Te Whatu Ora, Central Region Integration Hub
1.0.10-rc1 - ci-build
Te Whatu Ora, Central Region Integration Hub, published by Te Whatu Ora, Te Pae Hauora o Ruahine o Tararua, MidCentral. This guide is not an authorized publication; it is the continuous build for version 1.0.10-rc1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/centralRegion-integrationHub-ig/ and changes regularly. See the Directory of published versions
Change history for this FHIR Implementation Guide is as follows:
3-Sep-2024
2-Sep-2024
P36
for Protamine
to Allergy Alert CodesFLOWSTUDS
for Flow Studies
to Referral Reason Codes21-Aug-2024
WMHH
for Whanganui Mental Health Hospital
to Referral Site CodesWOPD
for Whanganui Outpatients
to Referral Site CodesYOPD
for Wairarapa Hospital Outpatients
Referral Site Codes19-Aug-2024
Z5
for Zuclopenthixol
alongside Z05
to H1 Alert CodesP35
for Perindopril
to H1 Alert Codes06
for Privately funded NZ
alongside 6
to Referral Health Purchaser13-Aug-2024
Patient.communication[].langauge.text
is used to record "Other" language code as ietf language codes don't include an OTHER value.Patient.communication[].preferred
is optional, as it can't be set when language is OTHER.12-Aug-2024
Subscription.type
is required and can only be rest-hook
Subscription.channel.payload
is required and can only be application/json
(The field states the mime-type of the payload)Subscription.extension[subscription-payload-search-criteria].valueString
allows API clients to be notified with whole bundles.Subscription.channel.extension[subscription-delivery-retry-count].valueString
allows API clients to limit the number of retries a subscription notification
will conduct, before placing the notification into the Dead Letter Queue.I
for Inactive
to ReferralStatus to account for delete referrals received in REF^I14
messages.5-Aug-2024
ClinicTypeCodeSystem
and ClinicTypeValueSet
to distinguish clinicId
field from clinicType
field.ServiceRequest.extension[referral].extension[clinicId]
as a valueString
extension field to hold the clinicId
along-side clinicType
.
There are more than 1300 unique clinicIds, and they change regularly; so it is not practible to add this as a valueCoding
field.ServiceRequest.extension[referral].extension[healthSpeciality]
to hold required field PV1-10
. Codings not currently known, so only available as valueString
ServiceRequest.extension[referral].extension[financialClass]
to hold required field PV1-20
. Codings not currently known, so only available as valueString
C
is for Civil union
and is mapped to OTH
T
for Domestic partner
as code C
for Common Law
is not available in R4.clinicType
on ServiceRequest
Z05
for Zuclopenthixol
to H1 Alert CodesFlag.period
is now optional as very occasionally we don't get given a start date in ZAL.5
or start date is after end date in ZAL.9
AllergyIntolerance.onset
is now optional as very occaisionally we don't get given a start date in ZAL.5
or start date is after end date in ZAL.9
OTH
and UNK
from Null Flavour to the Marital Status Value SetClinicalImpression.status
is derived from the legal status startDate (ZLS-3
) and endDate (ZLS-4
) fields.Patient.communication.language
and Patient.maritalStatus
holding multiple codings.Patient.maritalStatus
LABOUR
for Term Labour Assessment
to Referral Reason codesietf:bcp:47#cmn
to Mandarin Chinese
Flag.extension[recordingHospital]
already allows NP-Not Present valueoff
when Subscription is no-longer usedUNC
for Unencoded
to Hospital ValueSet to record codes that are not defined.extension[recordingHospital].coding.display
is now populated and is no longer missing for NHIMWS
, MA
and MC
category FlagsZAL-13
are not defined; in which case
the value will be placed in the text
field, rather than coding
.type
, category
and criticality
fields when field ZAL-4.1
is missing.extension[recordingHospital]
can have a simple text
value when the code in ZAL-13.1
is unknown.extension[allergyReaction]
can be populated for some Flag
alertsextension[recordingHospital]
can have a simple text
value when the code in ZAL-13.1
is unknown.$trigger-subscription
operation to Subscription
