Digital Referral Prescription Implementation Guide, published by eHealth Platform. 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/hl7-be/referral/ and changes regularly. See the Directory of published versions

Telemonitoring

Telemonitoring

A telemonitoring prescription instructs the recording of one or more vital parameters (blood pressure, heart rate, weight, …) over a defined period, and defines the rules under which the receiving system should raise an alert (absolute thresholds, sustained breaches, significant changes over time).

RemoteMonitoringPrescription is a specialization of BeReferralPrescription: it inherits the common prescription fields and adds the elements needed to express what to measure, how often, and when to alert.

The type of monitoring service is carried on the inherited careRequested element using SNOMED CT codes (e.g. 135840009 Blood pressure monitoring). The parameter being measured in monitoringPlan.parameter uses LOINC codes (e.g. 8480-6 systolic BP, 8462-4 diastolic BP). SNOMED has no separate code for systolic vs diastolic BP monitoring — both fall under 135840009, and the distinction is expressed per-parameter via the LOINC codes and their respective thresholds.

Two implementation options are provided, both as profiles of BeReferralServiceRequest:

• Inline extension (BeReferralServiceRequestTelemonitoring) — all monitoring rules live in a repeating extension on the ServiceRequest itself. Best for per-patient prescriptions with unique rules.
• ​PlanDefinition reference (BeReferralServiceRequestTelemonitoringPlanned) — the rules live in a referenced PlanDefinition. Best for reusable monitoring protocols applied to many patients.

In both profiles, the logical model’s maxIncrease and maxDecrease collapse into a single signed change Ratio (positive numerator = increase, negative = decrease).