-IllnessPerception Observation Ziektebeleving v3.1(2017NL) -
Mentale status http://nictiz.nl/fhir/StructureDefinition/zib-Problem Condition Probleem v4.1(2017NL) -
Voortplanting http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy/zib-Pregnancy Condition Zwangerschap v3.1(2017NL) -

Use case 3A: Send Aanmeldbericht (PUSH)

Introduction

The Send Aanmeldbericht scenario is used by the sending XIS to send the relevant data for the patient intake to the receiving XIS, and constitutes a subset of the Overdrachtsbericht. The structure of the eventual scenario is described in the functional design and additionally in Opbouw Aanmeldbericht. For the pilot a limited subset is implemented.

Actors

Transaction group Transaction Actor Role
Send Aanmeldbericht(PUSH) Send Aanmeldbericht Healthcare professional at organization A (using a XIS) Sends Aanmeldbericht
Healthcare professional at organization B (using a XIS) Receives Aanmeldbericht

Invocation

The Send Aanmeldbericht transaction is an HTTP POST method on the target XIS's base, where the body of the POST request is a FHIR document according to #Structure of the Aanmeldbericht (4 HCIMs + PDF). See #Sending documents for more information.

Trigger events

This transaction is invoked when the sending XIS needs to send the Overdrachtsbericht to the receiving XIS.

Expected response

The document Bundle should be processed as a transaction by the receiving XIS. See #Processing documents for more information.

Structure of the Aanmeldbericht (4 HCIMs + PDF)

The Aanmeldbericht consists of multiple FHIR resources, which are assembled into a FHIR document. See #Creating documents for information on how to assemble this document.

During phase 1, the Aanmeldbericht is based 4 HCIMs (Patient, Betaler, Contactpersoon en Zorgaanbieder) and uses a PDF to send the remaining data unstructured. The table below lists the FHIR profiles[1] that are applicable for the pilot implementation of the Aanmeldbericht transaction. All resources SHALL conform to the profiles listed in this table and SHALL include the profile canonical URL in the meta.profile element.

Section FHIR profile FHIR resource HCIM name HCIM version Remarks
- phase 1@ http://nictiz.nl/fhir/StructureDefinition/eOverdracht-aanmeldbericht-phase-one Composition - - The Composition resource used to assemble the document
Datum overplaatsing http://nictiz.nl/fhir/StructureDefinition/eOverdracht-TransferDate extension - - extension in the Composition resource
Persoonsgegevens http://fhir.nl/fhir/StructureDefinition/nl-core-patient Patient Patient v3.1(2017NL) -
http://nictiz.nl/fhir/StructureDefinition/zib-Payer Coverage Betaler v3.1(2017NL) -
Sturende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-organization Organization Zorgaanbieder v3.1.1(2017NL) -
Ontvangende organisatie http://fhir.nl/fhir/StructureDefinition/nl-core-organization Organization Zorgaanbieder v3.1.1(2017NL)
PDF Binary Binary - - Used to send unstructured PDF data

FHIR Documents

Both the Aanmeldbericht and the Overdrachtsbericht are sent as a FHIR Document. A document is a FHIR Bundle that assembles all relevant resources that need to be exchanged, together with a Composition resource that summarizes and references all these resources.

A FHIR document is immutable and considered to be attested by a healthcare professional.

Creating documents

To construct a document, a FHIR Composition resource is created that summarizes and references all the resources that need to be exchanged. This Composition resource is then placed together with all referenced resources in a Bundle with Bundle.type set to "document". The Composition resource SHALL be the first entry.

Profiles have been created for both the Composition and the document Bundle resources for each transaction within eOverdracht. All documents SHOULD adhere to these profiles, which are summarized in this implementation guide at the transaction level.

Sending documents

The document should be sent as an HTTP POST operation on the target XIS's base:

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

where the body of the POST request is the document.

Processing documents

The document Bundle should be processed as a transaction by the receiving XIS and each Bundle.entry should be treated as a create interaction for the Bundle.entry.resource. When the receiving XIS cannot create a new resource because of incorrect data or business rules, it should perform a rollback of the creation of any previous entries.

On success, the target XIS SHALL respond:

  • With the HTTP status code 201 Created.
  • With the Location header containing the new logical id and version id of the created resource version.
  • With a response body set to a Bundle of type "transaction-response", containing one entry for each entry in the request, in the same order, with the outcome of processing the entry. The sender may use the returned Bundle to track the outcomes of processing the entry, and the identities assigned to the resources by the server.

On failure, the target XIS SHALL respond:

  • With an HTTP status code set appropriate to the processing outcome:
    • When the resource syntax or data is incorrect or invalid, the status code should be 400 Bad Request.
    • When the server rejects the content of the resource because of business rules, the status code should be 422 Unprocessable Entity.
    • Additional HTTP status code may be used if more appropriate.
  • With a response body set to a FHIR OperationOutcome resource with detailed error messages describing the reason for the error.

FHIR CapabilityStatements

Footnotes

  1. 1,0 1,1 Please note that the direct links to the various conformance resources below will take you to the latest version, which might not match the package version. At time of writing, there is no way to render the conformance resource as found in the package. This is on the roadmap for Simplifier.