api endpoint and developer's guide.R42
for Spiritualist
to Patient Relgion Codesfragment
; We shall update the code system as new codes come to light.status
is derived from ZAL-5
and ZAL-9
fields and current dateTime, rather than ZAL-8
clinicalStatus
is derived from ZAL-5
and ZAL-9
fields and current dateTime, rather than ZAL-8
R86
and R87
codes, and added codes R88
and R89
in the Mental Health Legal Status codes:
R
- Routine
to Referral Priority codesFlag.extension[flag-alert].extension[allergyReaction]
is optional for Flag
resource; as it is used by some H2
Medical Condition alerts.Flag.extension[flag-alert].extension[allergyReaction]
is not populated for Flag
resource.A34
- Alcohol contain meds
A39
- Adalimumab
B15
- Benzydamine
H08
- Hyoscine
L14
- Lorazepam
L16
- Leflunomide
L18
- Loratadine
M21
- Methylphenidate
R09
- Rosuvastatin
s21
- Sotalol
R41
- Sikh
M30
- Ward 27
M37
- HOME
BPPET
- Hypertension or PET Assessment
MOVEMENT
- Concern with fetal movements
ANTENATAL
- Antenatal
MATCARE
- Maternity Care
NPR
- Not prioritised
STP
- Staged procedure
A37
- Alteplase
T28
- Ticagrelor
R75
- MHA S09 DAO notice
R76
- MHA S11(5)(b)
R77
- MHA S13(5)(b)
R78
- MHA S109 Police
R79
- Notice of death S132
R80
- Cust Sent S36(2)(b))
R82
- CPMIP S25(1)a UTST
R83
- S11(4) Cancel Leave
R84
- S13(4) Ntce Can Leav
R85
- S16 Withdrawn
R86
- MHA S29 CTO 12-Month
B02
- Brugada syndrome
temp
patient identifier available.
Added code IN
for NZ Indian
to Level 2 Ethnicity codesextension[allergy-alert].extension[webPASCategory]
to AllergyIntolerance and Flag resources to hold the original value of field ZAL.2.1
the alert category.F
for De Facto
to Marital Status codesR40
for Seventh Day Advents
to Patient Relgion codesB13
- Benzodiazepines
M35
for Levin Police
M31
for Star 1
M38
for OTHER
U
for Urgent
S
for Semi-urgent
example
in Flag & AllergyIntolerance extensionP33
for Pregabalin
AMBBP
for Ambulatory BP Machine
ECV
for External Cephalic Version
GENCARD
for General Cardiology
PLP
for Planned Procedure
CLINIC
for Antenatal Clinic Obstetric
AR
for Active review
PLP
for Planned procedure
Patient.active
is now optional, as it is used when ADT^A40
PatientMerge messages are received.ServiceRequest.reasonCode
bound to Referral Reason value set.ServiceRequest.authoredOn
is now optional, as field ZXV.9
may not be present in source HL7 message.ServiceRequest.requester
is now optional, as fields PV1.8
and PV1.9
may not be present in source HL7 message.ServiceRequest.performer
is now optional, as fields PV1.7
and PV1.9
may not be present in source HL7 message.ServiceRequest.locationCode
is now optional, as field ZXV.40
may not be present in source HL7 message.M32
for PN Emergency Dept
in Mental Health Review Location code system.Patient.communication.language
and Patient.contact.relationship
no-longer permit alternate codings.coding
entries on ethnicity
and nz-residency
fields.Patient.extension[ethnicity]
validation.AllergyIntolerance.recorder
field is now optional, as field ZAL.10
may not be present in source HL7 message.http://terminology.hl7.org/CodeSystem/v3-NullFlavor#NP
to Allergy Reaction Code to denote when field ZAL.4.1
is not present in the source HL7 message.http://terminology.hl7.org/CodeSystem/v3-NullFlavor#NP
to Flag Alert Code to denote when ZAL
segment is denotes an NHIMWS
category alert that has only free-text rather than a code value in the source HL7 messageClinicalImpression.effectiveDateTime
is now optional, as field ZLS-8
may not be present in the source HL7 message.#WRH
and #WHN
for Wairarapa Hospital
and Whanganui Hospital
, as well as #5750
Whanganui Mental Health Services
, #1234
New Zealand Health Information Service
, #6001
Centre for Adverse Reaction Monitoring
to Hospital Codes1
Mother
through 9
Nephew
are actually 01
through 09
.Patient.Adress.line
updated to 0..2
as can get lines from PID-11.1
and PID-11.2
#X
Separated
to Marital Codes to sit alongside #L
Legally Separated
R01
Drug anaphylaxis
from Allergy Reactionhttp://terminology.hl7.org/CodeSystem/v3-NullFlavor#NP
to Hospital Codes to denote when field ZAL.13.1
is not present in the source HL7 message.Flag.category
