Patient Monitoring Outcome FHIR Implementation Guide
0.1.0 - STU1 BE

Patient Monitoring Outcome FHIR Implementation Guide, published by HL7 Belgium. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/patient-monitoring/ and changes regularly. See the Directory of published versions

Carepath OPAT

This FHIR implementation content is currently under development and may be subject to significant changes. Use this information with caution, as it may not yet reflect finalized or fully validated guidance. Always verify details before relying on them for production use.

DRAFT: 2025-07-09

Carepath Overview

Note: This page focuses on the Carepath for OPAT, which details how individual data points and symptoms are exchanged between patient monitoring providers and consumers. For the structured report defining how this data, along with encounters and questionnaires, is shared between EPDs/care-teams (e.g., between the hospital OPAT team and home nursing organizations), please see the OPAT Careset.

Certain infections, such as those affecting bones, joints, heart valves, or the prostate, require long-term intravenous (IV) antibiotics. The OPAT (Outpatient Parenteral Antimicrobial Therapy) care pathway involves the continuation of intravenous antibiotic therapy initiated in the hospital, in the outpatient setting.

Process and Workflow Description

Start-Up

  • Parameters Monitored:

    • Body temperature
    • Heart rate
    • Blood pressure
    • Saturation
    • Body weight
    • Nausea
    • Diarrhea
    • Pain of shoulder region
    • Pain at insertion site
    • Lokalised pain
    • Eruption of skin
    • Itching
    • Peeling of skin
    • Vomiting symptom
    • Constipation
    • Decrease in appetite
    • Pain on flushing of implanted venous access device
    • Tired
    • Chill
    • Candidiasis
    • Pain of joint
    • Dyspnea
    • Facial swelling
    • Observation insertion site
    • Leakage
    • Accidental removal of catheter
    • Medication administration
    • Problem
    • Problems functionality injection
    • Problems insertion site
    • Problem fixation
    • Problem infection
    • Redness of skin over lesion
    • Problem swelling upper arm
    • Reaction to antibiotics
    • Allergic reaction
    • Care of central venous catheter
    • Site of intravenous insertion
    • Blocked catheter
    • In context of bandage insertion site:
      • Bleeding skin
      • Purulent discharge
      • Loose
      • Serous discharge
      • Wet
    • In context of insertion site:
      • Blister
      • Red color
      • Hematoma
      • Pus
      • Crust
      • Swelling
      • Extravasation
    • In context of catheter observation:
      • Pulmonary aspiration of blood
      • Infusion
      • Damaged catheter

Data Collection

  • Technology is CE-certified, with end-to-end encryption and GDPR compliance.

Integration Modules for EPD

Outcome Module - FHIR Integration

Vital Signs & symptoms
  • Frequency: Ad hoc registrations by patients and healthcare providers.
  • LOINC & SNOMED Codes:
General
Description Code(s) Possible answers
Body temperature - SNOMED 386725007
- LOINC 8310-5		 Not applicable
Heart rate - SNOMED 364075005
- LOINC 8867-4		 Not applicable
Saturation LOINC 2708-6 (sub 59408-5) Not applicable
Blood pressure - SNOMED
271649006 (Systolic) / 271650006 (Diastolic)

