RIVO-Noord Zorgviewer Implementation Guide
1.17.0 - CI build Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.17.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

EViews (experimental)

Op deze pagina staan de experimentele OpenEHR View renderings van de profielen.

Condition

.Clinical
..ProblemStatus
Cardinality: 1..1
code
The problem status describes the condition of the problem:



  • Active problems are problems of which the patient experiences symptoms or for which evidence exists.
  • Problems with the status 'Inactive' refer to problems that don't affect the patient anymore or that of which there is no evidence of existence anymore..


value is bound to Condition Clinical Status Codes. Codes:
..VerificationStatus
Cardinality: 0..1
code
Clinical status of the problem or the diagnosis.

value is bound to ConditionVerificationStatus. Codes:
extensionhas cardinality: 0..1
..ProblemName
Cardinality: 1..1
CodeableConcept
The problem name defines the problem. Depending on the setting, different code systems can be used. The ProblemNameCodelist provides an overview of the possible code systems.

value is bound to Zorgviewer probleem naam waardelijst (??)
..ProblemStartDate
Cardinality: 0..1
dateTime
Start of the disorder to which the problem applies. Especially in symptoms in which it takes longer for the final diagnosis, it is important to know not only the date of the diagnosis, but also how long the patient has had the disorder. A ‘vague’ date, such as only the year or the month and the year, is permitted.

..ProblemEndDate
Cardinality: 0..1
dateTime
Date on which the disorder to which the problem applies, is considered not to be present anymore. This date does not need to be the same as the date of the change in problem status. A ‘vague’ date, such as only the year or the month and the year, is permitted.

.Record Mgmt.
..ProblemType
Cardinality: 0..*
CodeableConcept
The type of problem; see the profile description.

value is bound to ProbleemTypeCodelijst. Codes:
.Other Data.
..Who has the condition?
Cardinality: 1..1
Reference
Indicates the patient or group who the condition record is associated with.

value must point to a nl-core-patient
..Encounter or episode when condition first asserted
Cardinality: 0..1
Reference
Encounter during which the condition was first asserted.

value must point to one of HCIM Encounter or nl-core-episodeofcare
..Person who asserts this condition
Cardinality: 0..1
Reference
Individual who is making the condition statement.

value must point to one of nl-core-relatedperson, nl-core-patient or nl-core-practitioner
extensionhas cardinality: 0..1

doco Documentation for this format

Practitioner

.Demographics
..NameInformation
Cardinality: 1..*
HumanName
Health professional’s full name. If a health professional identification number is entered, it will be the name as listed in UZI, AGB or by the healthcare center.

value must be a nl-core-humanname
..A contact detail for the practitioner (that apply to all roles)
Cardinality: 0..*
ContactPoint
A contact detail for the practitioner, e.g. a telephone number or an email address.

value must be a nl-core-contactpoint
..AddressInformation
Cardinality: 0..*
Address
Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

value must be a nl-core-address
.Record Mgmt.
..HealthProfessionalIdentificationNumber
Cardinality: 1..*
Identifier
The health professional identification number is a number that uniquely identifies the health professional.



The following numbers are used in the Netherlands:



  1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry.
  2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations.
  3. BIG-ID. The ID of the health professional listed in the BIG Register.




This information is not readily available for foreign health professionals.

..UZI
Cardinality: 0..1
Identifier
Unieke Zorgverlener Identificatie (Dutch physician identification number)

system is fixed to http://fhir.nl/fhir/NamingSystem/uzi-nr-pers
systemhas cardinality: 1..1
valuehas cardinality: 1..1
.Other Data.
..Qualifications obtained by training and certification
Cardinality: 0..*
Group
Qualifications obtained by training and certification.


doco Documentation for this format

LaboratoryTestResult

.Data
..Classification of type of observation
Cardinality: 1..*
CodeableConcept
A code that classifies the general type of observation being made.

value is bound to Observation Category Codes (8 codes)
..LaboratoryTestResultCode
Cardinality: 1..1
CodeableConcept
A code that classifies the general type of observation being made.

value must match SNOMED CT: 49581000146104("Laboratory test finding (finding)") from Observation Category Codes (8 codes)
..ResultType
Cardinality: 0..1
CodeableConcept
The type of result defines the laboratory specialty under which the test is categorized.

value is bound to ResultaatTypeCodelijst (7 codes)
..TestDateTime
Cardinality: 0..1
dateTime
The date and if possible the time at which the test was carried out.

