Te Whatu Ora, Central Region Integration Hub
1.0.12-rc1 - ci-build
Te Whatu Ora, Central Region Integration Hub
1.0.12-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 1.0.12-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:
17-Sep-2024
effectiveDateTime to ReferralS22 for Protamine to Allergy Alert Codes11-Sep-2024
hl7v2-message from meta on all resources except Patient and ServiceRequest - it was getting a bit repetitive.Patient.contact.relationship has extension field to hold original webPAS relationship code.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-hookSubscription.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 valueStringServiceRequest.extension[referral].extension[financialClass] to hold required field PV1-20. Codings not currently known, so only available as valueStringC is for Civil union and is mapped to OTHT for Domestic partner as code C for Common Law is not available in R4.clinicType on ServiceRequestZ05 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.9AllergyIntolerance.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.9OTH 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.maritalStatusLABOUR for Term Labour Assessment to Referral Reason codesietf:bcp:47#cmn to Mandarin ChineseFlag.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-8clinicalStatus is derived from ZAL-5 and ZAL-9 fields and current dateTime, rather than ZAL-8R86 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 medsA39 - AdalimumabB15 - BenzydamineH08 - HyoscineL14 - LorazepamL16 - LeflunomideL18 - LoratadineM21 - MethylphenidateR09 - Rosuvastatins21 - Sotalol
R41 - Sikh
M30 - Ward 27M37 - HOMEBPPET - Hypertension or PET AssessmentMOVEMENT - Concern with fetal movementsANTENATAL - AntenatalMATCARE - Maternity CareNPR - Not prioritisedSTP - Staged procedureA37 - AlteplaseT28 - TicagrelorR75 - MHA S09 DAO noticeR76 - MHA S11(5)(b)R77 - MHA S13(5)(b)R78 - MHA S109 PoliceR79 - Notice of death S132R80 - Cust Sent S36(2)(b))R82 - CPMIP S25(1)a UTSTR83 - S11(4) Cancel LeaveR84 - S13(4) Ntce Can LeavR85 - S16 WithdrawnR86 - MHA S29 CTO 12-MonthB02 - Brugada syndrometemp 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 - BenzodiazepinesM35 for Levin PoliceM31 for Star 1M38 for OTHERU for UrgentS for Semi-urgentexample in Flag & AllergyIntolerance extensionP33 for PregabalinAMBBP for Ambulatory BP MachineECV for External Cephalic VersionGENCARD for General CardiologyPLP for Planned ProcedureCLINIC for Antenatal Clinic ObstetricAR for Active reviewPLP for Planned procedurePatient.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 SeparatedR01 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 valueCodeableConceptFlag.extension[alert].extension[recordingHospital] changed from valueCoding to valueCodeableConceptFlag.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.14AllergyIntolerance.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.10Patient.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.11.6Patient.address.extension[domicile-code] is optional, it may not be populated in PID.12active 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 SurgeryA01 - Adrenal insufficienc to T01 - Transplant patientC01 - CRE to V01 - CVREC01 - Child abuse to R02 - Reserve for NHIV01 - Blood group antibodi to T01 - Transfusion reactionD01 - Intellectual disabil to P01 - ParentalSupport reqdA01 - Advance care plan to T01 - Treat/managt planR01 - Informal patient to R87 - MHA S30 1 yr CTOA01 - ACE Inhibitors to Z - ZincA01 - Alcohol Wipes to W01 - Wheat/glutenR03 - Unknown and R05 - Medication25-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