PanCareSurPass Project HL7 FHIR Implementation Guide
0.2.0 - CI Build 150

PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/pcsp/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

SurPass Logical model

Logical data models as HL7 FHIR resources

SurPass V2.0

Survivorship Passport V2.0

SurPass Bundle profile

HL7 FHIR profile for the SurPass document bundle

Bundle: Survivor Passport

This profile represents the constraints applied to the Bundle resource by the PCSP FHIR Implementation Guide.

Structures: Logical Models

These define data models that represent the domain covered by this implementation guide in more business-friendly terms than the underlying FHIR resources.

Care Plan

Care Plan

Chemotherapy

Chemotherapy

Diagnosis

Diagnosis

Front Line Treatment

Front Line Treatment. The first treatment given for a disease. It is often part of a standard set of treatments, such as surgery followed by chemotherapy and radiation. When used by itself, first-line therapy is the one accepted as the best treatment. If it does not cure the disease or it causes severe side effects, other treatment may be added or used instead. Also called induction therapy, primary therapy, and primary treatment.

Major Surgery

Major Surgery.

Metadata FSE Italy

Metadata FSE Italy.

Other info and relevant events

Other info and relevant events

Progression-Relapse after FLT

Progression-Relapse after FLT

Progression-Relapse during FLT

Progression-Relapse during FLT

Radiotherapy

Radiotherapy

Stem Cell Transplantation

Stem Cell Transplantation.

Subject of care

Subject of care

Treatment Summary

Treatment Summary data model

Structures: Questionnaires

These define forms used by systems conforming to this implementation guide to capture or expose data to end users.

FollowupSurPass

Follow up form. The first Followup-Surpass form must be completed at the same time as the SurPass is delivered or in any case at the first visit after the end of the treatment (OT).

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

BiologicallyDerivedProduct: Stem Cell

This profile defines how to represent Stem Cell in FHIR for describing a Stem Cell Transplantation data required by the PanCareSurPass algorithm to generate the care plan.

CarePlan: PCSP-generated plan

This profile defines how to represent the Care Plan proposed by the PCSP platoform in HL7 FHIR. This profile can be used for both the version generated by the platoform and that curated and validated by Clinicians.

Composition: Survivor Passport

This profile defines how to represent a PCSP Survivor Passport by using a HL7 FHIR Composition for the purpose of the PanCareSurPass project.

Condition: GvHD

This profile defines how to represent Graft versus host disease (GvHD) in HL7 FHIR for the purpose of the PanCareSurPass project.

Condition: Metastatic Cancer

This profile defines how to represent metastatic cancer in FHIR for the purpose of the PanCareSurPass project. This profile is inspired from the mCode IG. Records the history of secondary neoplasms, including location(s) and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

Condition: Others

This profile defines how to describe the presence of some other conditions (e.g. Hypogonadism, Growth hormone deficiency, Hydrocephalus in HL7 FHIR for the purpose of the PanCareSurPass project.

Condition: Primary Cancer

This profile defines how to represent Primary Cancer Condition in HL7 FHIR for the purpose of the PanCareSurPass project. This profile is inspired from the mCode IG. A primary cancer condition, the original or first tumor in the body (Definition from: NCI Dictionary of Cancer Terms). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary. This profile should be also used for documenting primary cancer relapses during or after FLT.

Condition: Severe Toxicity

This profile defines how to describe a Severe Toxicity event in HL7 FHIR for the purpose of the PanCareSurPass project.

DocumentReference: PCSP

This profile defines how to embed a PDF PCSP Survivor Passport in FHIR for the purpose of the PanCareSurPass project. This profile can be aslo used for send attachments (e.g Raditherapy reports or HDR) to the platform

Encounter: Treatment Center

This profile defines how to represent data of arrival to the center and Center information in FHIR for the purpose of the PanCareSurPass project.

Location: PCSP

This profile defines how to represent FHIR Location for the purpose of the PanCareSurPass project.

MedicationAdministration: Chemotherapy

This profile defines how to represent MedicationAdministration in HL7 FHIR for describing Chemotherapy data for the purpose of the PanCareSurPass project.

MedicationStatement: Chemotherapy

This profile defines how to represent MedicationStatement in FHIR for describing minimal information about provided medications for the purpose of the PanCareSurPass project.

