ACT-NOW Implementation Guide
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ACT-NOW Implementation Guide, published by Te aho o te kahu - Cancer Control Agency. This guide is not an authorized publication; it is the continuous build for version 0.4.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/davidhay25/actnow/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

CapabilityStatement representing the server requirements for a FHIR server

Server capability statement

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

ACT-NOW diagnosis

The primary diagnosis for this cancer. Can have an evidence.detail reference to an Observation that has the histology and a stage.assessment reference to the TNM Observation staging (clinical and pathological)

ACT-NOW medication administration

ACT-NOW medication administration. These are medications that were actually administered.

ACT-NOW medication request

ACT-NOW medication request. These are prescriptions given to the patient.

ACT-NOW patient

ACT-NOW patient

Body Surface Area

An observation that represents a Body Surface Area measurement

Clinical M-score

An observation that represents the clinical ‘M’ score

Clinical N-score

An observation that represents the clinical ‘N’ score which measures local lymph node involvement.

Clinical T-score

An observation that represents the clinical ‘T’ score which measures the tumour size.

Creatinine Clearance

An observation that represents a Creatinine Clearance measurement

Cycle Careplan

A CarePlan that represents a single cycle of treatment. It will have a ‘partOf’ reference to the regiment carePlan.

ECOG score

An observation that represents an ecog score

Estrogen Receptor status

An observation that represents an ER status

Gleason score

An observation that represents the Gleason score

HER2 status

An observation that represents a HER2 status

Height

An observation that represents a height measurement

Histology

An observation that represents a Histology finding

PR status

An observation that represents a Progesterone Receptor status

Pathological M-score

An observation that represents the pathological ‘M’ score which measures distant metastases.

Pathological N-score

An observation that represents the pathological ‘N’ score which measures local lymph node involvement.

Pathological T-score

An observation that represents the pathological ‘T’ score which measures tumour size.

Pathological TNM group score

An observation that represents the pathological TNM group score

Regimen Careplan

A CarePlan that represents a PlanDefinition being applied to a Patient. Referred to as a regimen. The regimen has multiple cycles also represented as CarePlans which have a ‘partOf’ reference back to the regimen plan.

Weight

An observation that represents a weight measurement

clinical TNM group score

An observation that represents the clinical TNM group score

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

ClinicalTrial

Is on a clinical trial

CourseNumber

The course number (sequential number) for this regimen

CycleCount

The number of cycles that administered for a regimen

CycleDay

The day of the cycle that this medication was given on. Includes planned day and administered day. Not the same as intended cycle length.

CycleNumber

The cycle number of the regimen that this CP represents

CyclePlannedLength

The number of cycles that administered for a regimen

DoseAdjustmentReason

The reason why the dose given was not the same as that in the regimen

FacilityAdministered

The facility where the medication was given. The HPI code of the facility

IOT

Intent of treatment

LastAdminDate

The last date that a medication administration was made for this cycle

PrescribedDose

The dose of this medication in the regimen (may not be the same as that given

RecurrenceType

Recurrence type

Regimen type

The overall type of the regimen - eg FOLFOX

RegimenDiscontinued

Reasons why a regimen may have been discontinued

RegimenOTU

Overall Treatment Utility measure for a regimen after it has completed.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Basis of diagnosis

Whether the diagnosis is based on clinical or pathological grounds

Dose adjustment reason

What was reason the dose was adjusted

ECOG status

ECOG status

ER status

Estrogen Receptor status

ER status

Estrogen Receptor status

HER2 status

Human epidermal growth status

Intent of treatment

What was the purpose of this treatment

Outcome of a regimen

How did applying the regimen affect the patient

Patient factors when discontinuing a regimen

Patient factors when discontinuing a regimen

The reason why a regimen was discontinued

The reason why a regimen was discontinued

Toxicity reasons why a regimen was discontinued

Toxicity reasons why a regimen was discontinued

Type of recurrence

Type of recurrence

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Outcome of a regimen

How did applying the regimen affect the patient

The reason why a regimen was discontinued

The reason why a regimen was discontinued

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Clincial M value
Clincial N value
Clinical T value
Clinical TNM group
CreatinineClearance
Cycle 1

Example of a cycle care plan

ERStatus
ExObservationECOG
ExObservationGleason
ExObservationHeight
ExObservationNoValueSystemWeight
ExObservationWeight
Example practitioner
HER2Status
Histology: Small cell lung cancer
Lorrie Lung
PRStatus
Pathological M value
Pathological N value
Pathological T value
Pathological TNM group
Small cell lung cancer diagnosis
bsa
careplan-regimen-1

Example of a regimen care plan

careplan-regimen-2

A regimen care plan that was discontinued after it started

cp-supporting-info

Searches for supportingInfo references

medicationadministration-1

An example medication administration

medicationrequest-1

An example medication administration