vpk:V3.1 FHIR eOverdracht Proeftuin

Work in progress - See official publication here.

Introduction

This page will detail the HL7 requirments for exhcanging the data in the eOverdracht Proeftuin phase 1 as described in the functional design. Imnplementation of the eOverdracht Proeftuin is spread over 3 different phases. Phase 2 and 3 can be found by navigating the following links in the table listed below.

Phase 2 and Phase 3 of the eOverdracht Proeftuin
Phase 2	Phase 3
Proeftuin Phase 2	eOverdracht FHIR implementation guide

• Phase 3 of the eOverdracht proeftuin consists of the total eOverdracht message, therefore you will be directed to the eOverdracht FHIR implementation guide.

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.

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:

• Composition examples
• Bundle examples

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 (4 HCIMs + PDF)

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 that are applicable for the pilot implementation of the Overdrachtsbericht transaction.

Section	FHIR profile	FHIR resource	HCIM name	HCIM version	Remarks
-	Overdrachtsbericht phase 1	Composition	-	-	The Composition resource used to assemble the document
Datum overplaatsing	eOverdracht-TransferDate	extension	-	-	extension in the Composition resource
Persoonsgegevens	nl-core-patient	Patient	Patient	v3.1(2017NL)	-
	zib-Payer	Coverage	Betaler	v3.1(2017NL)	-
Sturende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
Ontvangende organisatie	nl-core-organization	Organization	Zorgaanbieder	v3.1.1(2017NL)	-
	nl-core-practitioner	Practitioner	Zorgverlener	v3.2(2017NL)	-
	nl-core-practitionerrole	PractitionerRole
PDF	Binary	Binary	-	-	Used to send unstructured PDF data

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 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

• CapabilityStatement server
• CapabilityStatement client