Observation: Blood type/RH

This profile defines how to represent Blood type/RH before or after the SCT in HL7 FHIR for the purpose of the PanCareSurPass project.

Observation: Cancer Stage Group

The extent of the cancer in the body, according to a given cancer staging classification system, based on evidence such as physical examination, imaging, and/or biopsy or based on pathologic analysis of a specimen.

Observation: Chemotherapy Cumulative Dose

This profile defines how to represent Chemotherapy Cumulative Dose in FHIR for the purpose of the PanCareSurPass project.

Observation: Diagnosis details

This profile defines how to represent diagnosis details (when the diagnosis was made; who made it;…) in FHIR for the purpose of the PanCareSurPass project.

Observation: Hereditary Predisposition

This profile defines how to represent Hereditary Predispositions in HL7 FHIR for the purpose of the PanCareSurPass project.

Observation: Radiotherapy Total Dose PCSP

This profile defines how to represent Radiotherapy Total Dose in FHIR for the purpose of the PanCareSurPass project.

Observation: Risk Factor

This profile defines how to represent a Risk Factor in HL7 FHIR as determined by the PCSP platoform.

Observation: TNM Distant Metastases Category

Category describing the extent of a tumor metastasis in remote anatomical locations, based on evidence such as physical examination, imaging, and/or biopsy.

Observation: TNM Primary Tumor Category

Category of the primary tumor, based on its size and extent, based on evidence such as physical examination, imaging, and/or biopsy.

Observation: TNM Regional Nodes Category

Category of the presence or absence of metastases in regional lymph nodes, based on evidence such as physical examination, imaging, and/or biopsy.

Organization: Primary Treatment Center / Center of diagnosis

This profile defines how to represent the Primary Treatment Center or the Center of diagnosis in FHIR for the purpose of the PanCareSurPass project.

Patient: PCSP

This profile defines how to represent Patient in FHIR for the purpose of the PanCareSurPass project.

PlanDefinition: Front Line Treatment

This profile defines how to provide Front Line Treatment protocol infos in FHIR for the scope of the PanCareSurPass project.

Procedure: Catheter

This profile defines how to describe the Catheterization of vein Procedure in HL7 FHIR for the purpose of the PanCareSurPass project.

Procedure: Cryopreservation

This profile defines how to describe the cryopreservation of sperms or oocyte for cancer patient in HL7 FHIR for the purpose of the PanCareSurPass project.

Procedure: Front Line Treatment

This profile defines how to provide Front Line Treatment data in FHIR for the scope of the PanCareSurPass project.

Procedure: Other Treatments

This profile defines how to convey textual information about other oncological treatments in HL7 FHIR for the purpose of the PanCareSurPass project.

Procedure: Radiotherapy

This profile defines how to represent Procedures in FHIR for describing a set of Radiotherapy data required by the PanCareSurPass algorithm to generate the care plan.

Procedure: Radiotherapy Boost

This profile defines how to represent Procedures in FHIR for describing a set of data required by PanCareSurPass for Radiotherapy Boosts

Procedure: Radiotherapy Shielding

This profile defines how to represent Shielding Procedures in FHIR for describing a set of Radiotherapy data required by the PanCareSurPass algorithm to generate the care plan.

Procedure: SCT Prophylaxis

This profile defines how to represent GVHD prophylaxis, conditioning regimen Procedures in FHIR for supporting Stem Cell Transplantation data, as required by the PanCareSurPass algorithm to generate the care plan.

Procedure: Stem Cell Transplantation

This profile defines how to represent Procedures in FHIR for describing a set of Stem Cell Transplantation data required by the PanCareSurPass algorithm to generate the care plan.

Procedure: Surgery

This profile defines how to represent Procedures in FHIR for describing a set of Surgery data required by the PanCareSurPass algorithm to generate the care plan. It is used also to provide inforamtion about shunt, amputation, and other procedures

Procedure: Transfusion other infos

This profile defines how to describe the Transfusion Procedure in HL7 FHIR for the purpose of the PanCareSurPass project.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Act Location

This extension provides a means to indicate where an act was, is or it is intended to take place.

Annotation Type

This extension is used to indicate the kind of note captured

Body Location Qualifier

Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

Condition related to resource

The resource has an unspecified relationship with a Condition.

