Cross Border Data Exchange IG
1.0.0 - CI Build
Cross Border Data Exchange IG
1.0.0 - CI Build
Cross Border Data Exchange IG, published by IEHR-Workgroup. 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/InteropEHRate-project/cross-border-data-exchange/ and changes regularly. See the Directory of published versions
| Official URL: http://interopehrate.eu/fhir/ImplementationGuide/fhir.uv.crossborderdataexchange | Version: 1.0.0 | |||
| Draft as of 2024-04-08 | Computable Name: CBDS_IG | |||
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.
This ImplementationGuide is part of the InteropEHRate project. Details on the project background are available at interopEHRate.eu.
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.
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.
| 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.
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.
| 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 |