New Zealand Rheumatic Fever FHIR Implementation Guide
1.0.0 - draft

New Zealand Rheumatic Fever FHIR Implementation Guide, published by Te Whatu Ora. 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/tewhatuora/fhir-rheumatic-fever/ and changes regularly. See the Directory of published versions

: NZ-specific terminology in rheumatic fever data representation - XML Representation

Active as of 2024-09-26

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="nz-rheumaticfever-codesystem"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem nz-rheumaticfever-codesystem</b></p><a name="nz-rheumaticfever-codesystem"> </a><a name="hcnz-rheumaticfever-codesystem"> </a><a name="nz-rheumaticfever-codesystem-en-US"> </a><p>This case-sensitive code system <code>https://fhir-ig.digital.health.nz/rheumatic-fever/CodeSystem/nz-rheumaticfever-codesystem</code> defines the following codes in an undefined hierarchy:</p><table class="codes"><tr><td><b>Lvl</b></td><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>1</td><td style="white-space:nowrap">meta-tags<a name="nz-rheumaticfever-codesystem-meta-tags"> </a></td><td>meta tags</td><td>These codes are used to tag an instance via its meta.tag element</td></tr><tr><td>2</td><td style="white-space:nowrap">  rf-nz<a name="nz-rheumaticfever-codesystem-rf-nz"> </a></td><td>rheumatic fever</td><td>General purpose FHIR tag/classifier signifying FHIR information about an NZ rheumatic fever patient/case</td></tr><tr><td>1</td><td style="white-space:nowrap">condition-summary-codes<a name="nz-rheumaticfever-codesystem-condition-summary-codes"> </a></td><td>These codes are used in NZ to summarise the condition diagnosis</td><td>These code values originate in SNOMED CT but are defined only in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  302471000210100<a name="nz-rheumaticfever-codesystem-302471000210100"> </a></td><td>Rheumatic heart disease with absence of signs and symptoms of acute rheumatic fever (situation)</td><td>Can be used to summarise the diagnosis of a patient with a rheumatic fever condition</td></tr><tr><td>2</td><td style="white-space:nowrap">  299171000210109<a name="nz-rheumaticfever-codesystem-299171000210109"> </a></td><td>History of acute rheumatic fever without heart disease</td><td>Can be used to summarise the diagnosis of a patient with a rheumatic fever condition</td></tr><tr><td>1</td><td style="white-space:nowrap">diagnostic-certainty-codes<a name="nz-rheumaticfever-codesystem-diagnostic-certainty-codes"> </a></td><td>Certainty of diagnosis classifiers</td><td>As rheumatic fever can be difficult to diagnose, these codes provide a way to classify confidence in a particular case diagnosis</td></tr><tr><td>2</td><td style="white-space:nowrap">  not-a-case<a name="nz-rheumaticfever-codesystem-not-a-case"> </a></td><td>not a case</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  under-investigation<a name="nz-rheumaticfever-codesystem-under-investigation"> </a></td><td>under investigation</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  borderline<a name="nz-rheumaticfever-codesystem-borderline"> </a></td><td>borderline</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  possible<a name="nz-rheumaticfever-codesystem-possible"> </a></td><td>possible</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  probable<a name="nz-rheumaticfever-codesystem-probable"> </a></td><td>probable</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  definite<a name="nz-rheumaticfever-codesystem-definite"> </a></td><td>definite</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">rhd-severity-special-codes<a name="nz-rheumaticfever-codesystem-rhd-severity-special-codes"> </a></td><td/><td/></tr><tr><td>2</td><td style="white-space:nowrap">  300171000210106<a name="nz-rheumaticfever-codesystem-300171000210106"> </a></td><td>Trivial (qualifier value)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  59391000119102<a name="nz-rheumaticfever-codesystem-59391000119102"> </a></td><td>History of heart valve repair (situation)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  301561000210102<a name="nz-rheumaticfever-codesystem-301561000210102"> </a></td><td>History of heart valve replacement (situation)</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">diagnosis-evidence-group-codes<a name="nz-rheumaticfever-codesystem-diagnosis-evidence-group-codes"> </a></td><td>Observation diagnosis evidence groupings</td><td>These code values originate in SNOMED CT, two being defined only in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  439238004<a name="nz-rheumaticfever-codesystem-439238004"> </a></td><td>Echocardiography test interpretation (observable entity)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  447541000210107<a name="nz-rheumaticfever-codesystem-447541000210107"> </a></td><td>New Zealand Jones Criteria Assessment (observable entity)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  448011000210101<a name="nz-rheumaticfever-codesystem-448011000210101"> </a></td><td>Evidence of preceding Streptococcus group A infection</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">diagnosis-component-NZ-special-concepts<a name="nz-rheumaticfever-codesystem-diagnosis-component-NZ-special-concepts"> </a></td><td>Special concepts in NZ RF diagnosis</td><td>These code value originate in SNOMED CT, one being defined only in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  448021000210106<a name="nz-rheumaticfever-codesystem-448021000210106"> </a></td><td>Indolent carditis (disorder)</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">NZ-specific-role-codes<a name="nz-rheumaticfever-codesystem-NZ-specific-role-codes"> </a></td><td/><td/></tr><tr><td>2</td><td