International Birth And Child Model Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fetal_records/ and changes regularly. See the Directory of published versions

Use Case 3 Data Transfer

Page standards status: Informative

Use case 3: Data Transfer

Description

This is a basic use case where you communicate data from one system to another system. Usually such a data transfer is a combined set of data with information about the mother, the pregnancy or the fetus.

This of course could be in the various stages of the pregnancy and that has direct consequences on how to compose the set to communicate. Is there only a mother record? Are there fetus medical records? Is there already a child record?

There is more or less general consensus of what a child record should contain and in the elaboration of this use case we will explore the data categories.

Patient Information: Ms. MS is a 32-year-old female residing in a rural village in Sri Lanka. She was born on February 1, 1991, from a healthy couple and was diagnosed with achondroplasia based on clinical diagnosis, as she had macrocephaly and short limbs at birth. Her current address is 88 Factory Road, Peradeniya, and she can be contacted at +0012345678.

Pregnancy Details: Ms. MS's pregnancy was confirmed at 8 weeks of gestation by a urine HCG test, after which she was regularly monitored at the local Medical Officer of Health office (MOH) on a monthly basis. During the first visit, baseline examinations and testing done such as weight (47kg), height (147cm), Hb (12g/dl), Urine for sugar (negative). Continued monthly follow up at MOH office MS continued the pregnancy follow up at local MOH clinic. Other than general wellbeing, fetal growth by examination and maternal body weight is measured.

Additionally, she was seen by an obstetrician once every trimester at Teaching Hospital Kandy. At 32 weeks of pregnancy, Ms. MS had her third visit to the Obstetrician at Teaching Hospital Kandy, during which an ultrasound scan was performed. The scan revealed that the femur length (40mm) was lower than the expected range for the period of gestation, but the head circumference (318mm) was larger than expected. Besides, her general well-being and a few other parameters, including weight, were recorded and found to be within the normal range.

Management Plan: Considering the patient's medical history and ultrasound findings, the Obstetrician planned an Elective Lower Segment Cesarean (EL/LCSC) delivery at 38 weeks of gestation.

Roles & systems

Record initiator: Source provider Record receiver; Record receiver. Subject of procedure: fetus, mother, child or pregnancy. Carrier: pregnant woman

In this use case a source provider compiles a collection of data from the mother, the fetus and the pregnancy and sends it to a receiving system. The receiving system responds to the initiator to indicate whether it can process the information or else replies that it does not understand what is being sent.

FHIR

The graphs below show the mapping of this use case to FHIR. The FHIR example resources can be found in the FHIR artifacts section of this IG and in the tables below. Note that the example resources corresponding to this use case are prefixed with UC3.

The first graph represents the first visit to the MOH. Baseline examinations and testing are performed such as weight (47kg), height (147cm), Hb (12g/dl), Urine for sugar (negative)

Concept	Resource type	Example
Ms. MS - 32-year-old female	Patient	UC3 Mother
Pregnancy	Condition	UC3 Pregnancy
First visit to the MOH	Encounter	UC3 First MOH Visit
MOH	Location	UC3 Local MOH
Pregnancy test	Observation	UC3 Pregnancy Test First MOH Visit
Body weight	Observation	UC3 Body Weight First MOH Visit
Body height	Observation	UC3 Body Height First MOH Visit
Hemoglobin	Observation	UC3 Hemoglobin First MOH Visit
Reducing substances	Observation	UC3 Reducing Substances First MOH Visit

The second graph represents an example of a follow-up visit to the MHO. Other than general wellbeing, fetal growth by examination and maternal body weight is measured.

Concept	Resource type	Example
Ms. MS - 32-year-old female	Patient	UC3 Mother
Pregnancy	Condition	UC3 Pregnancy
Follow-up visit to the MOH	Encounter	UC3 Follow Up MOH Visit
MOH	Location	UC3 Local MOH
Body weight	Observation	UC3 Body Weight Follow Up MOH Visit
Uterus Fundal Weight	Observation	UC3 Uterus Fundal Weight Follow Up MOH Visit

The third graph represents the third visit to the Obstetrician at Teaching Hospital Kandy, during which an ultrasound scan was performed. The scan revealed that the femur length (40mm) was lower than the expected range for the period of gestation, but the head circumference (318mm) was larger than expected. Besides, her general well-being and a few other parameters, including weight, were recorded and found to be within the normal range. Considering the patient's medical history and ultrasound findings, the Obstetrician planned an Elective Lower Segment Cesarean (EL/LCSC) delivery at 38 weeks of gestation.

Concept	Resource type	Example
Ms. MS - 32-year-old female	Patient	UC3 Mother
Pregnancy	Condition	UC3 Pregnancy
Fetus	Patient	UC3 Fetus
Relation mother and fetus	RelatedPerson	UC3 RelatedPerson Fetus
Third visit to the Obstetrician at Teaching Hospital Kandy	Encounter	UC3 Obstetric Clinic Encounter
Third visit to the Obstetrician at Teaching Hospital Kandy	Encounter	UC3 Obstetric Clinic Encounter
Kandy Hospital	Location	UC3 Kandy Hospital
Patient's medical history	FamilyMemberHistory	UC3 FamilyMemberHistory of Fetus
Head circumference (318mm)	Observation	UC3 Head Circumference Obstetric Clinic
Femur length (40mm)	Observation	UC3 Femur Length Obstetric Clinic
Body weight	Observation	?
Planned Elective Lower Segment Cesarean (EL/LCSC) delivery at 38 weeks of gestation	Careplan	UC3 Care Plan