, Patient.extension[ethnicity]
etc are done using array slicing rather than FHIR AdditionalBinding extension. This means the original ValueSet bindings are removed.Patient.telecom
cardinality put back to 0..*
We turned on FHIR validation, which required the following fixes in the ImplementationGuide:
Flag.extension[alert].extension[allergyReaction]
changed from valueCoding
to valueCodeableConcept
Flag.extension[alert].extension[recordingHospital]
changed from valueCoding
to valueCodeableConcept
Flag.category
has two codings 'https://standards.digital.health.nz/ns/central-region/alert-category' and 'http://terminology.hl7.org/CodeSystem/flag-category'AllergyIntolerance.note
is optional, it may not be populated in ZAL.14
AllergyIntolerance.extension[severityLevel]
is optional, it may not be populated in ZAL.6
#A
is Accepted
rather than Active
and now matches what actually appears in source HL7 messages.meta.extension
fields recording the HL7 version number, triggering event/message, and l4h templates version number are now definedServiceRequest.identifier.type
is #FILL
- Filler Identifier
- denoting that PAS has assigned identifier.ServiceRequest.extension[referral].extension[dateReceived]
field to Referral profile.ServiceRequest.code
when no specific referral type is provided.ServiceRequest.reasonCode
is optional as field ZXV-7
is optional in the source HL7 messages.ServiceRequest.performer.display
, ServiceRequest.requestor.display
, ServiceRequest.extension[consultingPractitioner].display
, and ServiceRequest.extension[referringPractice].display
are marked as unused.ClinicalImpression.note
is optional, it may not be populated in ZLS.10
Patient.extension[ethnicity]
, Patient.extension[nz-residency].extension[status]
, and Patient.extension[patient-religion]
all have two bindings, the original from NZBase and a CentralRegion defined alternative which holds the (usually) finer grained original value received from source HL7 message.Patient.address.country
is optional, it may not be populated in PID.11.6
Patient.address.extension[domicile-code]
is optional, it may not be populated in PID.12
active
and published as the first edition.10-Nov-2023
Added Organization to the supported resources data model to hold
referringPractice
field from Referrals.
Adjustments of which alert type/category values in field ZAL-2
denote AllergyIntolerance, and which denote Flag.
Alert category codes A3, A4, H1 & H3 map to AllergyIntolerance
all other allert category codes, including DA & FA map to Flag
Alert type/category codes NHIMWS, MA and MC are non-coded alerts; the matching Alert field in ZAL-3
is free text;
therefore code systems nzcr-flag-alert-code-nhimws-cs
, nzcr-flag-alert-code-ma-cs
and nzcr-flag-alert-code-mc-cs
have been removed
S00 General Surgery
and S75 Vascular Surgery
A01 - Adrenal insufficienc
to T01 - Transplant patient
C01 - CRE
to V01 - CVRE
C01 - Child abuse
to R02 - Reserve for NHI
V01 - Blood group antibodi
to T01 - Transfusion reaction
D01 - Intellectual disabil
to P01 - ParentalSupport reqd
A01 - Advance care plan
to T01 - Treat/managt plan
R01 - Informal patient
to R87 - MHA S30 1 yr CTO
A01 - ACE Inhibitors
to Z - Zinc
A01 - Alcohol Wipes
to W01 - Wheat/gluten
R03 - Unknown
and R05 - Medication
25-Oct-2023
Added HL7 v2 Referral Priority code system to Referral Priority Value Set and the matching Concept Map as we have codes from multiple systems in use.
Removed category
field from Referral ServiceRequest mapping; category is implied by the use of Referral profile.
Added consultingPractitioner
field to referral
extension of Referral profile; populated from PV1-9
29-Sep-2023
Added Allergy Reaction code system, to record the nature of allergic reaction along with concept maps to provide suitable FHIR code fields:
Switched from using the ClinicalImpression.summary
field to using the ClinicalImpression.note
field to hold the comments recorded with the alert.
Added Developer Guide outlining the process for provisioning API clients, and obtaining an OAuth access token to authenticate subsequent FHIR API calls.
Added this release history page