MedMij FHIR Implementation Guide basic BgPZ data

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1 Introduction

The page describes the FHIR requirements for exchanging BgPZ information between the patients and healthcare providers in the context of MedMij.

Note: This implementation guide builds on the general guidelines described in the use case overarching principles.

2 Actors involved

Actors Systems FHIR Capability Statements
Name Description Name Description Name Description
Patient The user of a personal healthcare environment. PHR Personal health record Verwijzing.png CapabilityStatement: Client FHIR Client requirements
Healthcare professional The user of a XIS XIS Healthcare information system Verwijzing.png CapabilityStatement: Server FHIR Server requirements

3 Boundaries and Relationships

The BgPZ use case has similarities and differences with other use cases such as the BgZ, Medication Process, Vital Signs, GP Patient Data and Lab Results. These use cases use much of the same HCIM based FHIR profiles for exchanging information. Wherever possible every attempt is made to re-use the profiles as used in the BgZ. The BgPZ use case also has unique profiles compared to the aforementioned use cases. A second thing to note is that while the selection criteria of certain sections like procedure do not match with the BgZ or other use cases, this does not affect the profiles in use. For example, it is irrelevant for the response profile for procedures if you request ' surgical procedures' or 'every procedure'.

4 Use case: retrieve BgPZ information

Go to MedMij Afsprakenstelsel

This FHIR implementation guide assumes that the PHR system is able to make a connection to the right XIS that contains the patient's information. It does not provide information on finding the right XIS nor does it provide information about security. Moreover, each transaction is performed in the context of a specific authenticated patient, for whose context (token) has been established using the authentication mechanisms described in the 'Afsprakenstelsel'. Each XIS Gateway is required to perform filtering based on the patient associated with the context for the request, so only the records associated with the authenticated patient are returned. For this reason, search parameters should not be included for patient identification.

4.1 PHR: request message

The PHR system requests the patients BgPZ information using individual search interactions. The BgPZ consists of multiple FHIR resources with certain constraints. To obtain the patient's BgPZ, 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]}

The table below shows in the first three columns the HCIM name in Dutch, in English and what HCIM content is requested. The last column shows the FHIR search queries to obtain this information. These queries and expected responses are based on profiles listed in this section.

BGpZ Section HCIM NL HCIM EN Content Search URL[1]
Zorgverlening Zorgepisode Maternal record
GET [base]/EpisodeOfCare?type=|364320009
Contact Birthcare related encounters (e.g. prenatal visit, postnatal follow-up, counseling, birth assistance)
GET [base]/Encounter?episodeofcare=[recordid]
Zorgteam Care team
GET [base]/CareTeam?context=[recordid|encounterid]
Zorgverlener HealthProfessional General Practitioner of the patient see Patient, CareTeam
Zorgaanbieder HealthProvider General Practitioner's organization of the patient see Patient, CareTeam
Vrouw Patient Patient Identification, birthdate, gender, contact details, marital status, legal status, and general practitioner (practitioner or organization)
GET [base]/Patient?_include=Patient:general-practitioner
Anamnese Probleem Problem All known problems
GET [base]/Condition
Verrichting Procedure All known procedures
GET [base]/Procedure
Medicatiegebruik Medicatiegebruik MedicationUse All known medication use
GET [base]/MedicationStatement
Metingen Bloeddruk BloodPressure Blood pressure measured during prenatal visit
GET [base]/Observation?code=|85354-9
Lichaamsgewicht BodyWeight Body weight measured during prenatal visit
GET [base]/Observation?code=|29463-7
Lichaamslengte BodyHeight Body height measured during prenatal visit
GET [base]/Observation?code=|8302-2
Bloedonderzoek LaboratoriumUitslag LaboratoryTestResult Blood group, rhesus D, rhesus C
GET [base]/Observation?code=|883-9
GET [base]/Observation?code=|1305-2
GET [base]/Observation?code=|1159-3
Zwangerschap Zwangerschap Pregnancy Pregnancy
GET [base]/Condition?code=|364320009
Zwangerschap Pregnancy Parity, gravidity and pregnancy duration
GET [base]/Observation?code=11977-6
GET [base]/Observation?code=11996-6
GET [base]/Observation?code=57036006
Foliumzuurgebruik ??? Folic acid use
GET [base]/Observation?code=...
Drugsgebruik DrugUse All known drug use
GET [base]/Observation?code=|228366006
Alcoholgebruik AlcoholUse All known alcohol use
GET [base]/Observation?code=|228273003
Tabakgebruik TobaccoUse All known tobacco use
GET [base]/Observation?code=|365980008
AlgemeneMeting GeneralMeasurement
GET [base]/Observation?code=[code]
BevindingGeboortezorg (CIM) Fetal loss, aantal levende kinderen, typering gemellizwangerschap, aantal foetussen
GET [base]/Observation?code=[code]
TermDate ZIB2020? Definitieve a terme datum
GET [base]/Observation?code=[code]
GET [base]/Observation?code=[code]
Bevalling BevallingOntsluitingsfase
GET [base]/Procedure?code=|236973005
GET [base]/Procedure?code=|236973005
GET [base]/Procedure?code=|236973005
GET [base]/Condition?category=|362972006
GET [base]/Procedure?category=|386637004
Kind Patient Patient Identification, birthdate, gender
GET [base]/Patient
ApgarScore ApgarScore 1 minute, 5 minute, 10 minute Apgar Score
GET [base]/Observation?code=|9272-6,|9274-2,|9271-8
Lichaamsgewicht BodyWeight Birth weight
GET [base]/Observation?code=|8339-4
Lichaamslengte BodyLength Body length at birth
GET [base]/Observation?code=[code]
ApgarScore ApgarScore ApgarScore at birth
GET [base]/Observation?code=|9271-8
GET [base]/Observation?code=|9274-2
GET [base]/Observation?code=|9272-6
Schedelomvang Headcircumference Headcircumference at birth
GET [base]/Observation?code=|169876006
Lichamelijk onderzoek kind Probleem Problem Congenital and chromosomal disorders
GET [base]/Condition?category=|414025005
Verrichting_Kindspecifiek Child specific procedures during birth
GET [base]/Procedure?category=|386637004&part-of=[birthid]
Probleem_Kindspecifiek Child disorders
GET [base]/Condition?category=|414025005
LaboratoriumUitslag Child laboratory observations
GET [base]/Observation?code=[code]
  1. See Search URLs and search parameters for the interpretation of these search URLs