..TestDateTime
Cardinality: 0..1
dateTime
The date and if possible the time at which the test was carried out.

..TestResult
Cardinality: 0..1
Quantity
The test result. Depending on the type of test, the result will consist of a value with a unit or a coded value (ordinal or nominal).

..TestResult
Cardinality: 0..1
Quantity
The test result. Depending on the type of test, the result will consist of a value with a unit or a coded value (ordinal or nominal).

..High, low, normal, etc.
Cardinality: 0..1
CodeableConcept
The assessment made based on the result of the observation. Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.

value is bound to Observation Interpretation Codes (39 codes)
coding is bound to Observation Interpretation Codes (39 codes)
coding is bound to InterpretatieVlaggenCodelijst. Codes:
codinghas cardinality: 1..*
..Reference
Cardinality: 0..*
Group
Guidance on how to interpret the value by comparison to a normal or recommended range.

...ReferenceRangeLowerLimit
Cardinality: 0..1
Quantity
The lower reference limit for the patient of the value measured with the test.

value must be a SimpleQuantity
comparatorhas cardinality: 0..0
...ReferenceRangeUpperLimit
Cardinality: 0..1
Quantity
The upper reference limit for the patient of the value measured in the test.

value must be a SimpleQuantity
comparatorhas cardinality: 0..0
..LaboratoryTest
Cardinality: 0..*
Group
Container of the LaboratoryTest concept. This container contains all data elements of the LaboratoryTest concept.

...TestCode
Cardinality: 1..1
CodeableConcept
The TestCode is the name of the executed test.

value is bound to TestCodeCodelijst (>1000 codes)
...TestResult
Cardinality: 0..1
Choice
The test result. Depending on the type of test, the result will consist of a value with a unit or a coded value (ordinal or nominal).

value is a choice of:
...ResultFlags
Cardinality: 0..1
CodeableConcept
Attention codes indicating whether the result is above or below certain reference values or interpreting the result otherwise. (Resistent)

Comment: A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/InterpretatieVlaggenCodelijst-to-observation-interpretation) is available that maps ResultFlagsCodelist to the observation-interpretation value set.

value is bound to InterpretatieVlaggenCodelijst. Codes:
.Protocol
..Who is responsible for the observation
Cardinality: 0..*
Reference
Who was responsible for asserting the observed value as "true".

value must point to one of nl-core-organization, nl-core-patient, nl-core-practitioner or nl-core-relatedperson
extensionhas cardinality: 0..1
..TestMethod
Cardinality: 0..1
CodeableConcept
The test method used to obtain the result.

value is bound to TestmethodeCodelijst (671 codes)
..Specimen
Cardinality: 0..1
Reference
The specimen that was used when this observation was made.

value must point to a Specimen
..(Measurement) Device
Cardinality: 0..1
Reference
The device used to generate the observation data.

value must point to a HCIM MedicalDevice Product
.Context
..Fulfills plan, proposal or order including requester information.
Cardinality: 0..*
Reference
A plan, proposal or order that is fulfilled in whole or in part by this event.

Comment: Requester information should be captured and exchanged in the resource ProcedureRequest referenced by basedOn. Requester is the healthcare provider and/or organization where or by whom the LaboratoryTestResult was requested. There are a few required elements in ProcedureRequest:



  • ProcedureRequest.status (use fixed value active, unless you know what the actual value is)
  • ProcedureRequest.intent (use fixed value order, unless you know what the actual value is)
  • ProcedureRequest.code (use extension http://hl7.org/fhir/STU3/extension-iso21090-nullflavor.html with valueCode UNK, unless you know what the actual value is)
  • ProcedureRequest.subject (equal to Observation.subject)
  • ProcedureRequest.requester.agent (contains the requesting HealthProfessional)


value must point to one of CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ProcedureRequest or ReferralRequest
..Patient
Cardinality: 1..1
Reference
The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, donor, other observer (for example a relative or EMT), or any observation made about the subject.

value must point to one of Group, Device, nl-core-location or nl-core-patient
.Other Data
..Identifier
Cardinality: 0..*
Identifier
A unique identifier assigned to this observation.

..Encounter during which this observation is made
Cardinality: 0..1
Reference
The encounter during which this journal entry was made.

value must point to one of nl-core-episodeofcare, HCIM Encounter or gp-Encounter
..Comment or ResultInterpretation
Cardinality: 0..1
string
Comments, such as a textual interpretation or advice accompanying the result, for example or a comment of the laboratory specialist regarding the interpretation of the results.

