Te Whatu Ora Shared Care FHIR API
0.3.9 - release New Zealand flag

Te Whatu Ora Shared Care FHIR API, published by Te Whatu Ora. This guide is not an authorized publication; it is the continuous build for version 0.3.9 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/cinc-fhir-ig/ and changes regularly. See the Directory of published versions

Rheumatic Fever Data

Translating data between FHIR and the national rheumatic fever care coordination solution (RFCCS)

This section defines mappings to apply between data in RFCCS and the Te Whatu Ora Shared Care API FHIR representations.

The mappings are intended to be bi-directional, that is sector applications can update FHIR representations that can then flow through (Mulesoft) to updates in the RFCCS datastore.

Patient’s Current Address – type, use and currency

Applies to patient’s current address.

RFCCS value Code in FHIR Address.use Code in FHIR Address.type Date(s) in FHIR Address.period
Home #home none period.start SHOULD be set to date when patient registered / address recorded $
Work #work none period.start SHOULD be set to date when patient registered / address recorded $
Temporary #temp none period.start SHOULD be set to date when patient registered / address recorded $
Inactive #old none No period, or period.end set to any date in the past ^
Physical none #physical period.start SHOULD be set to date when patient registered / address recorded $
Postal none #postal period.start SHOULD be set to date when patient registered / address recorded $
Current none none period.start MUST be set to any date in the past, and period.end, if specified, must be in the future

Notes

  1. ‘none’ means no code is set - ie. the element is absent in the FHIR JSON representation

  2. $ It makes sense to use the date of patient registration as the default value for Address.period.start

  3. ^ When there is neither a use nor type code and Address.period is present with the current date in range, this maps to ‘Current’ in RFCCS. If Address.period is missing, the address shall be mapped to ‘Inactive’


Mapping members of whanau care team to Patient.contact[]

As a rheumatic fever patient’s whanau care team members need to have contact details, role and relationship to the patient captured, this IG uses Patient.contact rather than an instance of CareTeam resource. The data mapping between the national system and FHIR is given by the following table.

Business data field (national system) FHIR element of Patient resource FHIR data type translation FHIR data example 1 FHIR data example 2
care team member role .whanauMemberCareRole extension coding (SNOMED) - $sct#58626002 Legal Guardian $sct#394738000 Other related persons (person)
care team member relationship to patient (freetext) .whanauMemberCareRelationship extension string - "mother" "brother in law"
first name name.given string - "Beryl" "Mike"
last name name.family string - "Hackett" "Meringue"
primary contact (yes/no) .whanauMemberCarePrimary extension boolean - true false
status (active/inactive) .period.start - period.end datetime x2 Consider member an ACTIVE contact unless BOTH dates are in the past, in which case INACTIVE "2023-06-01" to "2026-05-31" "2021-01-01" to "2021-01-01"

Language mapping

Applies to patient’s preferred language.

Patient language is represented in the Patient.communication.language element.

Two character codes in the preferred CommonLanguages binding are not sufficient to encode the patient languages available in RFCCS.

Therefore the Te Whatu Ora Shared Care API uses ISO 639-3 three character language codes which is allowed by the AllLanguages (maximum) binding on Patient.communication.language.

The translation between RFCCS language and FHIR is given in the table below.

English name of language ISO 639-3 language code to use for FHIR mapping RFCCS Health Cloud language IANA primary language SUBTAG (BCP47)
English eng English en
Spanish (Castilian) spa Spanish es
Afrikaans afr Afrikaans af
Arabic ara Arabic ar
Rarotongan rar Cook Islands Maori  
Dutch dut Dutch nl
French fre French fr
German ger German de
Gujarati guj Gujarati gu
Hindi hin Hindi hi
Italian ita Italian it
Japanese jpn Japanese ja
Korean kor Korean ko
Mandarin Chinese cmn Mandarin  
Maori mao Maori mi
New Zealand Sign Language nzs New Zealand Sign Language  
Jinyu Chinese cjy “Northern Chinese”  
Panjabi; Punjabi pan Punjabi pa
Russian rus Russian ru
Samoan smo Samoan sm
Tagalog tgl Tagalog -
Tamil tam Tamil ta
Thai tha Thai th
Tonga (Tonga Islands) ton Tongan to
Vietnamese vie Vietnamese vi
Yue Chinese (Cantonese) yue Cantonese  

See the example patient Madeleine Meringue for how to correctly code language for FHIR representation of rheumatic fever patients.


FHIR representation of Rheumatic Heart Disease Severity

Rheumatic heart disease severity is the driving factor for severity of a patient’s rheumatic fever diagnosis.

To adequately encode the severity values supported by the RFCCS application three FHIR elements are used:

  1. Condition.severity: this is the basic severity classifier in a stock FHIR Condition

  2. RheumaticFeverCondition.rhdSeverity - this is a profile extension to Condition which allows a specific SNOMED code matching the patient’s rheumatic heart disease situation.

  3. RheumaticFeverCondition.assessmentDate - this is a profile extension to Condition which allows a specific date of assessment to be recorded (the stock recordedDate element of Condition is needed to capture the date of diagnosis).

Translation between the RFCCS RHD severity value and FHIR representation is given by the following table.

RFCCS - Rheumatic Heart Disease Severity FHIR Condition.severity (SNOMED) rhdSeverity extension in RheumaticFeverCondition / ValueSet FHIR NzCondition.long-term-condition indicator ^
“none” do not map #260413007 None (qualifier value) TRUE
“trivial” do not map #300171000210106 Trivial (qualifier value) TRUE
“mild” #255604002 Mild (qualifier value) #255604002 Mild (qualifier value) TRUE
“moderate” #1255665007 Moderate (qualifier value) #1255665007 Moderate (qualifier value) TRUE
“severe” #24484000 Severe (severity modifier) (qualifier value) #24484000 Severe (severity modifier) (qualifier value) TRUE
“Post valve repair” #24484000 Severe (severity modifier) (qualifier value) Post valve repair or replacement #59391000119102 History of heart valve repair (situation) TRUE
“Post valve replacement” #24484000 Severe (severity modifier) (qualifier value) #301561000210102 History of heart valve replacement (situation) TRUE
“Unknown” do not map #261665006 Unknown (qualifier value) TRUE

^ Note: The FHIR representation of rheumatic fever condition includes setting the long-term condition extension as the disease is considered in NZ a long term condition.


FHIR data models

These diagrams have moved to a separate page. See the rheumatic fever section of the navigation in this IG.