- LOINC
8480-6 (Systolic) / 8462-4 (Diastolic)		 Not applicable
Body weight LOINC 29463-7 Not applicable
Measured weight of elastomeric continuous infusion pump after infusion SNOMED 1381260006 Not applicable
Measured weight of elastomeric continuous infusion pump with medication before infusion SNOMED 1381257004 Not applicable
Nausea SNOMED 422587007 None
- LOINC LA137-2
- SNOMED 2667000
Mild
- LOINC LA6752-5
- SNOMED 255604002
Moderate
- LOINC LA6751-7
- SNOMED 673007
Severe
- LOINC LA6750-9
- SNOMED 24484000
Diarrhea SNOMED 62315008 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Pain of shoulder region SNOMED 45326000 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Pain at insertion site SNOMED 406189006-442093003 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Lokalised pain SNOMED 112104007 LOINC 72514-3 (Pain scale 0-10)
SNOMED
- 444431007 (Grade 0 on a scale of 0 to 3)
- 444456001 (Grade 1 on a scale of 0 to 3)
- 444457005 (Grade 2 on a scale of 0 to 3)
- 444447009 (Grade 3 on a scale of 0 to 3)
Eruption of skin SNOMED 271807003 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Itching SNOMED 418290006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Peeling of skin SNOMED 271767006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Vomiting symptom SNOMED 249497008 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Constipation SNOMED 14760008 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Decrease in appetite SNOMED 64379006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Pain on flushing of implanted venous access device SNOMED 698749006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Tired SNOMED 224960004 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Chill SNOMED 43724002 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Candidiasis SNOMED 78048006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Pain of joint SNOMED 57676002 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Dyspnea SNOMED 267036007 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Facial swelling SNOMED 278528006 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Observation insertion site SNOMED 364554009 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Leakage SNOMED 76676007 SNOMED
- 373066001 (Yes)
- 373067005 (No)
Accidental removal of catheter SNOMED 439377004 SNOMED
- 373066001 (Yes)
- 373067005 (No)
- 255609007 (Partial)
Medication administration SNOMED 18629005 SNOMED
- 373066001 (Yes)
- 373067005 (No)
Problem SNOMED 55607006 SNOMED
- 82449006 (IV catheter)
- 419241000 (Product)
- 44668000 (Pump)
- 705046008 (Deficit of medication supply)
- 281647001 (Adverse reaction)
- 373066001 (Other)
Problems functionality injection SNOMED 59108006 SNOMED
- 36203004 (Easy)
- 13705009 (Partial obstruction)
- 1156073005 (Blocked catheter)
Problems insertion site SNOMED 406148008 SNOMED
- 52475004 (Dry)
- 271765003 (Crust)
- 413867005 (Clear fluid)
- 297968009 (Bleeding skin)
- 255316004 (Purulent)
Problem fixation SNOMED 444915009 SNOMED
- 17621005 (Normal)
- 276626008 (Displacement)
- 43937704 (Accidental removal)
Problem infection SNOMED 405009004 SNOMED
- 260385009 (No signs of infection)
- 406189006 (Pain)
- 17038008 (Warmth)
- 65124004 (Swelling)
- 274640006 (Chills and fever)
- 822962003 (Redness)
Redness of skin over lesion SNOMED 822962003 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Problem swelling upper arm SNOMED 449619004 SNOMED
- 2667000 (Absent)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Reaction to antibiotics SNOMED 281789004 SNOMED
- 373066001 (Yes)
- 373067005 (No)
Allergic reaction SNOMED 472964009 SNOMED
- 2667000 (Absent)
- 255604002 (Mild)
- 6736007 (Moderate severity)
- 24484000 (Severe)
Care of central venous catheter SNOMED 40493441 SNOMED
- 373066001 (Yes)
- 373067005 (No)
Site of intravenous insertion SNOMED 406148008 SNOMED
- 17621005 (Normal)
- 263654008 (Abnormal)
Blocked catheter SNOMED 1156073005 SNOMED
- 373066001 (Yes)
- 373067005 (No)
In context of bandage insertion site: bleeding skin SNOMED 297968009 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of bandage insertion site: purulent discharge SNOMED 225550006 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of bandage insertion site: loose SNOMED 78799005 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of bandage insertion site: serous discharge SNOMED 447112000 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of bandage insertion site: wet SNOMED 17461003 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: blister SNOMED 339008 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: red color SNOMED 371240000 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: hematoma SNOMED 35566002 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: pus SNOMED 367646009 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: crust SNOMED 69640009 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: swelling SNOMED 65124004 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of insertion site: extravasation SNOMED 76676007 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of catheter observation: pulmonary aspiration of blood SNOMED 25797006 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of catheter observation: infusion SNOMED 36576007 SNOMED
- 31874001 (True)
- 64100000 (False)
In context of catheter observation: damaged catheter SNOMED 1156074004 SNOMED
- 31874001 (True)
- 64100000 (False)

These FHIR modules ensure standardized data exchange between systems and guarantee consistency of the vital parameters.

Specification:

For detailed specifications, refer to the