FHIR Implementation Guide: Pregnancy Card Echo DRAFT

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Please note that this is draft material which is still in development


1 Introduction

This page describes the process of collecting ultrasound data related to a pregnancy 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 Ultrasound Data Set is an addition to the Pregnancy Card (Dutch: gegevensdienst Integrale Zwangerschapskaart), which has overlap with other standards such as the BgZ (Basisgegevensset Zorg), Medication Process, Vital Signs and Lab Results. The Pregnancy Card and Pregnancy Ultrasound Data Set use 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 ultrasound data set

This use case covers the process of retrieving the Pregnancy Ultrasound Data Set in the Personal Health Record (PHR) of the (pregnant) woman.

4.1 PHR: request message

The PHR system requests the Pregnancy Ultrasound Data Set using individual search interactions. The Pregnancy Ultrasound Data Set consists of multiple FHIR resources with certain constraints. To obtain the patient's Pregnancy Ultrasound Data Set, 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 Ultrasound Data Set, a client has to execute the following requests.

Step 1: Retrieve patient data 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?_include=RelatedPerson:link
GET Patient
GET Coverage
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
GET DiagnosticReport?context=EpisodeOfCare/{record-id}	
GET ReferralRequest?context=EpisodeOfCare/{record-id}

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 [...]

5 Addendum MedMij Echo Beschikbaarstellen

Based on ART-DECOR transaction version: 2024-01-16T13:18:30

PWD 3.2 to FHIR
Type # Concept Card Profile Mapping
Container.png 1313 Administratief 1 .. 1
Container.png 1290    Betaler 0 .. 1 zib-Payer Coverage
Container.png 1297       Verzekeraar 1 .. * zib-Payer Coverage
Container.png 1298          Verzekering 1 .. * zib-Payer Coverage.payor
TS.png 1299             BeginDatumTijd 0 .. 1 zib-Payer Coverage.period.start
TS.png 1300             EindDatumTijd 0 .. 1 zib-Payer Coverage.period.end
CD.png 1301             Verzekeringssoort 0 .. 1 zib-Payer Coverage.type
II.png 1302          IdentificatieNummer 0 .. 1 nl-core-organization Organization.identifier
ST.png 1303          OrganisatieNaam 0 .. 1 nl-core-organization Organization.name
ST.png 1304          VerzekerdeNummer 1 .. 1 zib-Payer Coverage.subscriberId
Container.png 675    Patient 0 .. 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 0 .. 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 0 .. 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 .. 1 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 .. 1 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 1 .. 1 nl-core-patient Patient.birthDate
CD.png 684       Geslacht (administratief) 1 .. 1 nl-core-patient Patient.gender
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 .. 1 nl-core-organization Organization
ST.png 958       OrganisatieNaam 1 .. 1 nl-core-organization Organization.name
CD.png 960       AfdelingSpecialisme 0 .. 1 nl-core-organization Organization.type:departmentSpecialty
Container.png 978    Zorgverlener 1 .. 1 nl-core-practitioner Practitioner
II.png 979       ZorgverlenerIdentificatienummer 1 .. 1 nl-core-practitioner Practitioner.identifier
Container.png 3248       Naamgegevens 0 .. 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 0 .. 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 0 .. 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
Container.png 1314 Zorgverlening 0 .. 1 nvt
Container.png 8877    Verwijsgegevens 1 .. 1 bc-ReferralRequest ReferralRequest
Container.png 8879       Verwijzing van/ afkomstig van 1 .. 1 bc-ReferralRequest ReferralRequest.requester
Container.png 9660          Zorgaanbieder 1 .. 1 bc-ReferralRequest ReferralRequest.requester.agent
Container.png 674 Vrouw 1 .. 1 bc-Woman Patient
Container.png 1713    Demografische gegevens 0 .. 1 bc-Woman Patient
Container.png 1434       Patient 0 .. 1 bc-Woman Patient
Container.png 25 Zwangerschapsgegevens 1 .. 1 bc-MaternalRecord EpisodeOfCare
Container.png 3341    Zwangerschap 1 .. 1 zib-Pregnancy Condition
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
Container.png 3346       ATermeDatumItems 1 .. 1 bc-PregnancyObservation Observation
TS.png 3347          ATermeDatum 1 .. 1 bc-PregnancyObservation Observation.value[x]:valueDateTime