Laterality Qualifier

Qualifier to specify laterality.

Not affected Organ

This extension is used to explicitly indicate the Organ (body site) that has not been affected by this procedure.

Performed Timing

This extension allows to indicate when the procedure was performed as Timing.

Previous Status

This extension provides a mean to indicate the previous clinicalStatus of a condition. It might be used for example to indicate if a relapse is now in remission.

Procedure Used Reference

Extend the usedReference element to BiologicallyDerivedProduct

Radiotherapy Energy or Isotope

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope. This extension is based on the CodeX™ Radiation Therapy RadiotherapyEnergyOrIsotope extension

Randomization arm for trial

This extension is used to provide a textual description of the randomization arm for trials (FLT).

Relapse Type

This extension is used to indicate if a relapse/progression is local, remote or combined.

Resource related information

This extension provides a means to link the source resource to any target related information. This extension shall not be used when other more specific elements or standard extensions apply. E.g. Observation.hasMember.

Sacrified organ

Organs are 'sacrified' either to allow a radical excision of the tumor or on purpose (spleen) for staging procedures

Stem Cell Donor Type

Specify the type of donor for the cell used in a transplantation

Stem Cell Source Type

Specify the type of source for the cell used in a transplantation

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Active or resolved Condition

Active or resolved Condition

Acute Gvhd Grade

Acute Gvhd Grade

Affected Organs (surgery)

Affected Organs (surgery)

Amputation Surgical Procedure Type

Types of amputation procedure this resource is referring to

Annotation type

Annotation type

Antineoplastic and immunostimulating agents

List of WHO ATC codes for antineoplastic and immunostimulating agents.

Before/after procedure

SCT Timing events: Before/after procedure

Body Location Qualifier Value Set

Qualifiers to refine a body structure or location including qualifiers for relative location, directionality, number, and plane, and excluding qualifiers for laterality.

Body Location Qualifier Value Set

Types of documents exchanged with the PCSP platform

Brachytherapy Type

Types of Brachytherapy this procedure is referring to

Calculated|Estimated
Calculated Estimated Value Set
Cancer Staging System Value Set

System used for staging.

Chemotherapy cumulative dose units

Chemotherapy cumulative dose units

Chronic Gvhd condition

Acute Gvhd Grade

Colostomy Surgical Procedure Type

Types of colostomy procedure this resource is referring to

Conditions at risk

Condition at risk proposed by the PCSP algorithm

Conditions: follow up

Conditions: follow up

Document Type

Types of documents exchanged with the PCSP platform

FLT Plan Type

FLT Plan Type

Gastrostomy Surgical Procedure Type

Types of Gastrostomy procedure this resource is referring to

Grade: follow up

Grade: follow up

Gvhd condition

Gvhd condition

Hereditary Predispositions (ICD10)

Hereditary Predispositions (ICD10)

Hereditary Predispositions (Orphacode)

Hereditary Predispositions (Orphacode)

Hereditary Predispositions or Disease

Hereditary Predispositions or Disease

ICCC-3

International Classification of Childhood Cancer, third edition + exceptional values

ICD-O-3 Morphology

ICD-O-3 Morphology

ICD-O-3 Topography

ICD-O-3 Topography

Laterality Qualifier Value Set

Qualifiers to specify laterality.

Morphologically abnormal structure

Morphologically abnormal structure.

Not Applicable|Unknown

Not Applicable/Unknown Value Set

Not Performed|Unknown

Not Performed/Unknown Value Set

Observation Codes for Distant Metastases Category

Identifying codes based on the timing of classification for distant metastases (M) staging observations.

Observation Codes for Primary Tumor Category

Identifying codes based on the timing of classification for primary tumor (T) staging observations.

Observation Codes for Regional Node Category

Identifying codes based on the timing of classification for regional node (N) staging observations.

Observation Codes for Stage Group Category

Identifying codes based on the timing of classification for stage group observations.

