UV_Vital Records Birth and Fetal Death Reporting
1.1.0 - STU 1.1

UV_Vital Records Birth and Fetal Death Reporting, published by IHE International. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/fhir-bfdr/ and changes regularly. See the Directory of published versions

## Change Log

### STU 1.1 Update, July 2023

Jira Issue | Description of Change | Changes Made
--- | --- | ---
FHIR-40613 | On profiles: Composition - Provider Live Birth Report Composition - Provider Fetal Death Report Make all slices on Composition.identifier optional (0..1) (as opposed to 1..1) | Update Composition.identifier slices to 0..1 on: Composition - Provider Live Birth Report Composition - Provider Fetal Death Report
FHIR-40680 | Observations with value sets containing a mix of Conditions, Observations, and Procedures have been used in the IG. This is not how the data is represented in the real world. Split the Observations into separate profiles using the appropriate resource. Replaced profiles: Condition - Abnormal Condition of Newborn Condition - Maternal Morbidity Observation - Characteristic of Labor and Delivery | Added the following profiles: Procedure - Assissted Ventilation Following Delivery Procedure - Assisted Ventilation More Than Six Hours Observation - NICU Admission Procedure - Surfactant Replacement Therapy Procedure - Antibiotic for Suspected Neonatal Sepsis Condition - Seizure Observation - None Of Specified Abnormal Conditions of Newborn Procedure - Blood Transfusion Condition - Perineal Laceration Condition - Ruptured Uterus Procedure - Unplanned Hysterectomy Observation - ICU Admission Observation - None Of Specified Maternal Morbidities Procedure - Induction of Labor Procedure - Augmentation of Labor Observation - Administration of Steroids for Fetal Lung Maturation Observation - Antibiotics Administered During Labor Condition - Chorioamnionitis Procedure - Epidural or Spinal Anesthesia Observation - None Of Specified Characteristics of Labor and Delivery
FHIR-40847 | Update to latest published version of US Core (5.0.1) | Small updates based on US Core profiles changes Update to Condition profiles due to split in US Core Condition into US Core Condition Encounter Diagnosis and US Core Problems and Health Concerns Profile - after consultation on Zulip, all cause of death condition profiles are based on US Core Condition Encounter Diagnosis, and all other Condition profiles are based on US Core Problems and Health Concerns Profile
FHIR-40929 | Revisit profile focus/subject mappings (mother and child/fetus) and update where needed During the Connectathon implementers noticed that there were a few profiles where the focus and subject were the wrong way round. Need to list all the profiles and ensure that they are all correct and update where needed. |
FHIR-41323 | Add and update a “Change Log” narrative page to the BFDR | This file/referencing page
FHIR-41325 | Update Narrative pages for project info, correct external links, etc. Additionally, remove the IHE page and include relevant information on remaining narrative pages. | Narrative pages
FHIR-41385 | Add Extension to Live Birth Compositions to reference maternity Encounter Composition.encounter is limited to a maximum of 1 encounter, however a Live Birth spans two encounters - the Birth Encounter and the Maternity Encounter. The two Live Birth Compositions have the Birth Encounter as the one encounter referenced. Pilot implementers have requested that we add an extension to these Compositions to reference the Maternity Encounter to allow them to more easily get to the data in that Encounter. Add to Composition - Provider Live Birth Report and Composition - Jurisdiction Live Birth Report an extension (must support and 0..1) that references the Maternity Encounter. | Added: Extension-encounter-maternity-reference Updated both Live Birth Compositions to optionally contain extension (on Composition.encounter)
FHIR-41386 | Add receipt date Parameters profile similar to VRDR “Coding Status Values” Adding a Parameters profile similar to StructureDefinition-vrdr-coding-status-values will allow BFDR implementers to use status flags that result from the NCHS coding process, e.g., Receipt date – Day, Month, Year (IJE codes R_DY, R_MO, R_YR) | Added profile to VRCPL: Parameters-coding-status-values-vr
FHIR-41387 | Add Extension similar to VRDR “Extension: Replacement Status of a Death Record”, for replacement status of a birth / fetal death record Adding an Extension will allow implementers to designate a Replacement (amended) record (IJE code: REPLACE) in IJE exchanges. In VRDR, the Extension is on the Death Certificate composition. Similarly, in BFDR, the extension will be available for the 4 Compositions (Provider/Jurisdiction Live Birth Report & Provider/Jurisdiction Fetal Death Report) | Added profile: Extension-replacement-status
FHIR-41564 | FHIR-IJE Mismatch: This profile is used for the value known as AUTOPF. According to IJE Spreadsheet, the AUTOPF is a Y/N/NA value. The profile provides only a boolean value. Suggest that it be a codeable concept bound to a Y/N/NA valueset. | Updated as suggested
FHIR-41580 | Obsolete value in PHVS_FetalPresentations_NCHS value set: SNOMEDCT code 163518000 – On examination – fetal presentation unsure | Replace code with nullFlavor UNK in PhinVads value set: 2.16.840.1.114222.4.11.7113
FHIR-41596 | Composition data sources for items on the mother’s/patient’s worksheet: The provider live birth composition HL7.FHIR.US.BFDR\Composition - Provider Live Birth Report - FHIR v4.0.1 and the provider fetal death report composition HL7.FHIR.US.BFDR\Composition - Provider Fetal Death Report - FHIR v4.0.1 include elements that have information that is directly asked from the mother and typically not found in the same format within an EMR unless this information is collected from the mother using the questions and wording of the jurisdiction’s mothers’ worksheet for the birth certificate via a patient portal or tablet that is uploaded to the EMR. The data source for this information should be the mother (live birth) or patient (fetal death). To help make this more explicit for implementers we are requesting that descriptions within the entries be updated to include such information on where the information may be found. | Add data source to Composition, Profiles, add guidance on mapping tables page, add guidance on use cases page.
FHIR-41600 | Add guidance on:Mother/Baby linkage: Consider adding guidance (perhaps on Use Cases) on how FHIR models mother/baby linkage using RelatedPerson and noting that EHR systems may not use this method of linking the two participants. | Added guidance as suggested and also added guidance on alternate way of linking mother and baby found in some EHRs.
FHIR-41601 | Add guidance on Plurality & Multiple Births | Added guidance as suggested on Use Cases page
FHIR-41602 | Add guidance on sources and coding of data for forms | Added guidance as suggested on Use Cases page