CD.png 3348          BepalingsMethode 0 .. 1 bc-PregnancyObservation Observation.method
TS.png 3349          DatumBepaling 1 .. 1 bc-PregnancyObservation Observation.effective[x]:effectiveDateTime
Container.png 111    Prenatale controle 0 .. 1 bc-Encounter Encounter
Container.png 1775       Uitwendig onderzoek 0 .. 1 nvt
Container.png 10522          Bevindingen Foetus 0 .. 1 bc-MaternalObservation Observation
Container.png 4060             LiggingFoetus (Meting) 0 .. * bc-MaternalObservation Observation
CD.png 4062                LiggingFoetusWaarde 0 .. 1 bc-MaternalObservation Observation.value[x]:valueCodeableConcept
CD.png 4063                MeetMethode 0 .. 1 bc-MaternalObservation Observation.method
TS.png 4066                MeetDatumBeginTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 4067                MeetDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
ST.png 4068                Toelichting 0 .. 1 bc-MaternalObservation Observation.comment
Container.png 4069                AnatomischeLocatieMeting 0 .. 1 bc-MaternalObservation Observation.bodySite
CD.png 4070                   Locatie 0 .. 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 0 .. 1 bc-FetalHeartRate Observation.value[x]:valueQuantity
CD.png 1779                HartslagMeetMethode 0 .. 1 bc-FetalHeartRate Observation.method
CD.png 1781                HartslagRegelmatigheid 0 .. 1 bc-FetalHeartRate Observation.component:heartRateRegularity.value[x]:valueCodeableConcept
CD.png 1782                InterpretatieFrequentie 0 .. 1 bc-FetalHeartRate Observation.interpretation
ST.png 1780                Toelichting 0 .. 1 bc-FetalHeartRate Observation.comment
Container.png 1123 Medisch onderzoek 1 .. 1 nvt
Container.png 2416    Verrichting (Onderzoek) 1 .. 1 zib-Procedure Procedure
2417       VerrichtingStartDatum 1 .. 1 zib-Procedure Procedure.effectivePeriod.start
CD.png 2423       VerrichtingType 1 .. 1 bc-ObstetricProcedure Procedure.code
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 8912    Media 0 .. 1 DocumentReference
II.png 8913       Identificatienummer 0 .. 1 DocumentReference.masterIdentifier
CD.png 8914       Type beeldmateriaal 0 .. 1 DocumentReference.extension
CD.png 8915       Beeldmateriaal 0 .. 1 DocumentReference.extension
blob 8943       Beeld 0 .. 1 Binary
TS.png 8916       Datum/Tijd 0 .. 1 DocumentReference.indexed
ST.png 8917       Toelichting 0 .. 1 DocumentReference.extension
Container.png 1208    Foetusspecifieke onderzoeksgegevens 1 .. * bc-FetusObservation Observation
Container.png 1209       Echoscopie 1 .. 1 bc-PregnancyUltraSound DiagnosticReport
Container.png 8918          Echografiche bevindingen algemeen (Observatie) 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation
TS.png 8919             ObservatieDatumTijd 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.effective[x]:effectiveDateTime
CD.png 8929             ObservatieMethode 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.method
CD.png 8921             ConclusieWaarde 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.component:conclusion.value[x]:valueCodeableConcept
CD.png 8931             VerdenkingAfwijkingobvWaarde 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.component:suspicionAbnormalities.value[x]:valueCodeableConcept
CD.png 8930             AdviesWaarde 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.component:advice.value[x]:valueCodeableConcept
ST.png 8927             Toelichting 0 .. 1 bc-PregnancyUltraSoundGeneralFindings Observation.comment
Container.png 1210          Biometrie 0 .. 1 bc-PregnancyUltraSound DiagnosticReport
Container.png 3513             FoetaleBuikomtrek / AC (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3515                ACWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
PQ.png 3525                ACPercentielWaarde 0 .. 1 ntb
CD.png 3516                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3519                ACDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3520                ACDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3521                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3626             FoetaleSchedelomvang 0 .. 1 zib-HeadCircumference Observation
CD.png 3627                SchedelomvangMeetmethode 0 .. 1 zib-HeadCircumference Observation.method
ST.png 3628                Toelichting 0 .. 1 zib-HeadCircumference Observation.comment
PQ.png 3629                SchedelomvangWaarde 0 .. 1 zib-HeadCircumference Observation.value[x]:valueQuantity
