Technical Design Lab2patient V1.0.0-beta.2

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Icoon Nictiz Cirkel Informatie Oranje.svg

'IsUitbesteed' and POC-test are not yet part of the Technical Design (TO). In the Functional Design (FO) they have already been described. These elements will also be included in another release.


AfsprakenstelselFunctionalTechnicalAfspraken-Functioneel-Technisch

For an overview of all current documentation see information standard lab exchange main page


1 Introduction

Go to functional design

This is the technical design (TO) for the information standard (IS) Lab2patient. This TO must be used together with the IS functional design, see functional design Lab2patient 1.0.0-beta.2. The data exchange format used in this version is: FHIR R4.

1.1 Support

For questions, feedback, or change requests, please contact our support team at Nictiz Servicemanagement.

1.2 Boundaries

This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see functional design Lab2patient 1.0.0-beta.2.

1.3 Prerequisite knowledge

The following background information is required for understanding this TO:

2 Relationships

The diagram below shows the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.

For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.

FHIR-model-overview-L2P.png

3 Components

HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

3.1 HL7 FHIR R4

3.1.1 Artifacts

The artifacts of the information standard are presented in the following table:

zib FHIR resource FHIR profile
HealthcareProvider Organization nl-core-HealthcareProvider-Organization
HealthProfessional Practitioner nl-core-HealthProfessional-Practitioner
PractitionerRole nl-core-HealthProfessional-PractitionerRole
LaboratoryTestResult Device nl-core-LaboratoryTestResult.Specimen.Source
Observation nl-core-LaboratoryTestResult
Specimen nl-core-LaboratoryTestResult.Specimen
Patient Patient nl-core-Patient
DiagnosticReport lu-LaboratoryTestResult-DiagnosticReport
ServiceRequest lu-OrderData

3.1.2 Examples of FHIR instances

You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: Lab exchange HL7-mappings repository.

4 Transactions

4.1 Patient retrieves laboratory results in their PGO

4.1.1 Involved actors

Transaction group Transaction Actor System role code
Retrieve laboratory results (PULL) Retrieve laboratory results request Client LAB-LRR-PGO
Retrieve laboratory results response Server LAB-LRB-PGO
Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem), PGO = Persoonlijke gezondheidsomgeving.

4.1.2 Search parameters

FHIR Search Parameter Description FHIR Resource Example
Retrieve laboratory results (Observation search)
category Restrict search to laboratory observations Observation
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
code Filter by laboratory test code (LOINC/NHG) Observation
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
date Filter results based on observation date Observation
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date=gt2022-03-12&date=lt2022-06-07
Retrieve latest laboratory results ($lastn operation)
$lastn Retrieve most recent lab results using the $lastn operation Observation
GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&code=http://loinc.org|14683-7
Retrieve related resources
_include Include linked resources (Specimen, Patient, Organization) in the response bundle Observation
GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&_include=Observation:specimen&_include=Observation:patient&_include=Observation:performer
All queries are executed in the authenticated patient context as per MedMij Afsprakenstelsel; no patient search parameters are used.