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

Overview caresets

What is a Careset?

In the context of this Implementation Guide, the Careset definitions describe how clinical data is collected in a structured report that can be securely shared between Electronic Patient Dossiers (EPDs) or other healthcare systems.

While Carepaths focus on how individual data points are exchanged between telemonitoring providers and consumers, Careset reports provide a more holistic clinical picture. These reports may include data imported from the Carepath definitions (such as vital signs and symptoms), but can also contain additional, extensive information including:

• Encounter resources (contextualizing the care event)
• Questionnaire and QuestionnaireResponse (PROMs/PREMs)
• Mappings from raw observations to derived clinical concepts

Example Use Case

Consider a scenario where a patient is home-hospitalized and a home nurse is scheduled to come by to take care of the patient. The critical clinical communication happens between the central care team in the hospital (e.g., an OPAT team) and the home nurse or home nursing organization. A Careset facilitates this communication by bundling all relevant measurements, questionnaires, and encounter details into a cohesive report that is easily transferable between their respective EHRs/systems.

Processing QuestionnaireResponses with SDC Extract

Once a hospital receives a QuestionnaireResponse from the home nursing system, it typically needs to write the individual answers back into the patient’s medical record as discrete clinical data (e.g., as Observation resources). Doing this manually — field by field — is error-prone and expensive to maintain.

HL7 Structured Data Capture (SDC) defines a mechanism called definition-based extraction that solves this. Each question item in the Questionnaire carries a definition field pointing to a FHIR element path (e.g., Observation#Observation.valueCodeableConcept). An SDC-capable server can then automatically extract a complete set of Observation resources from a submitted QuestionnaireResponse — no custom mapping code needed.

How It Works

QuestionnaireResponse (received from home nurse)
        │
        ▼  [SDC $extract operation]
  Observation: body temperature
  Observation: blood pressure
  Observation: nausea severity
  ...

Each Questionnaire item that carries a definition field like:

"definition": "http://hl7.org/fhir/StructureDefinition/Observation#Observation.valueCodeableConcept"

tells the extraction engine how to map the answer into a structured FHIR resource.

Examples

The following Questionnaire instances include full SDC item.definition annotations and can be used directly with an SDC-capable server to test the $extract operation:

• OPAT SDC Questionnaire (Continuous Infusion) — based on the OPAT careset
• ONCO SDC Questionnaire (Trastuzumab) — based on the antitumoral careset

These examples cover the same questionnaire content as the base Questionnaire instances defined in this IG, with the addition of definition fields on every extractable item. Implementers can use these as a starting point for all other drug questionnaires defined in this IG.