style="white-space:nowrap">  320731000210100<a name="nz-rheumaticfever-codesystem-320731000210100"> </a></td><td>Support person</td><td>Role code used in patient whanau care team (RfPatient.contact)</td></tr><tr><td>1</td><td style="white-space:nowrap">NZ-specific-injection-site-codes<a name="nz-rheumaticfever-codesystem-NZ-specific-injection-site-codes"> </a></td><td>Specific injection sites in rheumatic fever secondary prophylaxis</td><td>These code values originate in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  299151000210101<a name="nz-rheumaticfever-codesystem-299151000210101"> </a></td><td>Structure of left ventrogluteal region (body structure)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  299161000210103<a name="nz-rheumaticfever-codesystem-299161000210103"> </a></td><td>Structure of right ventrogluteal region (body structure)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  299121000210105<a name="nz-rheumaticfever-codesystem-299121000210105"> </a></td><td>Structure of left upper outer quadrant of buttock (body structure)</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  299141000210104<a name="nz-rheumaticfever-codesystem-299141000210104"> </a></td><td>Structure of right upper outer quadrant of buttock (body structure)</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">nz-specific-medication-frequency-codes<a name="nz-rheumaticfever-codesystem-nz-specific-medication-frequency-codes"> </a></td><td>Specific medication frequency in rheumatic fever secondary prophylaxis</td><td>This code value originates in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  447521000210101<a name="nz-rheumaticfever-codesystem-447521000210101"> </a></td><td>Every thirteen weeks (qualifier value)</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">nz-specific-medication-allergy-codes<a name="nz-rheumaticfever-codesystem-nz-specific-medication-allergy-codes"> </a></td><td>Specific allergy types relevant to rheumatic fever secondary prophylaxis</td><td>These code values originate in the SNOMED NZ Edition</td></tr><tr><td>2</td><td style="white-space:nowrap">  332571000210107<a name="nz-rheumaticfever-codesystem-332571000210107"> </a></td><td>Allergy to benzathine penicillin</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  332581000210109<a name="nz-rheumaticfever-codesystem-332581000210109"> </a></td><td>Allergy to pharmaceutical excipient</td><td/></tr><tr><td>1</td><td style="white-space:nowrap">nz-national-system-identifier-type-codes<a name="nz-rheumaticfever-codesystem-nz-national-system-identifier-type-codes"> </a></td><td>Codes for differentiating types of external identifiers in national system slice of FHIR resource Identifier</td><td>These codes signify identifiers which originate in a national system but synchronised into FHIR.  The purpose of designating these codes is to provide a type discriminator for slicing Identifier in FHIR resource profiles</td></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-careplan-id<a name="nz-rheumaticfever-codesystem-rfccs-careplan-id"> </a></td><td>Identifies a CarePlan (case number) object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-careplanactivity-id<a name="nz-rheumaticfever-codesystem-rfccs-careplanactivity-id"> </a></td><td>Identifies a CarePlanActivity object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-condition-id<a name="nz-rheumaticfever-codesystem-rfccs-condition-id"> </a></td><td>Identifies a patient Condition object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-careteam-id<a name="nz-rheumaticfever-codesystem-rfccs-careteam-id"> </a></td><td>Identifies a CareTeam object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-serviceappointment-id<a name="nz-rheumaticfever-codesystem-rfccs-serviceappointment-id"> </a></td><td>Identifies a patient appointment object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-clinicalencounter-id<a name="nz-rheumaticfever-codesystem-rfccs-clinicalencounter-id"> </a></td><td>Identifies a secondary prophylaxis appointment encounter object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  rfccs-observation-id<a name="nz-rheumaticfever-codesystem-rfccs-observation-id"> </a></td><td>Identifies an observation object in the NZ national RF Care Coordination System</td><td/></tr><tr><td>2</td><td style="white-space:nowrap">  episurv-number<a name="nz-rheumaticfever-codesystem-episurv-number"> </a></td><td>Identifies a notifiable disease surveillance case number in ESR's EpiSurv national system</td><td/></tr></table></div>
  </text>
  <url
       value="https://fhir-ig.digital.health.nz/rheumatic-fever/CodeSystem/nz-rheumaticfever-codesystem"/>
  <version value="1.0.0"/>
  <name value="NzRheumaticFeverCodeSystem"/>
  <title
         value="NZ-specific terminology in rheumatic fever data representation"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-09-26T01:10:25+00:00"/>
  <publisher value="Te Whatu Ora"/>
  <contact>
    <name value="Te Whatu Ora"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.tewhatuora.govt.nz/"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="integration@tewhatuora.govt.nz"/>
    </telecom>
  </contact>
  <contact>
    <name value="HNZ Integration Team"/>
    <telecom>
      <system value="email"/>
      <value value="integration@tewhatuora.govt.nz"/>
      <use value="work"/>
    </telecom>
  </contact>
  <description
               value="This system defines standard codes used throughout this Implementation Guide for New Zealand rheumatic fever data representation"/>
  <purpose
           value="The codes defined in this CodeSystem are used throughout the rheumatic fever IG, including in resource profiles.