4.2 Server - XIS

The returned data to the PHR should conform to the profiles listed in #List_of_profiles.

4.3 List of profiles

The profiles represent their entire respective HCIM and are applicable in a broader context than the exchange of BgPZ information.

Allergies AllergyIntolerance AllergyIntolerance
Foetus Fetus BodySite
Zorgteam CareTeam
Probleem Problem Condition
Probleem_Kindspecifiek Problem Condition
Probleem_Maternaal Problem Condition
Probleem_Maternaal Problem Condition
Probleem_Maternaal Problem Condition
Zwangerschap Pregnancy Condition
BehandelAanwijzing TreatmentDirective Consent
Informed Consent (CIM) Consent
Bevindingen Vaginaal toucher (CIM) DiagnosticReport
Echoresultaat (CIM) DiagnosticReport
Foetale monitoring (CIM) DiagnosticReport?
Observatie UterusActiviteit (CIM) DiagnosticReport?
Contact Encounter
Contact Encounter
Zorgepisode EpisodeOfCare
FamilieAnamnese FamilyMemberHistory
Medicatiegebruik MedicationUse MedicationStatement
Alcoholgebruik AlcoholUse Observation
AlgemeneMeting GeneralMeasurement Observation
BevindingGeboortezorg (CIM) Observation
BevindingGeboortezorg (CIM) Observation
BevindingGeboortezorg (CIM) Observation
BevindingGeboortezorg (CIM) Observation
BevindingGeboortezorg (CIM) Observation
BevindingGeboortezorg (CIM) Observation
Bloeddruk BloodPressure Observation
Drugsgebruik DrugUse Observation
Echouitslag (CIM) Observation?
Hartfrequentie Observation
LaboratoriumUitslag LaboratoryTestResult Observation
Lichaamsgewicht BodyWeight Observation
Lichaamslengte BodyLength Observation
ParticipatieInMaatschappij ParticipationInSociety Observation
Schedelomvang Headcircumference Observation
Tabakgebruik TobaccoUse Observation
Zorgaanbieder Organization Organization
Patient Patient Patient
Opleiding Patient
BurgerlijkeStaat MaritalStatus Patient.maritalStatus
Etniciteit (CIM) Patient.extension:ethnicity
Taalvaardigheid LanguageProficiency Patient.communication.extension:languageProficiency
NationaliteitRC Patient.extension:nationality
Patient Patient Patient
Zorgverlener HealthProfessional Practitioner
Zorgverlener HealthProfessional PractitionerRole
BevallingOntsluitingsfase, BevallingUitdrijvingsfase, BevallingNageboortefase Procedure
Geboorte Procedure
Verrichtingen_Maternaal, Verrichting_Kindspecifiek Procedure Procedure
Verwijzing ReferralRequest
Moeder-kind relatie RelatedPerson

Example instances of FHIR resources can be found on Simplifier. Please note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of any information standard..

5 Terminology, NamingSystems, Mappings

5.1 Terminology

Relevant ValueSets can be found through the ValueSet bindings in the listed StructureDefinitions. All ValueSets can be found here here and can be downloaded as a .zip in XML or JSON format.

5.2 NamingSystems

Relevant NamingSystems can be found here.

5.3 Mappings

A FHIR ConceptMap resource is provided when a FHIR value set is used instead of a HCIM value set. A ConceptMap maps the values between the two value sets. These ConceptMaps can be found here.

An explanation about mappings can be found at Mapping of coded concepts.

6 Release notes

Release notes can be found on the functional design page.