Cross Border Data Exchange IG
1.0.0 - CI Build

Cross Border Data Exchange IG, published by IEHR-Workgroup. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/InteropEHRate-project/cross-border-data-exchange/ and changes regularly. See the Directory of published versions

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Purpose

The goal of this Implementation Guide is to specify the HL7 FHIR profiles to exchange data within cross-border medical scenarios defined in the project InteropEHRate (IEHR) and evaluated in project pilot. This includes both administrative and medical information relevant to the pilot. Wherever possible, existing profiles / IGs are used without changing them in order to ensure the highest possible standardization.

Project Background

This ImplementationGuide is part of the InteropEHRate project. Details on the project background are available at interopEHRate.eu.

IEHR logo
Fig. 1.1: Official logo of the InteropEHRate project

InteropEHRate in a nutshell - In short, the project enables patients to be in full control of the usage and the routes of their health data. The central instrument, being laid in "patients' hands" is the Smart EHR (S-EHR), leveraging a set of new protocols for secure and cross border exchange of health data.

Read more about this project's goal and purpose here.

Project Scope

Within the project, 2 scenarios (medial visit abroad, emergency access) regarding cross-border data exchange have been analysed (D2.2 – User Requirements for cross-border HR integration-v2). The scenario medical visit abroad focuses on an information exchange between a healthcare professional (HCP) and a patient based on the patient as the actual data provider, while the scenario emergency access supports data exchange without the patient’s involvement. The data requirements have been adopted and are the basis for the following data sets.

Table 1.1: IEHR Data Requirements
Super-category Sub-category Data
Demographics General Data Name, Surname
administrative gender
Date of Birth
Allergies General Data Allergies (ATC drug codes, LOINC), intolerance codes
Allergies (ATC drug codes, LOINC), intolerance notes
Diseases Main chronic conditions Hypertension
Hypertension starting date
Ischemic heart disease
Diseases General Data Heart failure
Pulmonary disease
Abnormal kidney function
Abnormal liver function
Previous major surgery
Previous major surgery date
Active malignancy
Current Medications, previous medications
Backup Contacts
Diseases Eventual acute (ongoing) Diseases Eventual acute (ongoing) Diseases
History previous visits (pdf and structured data) diagnosis
treatment plan (next visits, exams, etc)
current Medications, previous medications
visit prescription current visit prescribed drugs prescribed drugs
Vital Signs Vital parameters for the last ambulatory weight (Kg)
height (cm)
blood pressure (mmHg)
resting heart rate (bpm)
peripheral edema (presence/absence)
signs of lung congestion (presence/absence)
pleural effusion (presence/absence)
sign of ascites (presence/absence)
jugular vein distension (presence/absence);
Cardiac and lung auscultation (normal/abnormal)
EKG Latest EKG rhythm (eg sinus rhythm, atrial fibrillation, paced, etc.)
heart rate (bpm)
PR
QRS intervals (msec)
QTc intervals (msec)(optional)
left bundle branch block (presence/absence)
EKG signal waveform
EKG signal pdf/other
EKG report (text)
EKG report (pdf/other)
Echo Latest echocardiogram LVEF (%)
septum thickness
left ventricular end systolic/diastolic volume (mL)
grade of diastolic dysfunction (0/1/2/3)
estimated pulmonary artery pressure (mmHg)
degree of mitral regurgitation (no, mild, moderate, severe)
degree of tricuspid regurgitation (no, mild, moderate, severe)
DICOM movie
Report pdf
Report text
X-Ray Latest chest X-Ray report
report
Latest Holter monitoring Latest Holter monitoring mean heart rate (bpm)
number of premature ventricular beats
number of ventricular tachycardias (with max length in bpm)
atrial fibrillation (presence/absence)
Latest bio-humoral values Latest bio-humoral values hemoglobin (g/dl)
white blood count
creatinine (mg/dl)
eGFR (ml/min/1.73m2)
AST
ALT
GGT
bilirubin
BNP (ng/L)
NT-proBNP (ng/L)
Latest cardiac magnetic resonance Latest cardiac magnetic resonance LVEF (%)
left ventricular end systolic/diastolic volumes
late gadolinium enhancement (presence/absence).
Surgical history Surgical history Surgical history
Encounter Encounter Encounter

See the requirements mapped to the profiles used for realization and links to handling instructions here.

Relationship to other Guidelines / IGs

To increase the interoperability of this project already existing profiles where used to fulfill the requirements whenever it was possible. If a new profile had to be defined, it was attempted to base them on profiles from already existing projects to make them conform to the requirements of the other project. In addition to the base FHIR definitions two other IGs were used for this.

Table 1.2: Related IGs
Name Workgroup FHIR Version Publishing date of used version
FHIR Health Level Seven International Orders and Observations Workgroup 4.0.1 2019-10-30
International Patient Summary Health Level Seven International-Patient Care Work Group 4.0.1 2020-05-19
HL7 FHIR® US Core Implementation Guide HL7 International-US Realm Steering Committee 4.0.1 2020-08-28