PQ.png 3631                SchedelomvangPercentielWaarde 0 .. 1 ntb
TS.png 3630                SchedelomvangDatumTijd 0 .. 1 zib-HeadCircumference Observation.effective[x]:effectiveDateTime
Container.png 3539             FoetaleFemurlengte / FL (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3541                FLWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
PQ.png 3551                FLPercentielWaarde 0 .. 1 ntb
CD.png 3542                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3545                FLDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3546                FLDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3547                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3552             FoetaleBipariëtaleDiameter / BPD (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3554                BPDWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
CD.png 3555                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3558                BPDDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3559                BPDDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3560                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3564             FoetaalLongitudinaleBlaasDiameter / LBD (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3566                LBDWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
CD.png 3567                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3570                LBDDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3571                LBDDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3572                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3576             FoetaleKruinRompLengte / CRL (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3578                CRLWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
PQ.png 3588                CRLPercentielWaarde 0 .. 1 ntb
CD.png 3579                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3582                CRLDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3583                CRLDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3584                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3589             FoetaleTranscerebellarDiameter / TCD (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3591                TCDWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
PQ.png 3601                TCDPercentielWaarde 0 .. 1 ntb
CD.png 3592                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3595                TCDDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3596                TCDDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3597                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3602             FoetaleNekplooidikte / NT (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3604                NTWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
CD.png 3605                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3608                NTDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3609                NTDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3610                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3614             FoetaalGeschatGewicht / EFW (Meting) 0 .. 1 bc-FetusObservation Observation
PQ.png 3616                EFWWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueQuantity
CD.png 3617                MeetMethode 0 .. 1 bc-FetusObservation Observation.method
TS.png 3620                EFWDatumBeginTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.start
TS.png 3621                EFWDatumEindTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectivePeriod.end
ST.png 3622                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 2451          Bevindingen 0 .. 1 bc-FetusObservation Observation
Container.png 1784             Foetale hartslag (Hartfrequentie) 0 .. 1 zib-HeartRate Observation.value[x]:valueQuantity
Container.png 7789             LiggingFoetus (Meting) 1 .. 1 bc-FetusObservation Observation
Container.png 2404             Beweging foetus (Observatie) 0 .. 1 bc-FetusObservation Observation
TS.png 2405                BewegingFoetusDatumTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectiveDateTime
CD.png 2407                BewegingFoetusWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueCodeableConcept
CD.png 2408                ObservatieMethode 0 .. 1 bc-FetusObservation Observation.method
ST.png 2409                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 2410             Vruchtwater (Meting) 0 .. 1 bc-AmnioticFluid Observation
TS.png 2411                MeetDatumTijd 0 .. 1 bc-AmnioticFluid Observation.effective[x]:effectiveDateTime
CD.png 2413                HoeveelheidVruchtwaterWaarde 0 .. 1 bc-AmnioticFluid Observation.component:amnioticFluidQuantity.value[x]:valueCodeableConcept
CD.png 2479                VruchtwatercompartimentWaarde 0 .. 1 bc-AmnioticFluid Observation.component:amnioticFluidCompartment.value[x]:valueCodeableConcept
CD.png 2414                MeetMethode 0 .. 1 bc-AmnioticFluid Observation.method
ST.png 2415                Toelichting 0 .. 1 bc-AmnioticFluid Observation.comment
Container.png 2437             PlacentaLokalisatie (Observatie) 1 .. 1 bc-PlacentaLocalization Observation
TS.png 2438                PlacentaLokalisatieDatumTijd 0 .. 1 bc-PlacentaLocalization Observation.effective[x]:effectiveDateTime
CD.png 2449                PlacentalokalisatieWaarde 1 .. 1 bc-PlacentaLocalization Observation.component:placentaLocalization.value[x]:valueCodeableConcept
BL.png 7867                SectioLittekenWaarde 0 .. 1 bc-PlacentaLocalization Observation.component:sectionScar.extension:valueBoolean
CD.png 2448                OstiumWaarde 0 .. 1 bc-PlacentaLocalization Observation.component:ostium.value[x]:valueCodeableConcept
CD.png 2441                ObservatieMethode 0 .. 1 bc-PlacentaLocalization Observation.method
ST.png 2442                Toelichting 0 .. 1 bc-PlacentaLocalization Observation.comment
Container.png 2458             Afwijking placenta 0 .. 1 bc-DisorderOfPregnancy Condition
Container.png 2460                Probleem 0 .. 1 bc-DisorderOfPregnancy Condition
CD.png 2461                   ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfPregnancy Condition.bodySite
CD.png 2462                   ProbleemLateraliteit 0 .. 1 bc-DisorderOfPregnancy Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 2463                   ProbleemType 0 .. 1 bc-DisorderOfPregnancy Condition.category
CD.png 2464                   ProbleemNaam 0 .. 1 bc-DisorderOfPregnancy Condition.code
TS.png 2465                   ProbleemBeginDatum 0 .. 1 bc-DisorderOfPregnancy Condition.onsetDateTime:onsetDateTime
TS.png 2466                   ProbleemEindDatum 0 .. 1 bc-DisorderOfPregnancy Condition.abatementDateTime:abatementDateTime
CD.png 2467                   ProbleemStatus 0 .. 1 bc-DisorderOfPregnancy Condition.clinicalStatus
CD.png 2468                   VerificatieStatus 0 .. 1 bc-DisorderOfPregnancy Condition.verificationStatus
ST.png 2469                   Toelichting 0 .. 1 bc-DisorderOfPregnancy Condition.note
Container.png 3635             Cervixlengte (Meting) 0 .. 1 bc-MaternalObservation Observation
PQ.png 3637                CervixlengteWaarde 0 .. 1 bc-MaternalObservation Observation.value[x]:valueQuantity
CD.png 3638                MeetMethode 0 .. 1 bc-MaternalObservation Observation.method
TS.png 3641                CervixlengteDatumBeginTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.start
TS.png 3642                CervixlengteDatumEindTijd 0 .. 1 bc-MaternalObservation Observation.effective[x]:effectivePeriod.end
ST.png 3643                Toelichting 0 .. 1 bc-MaternalObservation Observation.comment
Container.png 7790             Navelstreng (Observatie) 0 .. 1 bc-UmbilicalCord Observation
TS.png 7791                NavelstrengDatumTijd 0 .. 1 bc-UmbilicalCord Observation.effective[x]:effectiveDateTime
CD.png 7846                NavelstrengWaarde 0 .. 1 bc-UmbilicalCord Observation.value[x]:valueCodeableConcept
CD.png 7793                NavelstrengVatenWaarde 0 .. 1 bc-UmbilicalCord Observation.component:umbilicalCordVessels.value[x]:valueCodeableConcept
CD.png 7794                ObservatieMethode 0 .. 1 bc-UmbilicalCord Observation.method
ST.png 7799                Toelichting 0 .. 1 bc-UmbilicalCord Observation.comment
Container.png 7836             OrgaansysteemFoetus (Observatie) 0 .. 1 bc-FetusObservation Observation
TS.png 7837                OrgaansysteemFoetusDatumTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectiveDateTime
CD.png 7887                ObservatieNaam 0 .. 1 bc-FetusObservation Observation.code
CD.png 7839                OrgaansysteemFoetusWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueCodeableConcept
CD.png 7840                ObservatieMethode 0 .. 1 bc-FetusObservation Observation.method
ST.png 7845                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 3920             Probleem (Hart & perifeer vaatstelsel) 0 .. 1 bc-DisorderOfChild Condition
CD.png 3921                ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfChild Condition.bodySite
CD.png 3922                ProbleemLateraliteit 0 .. 1 bc-DisorderOfChild Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 3923                ProbleemType 0 .. 1 bc-DisorderOfChild Condition.category
CD.png 3924                ProbleemNaam 0 .. 1 bc-DisorderOfChild Condition.code
TS.png 3925                ProbleemBeginDatum 0 .. 1 bc-DisorderOfChild Condition.onsetDateTime:onsetDateTime
TS.png 3926                ProbleemEindDatum 0 .. 1 bc-DisorderOfChild Condition.abatementDateTime:abatementDateTime
CD.png 3927                ProbleemStatus 0 .. 1 bc-DisorderOfChild Condition.clinicalStatus
CD.png 3928                VerificatieStatus 0 .. 1 bc-DisorderOfChild Condition.verificationStatus
ST.png 3929                Toelichting 0 .. 1 bc-DisorderOfChild Condition.note
Container.png 3930             Probleem (Hersenen, hersenstructuren, intracranieel) 0 .. 1 bc-DisorderOfChild Condition
CD.png 3931                ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfChild Condition.bodySite
CD.png 3932                ProbleemLateraliteit 0 .. 1 bc-DisorderOfChild Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 3933                ProbleemType 0 .. 1 bc-DisorderOfChild Condition.category
CD.png 3934                ProbleemNaam 0 .. 1 bc-DisorderOfChild Condition.code
TS.png 3935                ProbleemBeginDatum 0 .. 1 bc-DisorderOfChild Condition.onsetDateTime:onsetDateTime
TS.png 3936                ProbleemEindDatum 0 .. 1 bc-DisorderOfChild Condition.abatementDateTime:abatementDateTime
CD.png 3937                ProbleemStatus 0 .. 1 bc-DisorderOfChild Condition.clinicalStatus
CD.png 3938                VerificatieStatus 0 .. 1 bc-DisorderOfChild Condition.verificationStatus
ST.png 3939                Toelichting 0 .. 1 bc-DisorderOfChild Condition.note
Container.png 3940             Probleem (Wervelkolom, ruggemerg) 0 .. 1 bc-DisorderOfChild Condition
CD.png 3941                ProbleemAnatomischeLocatie 0 .. 1 bc-DisorderOfChild Condition.bodySite
CD.png 3942                ProbleemLateraliteit 0 .. 1 bc-DisorderOfChild Condition.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept
CD.png 3943                ProbleemType 0 .. 1 bc-DisorderOfChild Condition.category
CD.png 3944                ProbleemNaam 0 .. 1 bc-DisorderOfChild Condition.code
TS.png 3945                ProbleemBeginDatum 0 .. 1 bc-DisorderOfChild Condition.onsetDateTime:onsetDateTime
TS.png 3946                ProbleemEindDatum 0 .. 1 bc-DisorderOfChild Condition.abatementDateTime:abatementDateTime
CD.png 3947                ProbleemStatus 0 .. 1 bc-DisorderOfChild Condition.clinicalStatus
CD.png 3948                VerificatieStatus 0 .. 1 bc-DisorderOfChild Condition.verificationStatus
ST.png 3949                Toelichting 0 .. 1 bc-DisorderOfChild Condition.note
Container.png 7847             Sonomarkers (Observatie) 0 .. 1 bc-FetusObservation Observation
TS.png 7848                ObservatieDatumTijd 0 .. 1 bc-FetusObservation Observation.effective[x]:effectiveDateTime
CD.png 7886                SonomarkerNaam 0 .. 1 bc-FetusObservation Observation.code
CD.png 7850                SonomarkerWaarde 0 .. 1 bc-FetusObservation Observation.value[x]:valueCodeableConcept
CD.png 7851                ObservatieMethode 0 .. 1 bc-FetusObservation Observation.method
ST.png 7856                Toelichting 0 .. 1 bc-FetusObservation Observation.comment
Container.png 7868          TekstUitslag 0 .. 1 zib-TextResult DiagnosticReport
TS.png 7869             TekstUitslagDatumTijd 0 .. 1 zib-TextResult DiagnosticReport.effectiveDateTime
Container.png 7870             Verrichting 0 .. 1 bc-ObstetricProcedure Procedure.report
Container.png 7875                Verrichting (Onderzoek) 0 .. 1 bc-ObstetricProcedure Procedure
CD.png 7872             TekstUitslagStatus 0 .. 1 zib-TextResult DiagnosticReport.status.extension:TextResultStatus
ST.png 7873             TekstResultaat 0 .. 1 zib-TextResult DiagnosticReport.conclusion
CD.png 7874             TekstUitslagType 0 .. 1 zib-TextResult DiagnosticReport.code
Container.png 9885          Media 0 .. 1 Binary