Other Infors Condition

Other Infors Condition

Other/Unknown/Text

Other/Unknown/Text Value Set

Prosthesis Type

Types of Prosthesis this procedure is referring to

Prosthetic Surgical Procedure Type

Types of Prosthetic procedure this resource is referring to

Radiotherapy Device Type

Radiotherapy device type this procedure is referring to

Radiotherapy Dose Type

Types of radiotherapy cumulative dose this procedure is referring to

Radiotherapy Isotopes

Radiotherapy Isotopes

Radiotherapy Type

Types of radiotherapy this procedure is referring to

Radiotherapy dose units

Radiotherapy dose units

Radiotherapy sites

PancareSurPass radiotherapy sites Value Set

Recommendations

Recommendations proposed by the PCSP algorithm

Relapse type (Local/Distant/Combined)

Relapse type (Local/Distant/Combined)

Risk Factors

Risk Factors used by the PCSP algorithm

Route of administration

Route of administration

SCT Prophylaxis Cathegory

SCT Prophylaxis Cathegory

SCT Prophylaxis Type

SCT Prophylaxis Type

Sacrified Organs (surgery)

Sacrified Organs (surgery). Organs are 'sacrified' either to allow a radical excision of the tumor or on purpose (spleen) for staging procedures

Shunt Procedure Type

Types of shunt surgical procedure this resource is referring to

Stage Group Value Set

This value set is intended to contain allowable values for Stage Group, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

Stem Cell Donor type

Stem Cell Donor type

Stem Cell Source type

Stem Cell Source type

Stem Cell Transplantation type

Stem Cell Transplantation type

Surgical Actions

Surgical Actions

Surgical Procedure Type

Types of surgical procedure this resource is referring to

TNM Distant Metastases Category Value Set

This value set is intended to contain allowable values for the M category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Primary Tumor Category Value Set

This value set is intended to contain allowable values for the T category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Regional Nodes Category Value Set

This value set is intended to contain allowable values for the N category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

Toxicity Severity

Toxicity Severity

Unknown|Other

Unknown or Other

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Conditions

PancareSurPass Conditions Code System

International Classification of Childhood Cancer, Third Edition

The International Classification of Childhood Cancer, Third Edition (ICCC-3) is a classification system used to categorize childhood cancers based on their histology and primary site. It is widely used in pediatric oncology for epidemiological studies and clinical research.

International Classification of Diseases for Oncology, Third Edition

The International Classification of Diseases for Oncology, Third Edition (ICD-O-3) is a coding system used primarily for classifying and coding neoplasms (tumors) based on their topography (site) and morphology (histology). It is widely used in cancer registries and epidemiological research.

OrphaNet

Orphanet selected codes

PCSP Code System

Coded concepts specified by the PancareSurPass Project

PCSP Conditions at risk

Condition at risk proposed by the PCSP algorithm

PCSP Recommendations

Recommendations proposed by the PCSP algorithm

Radiotherapy sites

PancareSurPass radiotherapy sites Code System

Risk Factors

Risk Factors used by the PCSP algorithm

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Austria - Bundle: Example of a Childhood Cancer Survivor Passport

Example of a Childhood Cancer Survivor Passport Bundle for the PanCareSurPass project

Cineca - Clinical Protocol

Clinical protocol for the CINECA project

Cineca - Patient: Sample of Patient (Rossi)

Sample of Patient created based on information available in the PCSP platform

Hulafe - Bundle: Example of a Childhood Cancer Survivor Passport

Example of a Childhood Cancer Survivor Passport Bundle for the PanCareSurPass project (Hulafe)

Hulafe - CarePlan: Follow-up Recommendations

Sample of Care Plan generated by the platform

Hulafe - Condition: Primary Diagnosis

Sample of Primary Diagnosis based on information provided by Hulafe (Condition)

Hulafe - DocumentReference: Preliminary SurPass

Sample of DocumentReference used to refer a preliminary SurPass

Hulafe - Encounter: Primary Diagnosis

Sample of Primary Diagnosis based on information provided by Hulafe (Encounter)

Hulafe - Location: Chemotherapy

Sample of Chemotherapy based on information provided by Hulafe (Location)

Hulafe - MedicationAdministration: Chemotherapy Ciclofosfamide

Sample of Chemotherapy based on information provided by Hulafe (Ciclofosfamide)

Hulafe - MedicationAdministration: Chemotherapy Citarabina

Sample of Chemotherapy based on information provided by Hulafe (Citarabina)