..RelatedResults
Cardinality: 0..*
Group
Reference to related LaboratoryTestResult instances, or to the LaboratoryTest concept if this is a grouping Observation.

Comment: The Observation.related field is used for two different HCIM use cases:



  1. The LaboratoryTestResult can reference other, related LaboratoryTestResults (RelatedResult, NL-CM:13.1.33).
  2. The LaboratoryTestResult can consist of multiple LaboratoryTest concepts (NL-CM:13.1.3)




See the documentation on the root if this profile for guidance on implementing these use cases.

...Resource that is related to this one
Cardinality: 1..1
Reference
A reference to the observation or QuestionnaireResponse resource that is related to this observation.

value must point to one of QuestionnaireResponse, Sequence or HCIM LaboratoryTestResult Observation

doco Documentation for this format

Patient

.Demographics
..NameInformation
Cardinality: 1..*
HumanName
A name associated with the individual.

value must be a nl-core-humanname
extensionhas cardinality: 0..1
..A contact detail for the individual
Cardinality: 0..*
ContactPoint
A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'.

value must be a nl-core-contactpoint
..AddressInformation
Cardinality: 0..*
Address
Addresses for the individual.

value must be a nl-core-address
..MultipleBirthIndicator
Cardinality: 0..1
Choice
Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).

value is a choice of:
.Contacts
..ContactPerson
Cardinality: 0..*
Group
Contacts are related persons in some way, but not all related persons are contacts. The HCIM ContactPerson is designed to deal with both related persons and contacts. An HCIM ContactPerson who is a contact, is expected to have an NL-CM:3.1.2 Role primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon'). See Patient.contact.relationship in slice 'role'.

...Relationship
Cardinality: 0..*
CodeableConcept
The nature of the relationship between the patient and the contact person.

value is bound to RelatieCodelijst (35 codes)
...Role
Cardinality: 0..*
CodeableConcept
Expectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon')

value is bound to RolCodelijst (??)
...NameInformation
Cardinality: 0..1
HumanName
A name associated with the contact person.

value must be a nl-core-humanname
extensionhas cardinality: 0..1
...A contact detail for the person
Cardinality: 0..*
ContactPoint
A contact detail for the person, e.g. a telephone number or an email address.

Comment: Telecommunication data details (phone/email) is physically modeled in the HCIM Patient, which is why the telecommunication mappings appear to be coming from the HCIM Patient instead of the HCIM ContactPerson

value must be a nl-core-contactpoint
...AddressInformation
Cardinality: 0..1
Address
Address for the contact person.

value must be a nl-core-address
.Record Mgmt.
..PatientIdentificationNumber
Cardinality: 1..*
Identifier
The Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst).

..BSN
Cardinality: 1..1
Identifier
An identifier for this patient.

system is fixed to http://fhir.nl/fhir/NamingSystem/bsn
systemhas cardinality: 1..1
valuehas cardinality: 1..1
..Whether this patient's record is in active use
Cardinality: 0..1
boolean
This field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP.

..GeneralPractitioner
Cardinality: 0..1
Reference
Patient's nominated care provider.

value must point to one of nl-core-organization or nl-core-practitioner
extensionhas cardinality: 0..1
.Other Data.
..References a patient's preferered pharmacy
Cardinality: 0..1
Extension
Optional Extension Element - found in all resources.

value must be a nl-core-preferred-pharmacy
..Nationality
Cardinality: 0..*
Extension
The nationality of the patient.

value must be a nationality
extensionhas cardinality: 0..1
extensionhas cardinality: 0..1
url is fixed to nationality
value[x]has cardinality: 0..0
..legalStatus
Cardinality: 0..2
Extension
The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

value must be a Patient LegalStatus
url is fixed to Patient LegalStatus
value[x] is bound to JuridischeStatusCodelijst (??)
value[x]has cardinality: 1..1
..Optional Extensions Element
Cardinality: 0..*
Extension
Optional Extension Element - found in all resources.

value must be a HCIM LifeStance
url is fixed to HCIM LifeStance
value[x]has cardinality: 1..1
value[x]has cardinality: 1..1

doco Documentation for this format

unsupported types

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type

This view is not supported for this profile because it is of an unsupported type