6 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.

6.1 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 HeadCircumference Observation HeadCircumference http://nictiz.nl/fhir/StructureDefinition/zib-HeadCircumference
zib HeartRate Observation HeartRate http://nictiz.nl/fhir/StructureDefinition/zib-HeartRate
zib Payer Coverage Payer http://nictiz.nl/fhir/StructureDefinition/zib-Payer
zib Pregnancy Condition Pregnancy http://nictiz.nl/fhir/StructureDefinition/zib-Pregnancy
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 Procedure Procedure Procedure http://nictiz.nl/fhir/StructureDefinition/zib-Procedure
zib TextResult DiagnosticReport TextResult http://nictiz.nl/fhir/StructureDefinition/zib-TextResult

6.2 Birthcare specific profiles

Profile name Pattern FHIR Resource HCIM EN Canonical URL Description
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-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-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-FetusObservation Observation http://nictiz.nl/fhir/StructureDefinition/bc-FetusObservation An Observation profile describing fetus-related Observations in a pregnancy, such as movement and heart action, as defined by BabyConnect. 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-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-PlacentaLocalization Observation http://nictiz.nl/fhir/StructureDefinition/bc-PlacentaLocalization An Observation profile describing the localization of the placenta as defined by BabyConnect. 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-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-PregnancyUltraSound DiagnosticReport http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyUltraSound A DiagnosticReport profile describing a pregnancy ultrasound as defined by BabyConnect. The ultrasound DiagnosticReport groups Observations related to the pregnancy ultrasound. The woman Patient is the subject of the report.
  • This report refers to the EpisodeOfCare with DiagnosticReport.context.reference
bc-PregnancyUltraSoundGeneralFindings Observation http://nictiz.nl/fhir/StructureDefinition/bc-PregnancyUltraSoundGeneralFindings An Observation profile describing general ultrasound findings for the fetus as defined by BabyConnect. 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-ReferralRequest ReferralRequest http://nictiz.nl/fhir/StructureDefinition/bc-ReferralRequest A ReferralRequest profile describing referral details as defined by BabyConnect.

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).

bc-UmbilicalCord Observation bc-UmbilicalCord An Observation profile describing the umbilical cord a as defined by BabyConnect. 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-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.

7 Release notes

Release notes can be found on the functional design page.

8 Support

For questions and change requests regarding this IG, please create a ticket in BITS.

Overgenomen van "https://informatiestandaarden.nictiz.nl/index.php?title=GZ:FHIR_Pregnancy_Card_Echo&oldid=217667"