Hulafe - MedicationAdministration: Chemotherapy Metotrexato

Sample of Chemotherapy based on information provided by Hulafe (Metotrexato)

Hulafe - MedicationAdministration: Chemotherapy Vincristina

Sample of Chemotherapy based on information provided by Hulafe (Vincristina)

Hulafe - MedicationStatement: Chemotherapy Corticosteroids

Sample of Chemotherapy based on information provided by Hulafe (Corticosteroids not used for at least 4 weeks continuously)

Hulafe - Observation: Chemotherapy Ciclofosfamide Cumulative Dose

Sample of Chemotherapy based on information provided by Hulafe (Ciclofosfamide Cumulative Dose)

Hulafe - Observation: Chemotherapy Citarabina Cumulative Dose

Sample of Chemotherapy based on information provided by Hulafe (Citarabina Cumulative Dose)

Hulafe - Observation: Chemotherapy Metotrexato Cumulative Dose

Sample of Chemotherapy based on information provided by Hulafe (Metotrexato Cumulative Dose)

Hulafe - Observation: Chemotherapy Vincristina Cumulative Dose

Sample of Chemotherapy based on information provided by Hulafe (Vincristina Cumulative Dose)

Hulafe - Observation: Risk Factor Anthracyclines

Sample of Risk Factor: Anthracyclines >= 250 mg/m2

Hulafe - Observation: Risk Factor RT breasts

Sample of Risk Factor: RT >= 10 Gy to breasts

Hulafe - Observation: Risk Factor RT heart

Sample of Risk Factor: RT >= 35 Gy to heart

Hulafe - Observation: Risk Factor RT thyroid gland

Sample of Risk Factor: RT to thyroid gland

Hulafe - Organization: Primary Diagnosis

Sample of Primary Diagnosis based on information provided by Hulafe (Organization)

Hulafe - Patient: Sample of Patient (Basoa Mancebo)

Sample of Patient created based on information provided by Hulafe

Hulafe - Patient: Sample of demographics data

Sample of Patient demographics data based on information provided by Hulafe

Mainz - BiologicallyDerivedProduct: Stem Cell Transplantation (Zeisig)

Sample of stem cell transplantation biologically derived product (Zeisig)

Mainz - Condition: Primary Cancer (Fischer)

Sample of Primary Cancer Condition based on information available by Mainz (Fischer)

Mainz - Condition: complete Primary Cancer Condition example (TBC) (Zeisig)

Sample of Primary Cancer Condition based on information available by Mainz (Zeisig)

Mainz - Condition: complete metastatic site Condition example (TBC) (Zeisig)

Sample of metastatic site Condition based on information available by Mainz (Zeisig)

Mainz - Encounter: Primary Cancer (Fischer)

Sample of Encounter associated to the Primary Cancer Condition Mainz sample (Fischer)

Mainz - Encounter: Primary Cancer (Zeisig)

Sample of Encounter associated to the Primary Cancer Condition Mainz sample (Zeisig)

Mainz - Location: Stem Cell Transplantation (Zeisig)

Sample of location for stem cell transplantation (Zeisig)

Mainz - Observation: Blood type/RH before the SCT (Zeisig)

Sample of blood type/RH observation (Zeisig)

Mainz - Observation: Primary Cancer (Zeisig)

Sample of Observation associated to the Primary Cancer Condition Mainz sample to provide details about the diagnosis (Zeisig)

Mainz - Observation: Radiotherapy Total Dose (Zeisig)

Sample of radiotherapy total dose observation from Mainz (Zeisig)

Mainz - Patient: Sample of Patient (Fischer)

Sample of Patient created based on information provided by Mainz (Fischer)

Mainz - Patient: Sample of Patient (Zeisig)

Sample of Patient created based on information provided by Mainz (Zeisig)

Mainz - Procedure: Radiotherapy (Zeisig)

Sample of radiotherapy procedure based on information from Mainz (Zeisig)

Mainz - Procedure: Stem Cell Transplantation (Zeisig)

Sample of stem cell transplantation procedure from Mainz (Zeisig)

Mainz - Procedure: Transfusion (Zeisig)

Sample of transfusion procedure (Zeisig)

Vulsk - Patient: Sample of Patient (Jonaitė)

Sample of Patient created based on information provided by Vulsk