Originally it was sought to define these codes as concepts in the NZ Edition of SNOMED CT.  However, this turned out to be unworkable due to 
restrictions imposed by SNOMED that only 'affiliate members' can access the contents of the SNOMED CT edition.  As a consequence of this, applications 
cannot lookup nor access term definitions on NZHTS -- NZ's official terminology server.  This prevents FHIR validation of FHIR resources using (or 
meant to use) NZ edition SNOMED terms/codes.

Due to these restrictions this IG defines codes needed for NZ rheumatic fever data representation locally within the IG, in this CodeSystem.  
Some of these codes re-use the original code numbers assigned in the NZ SNOMED edition in case this becomes publically accessible in future.
The codes here are arranged in a 2-layer hierarchy which enables ValueSets segregated by purpose and help consumers understand the various purposes of the codes."/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="43"/>
  <concept>
    <code value="meta-tags"/>
    <display value="meta tags"/>
    <definition
                value="These codes are used to tag an instance via its meta.tag element"/>
    <concept>
      <code value="rf-nz"/>
      <display value="rheumatic fever"/>
      <definition
                  value="General purpose FHIR tag/classifier signifying FHIR information about an NZ rheumatic fever patient/case"/>
    </concept>
  </concept>
  <concept>
    <code value="condition-summary-codes"/>
    <display
             value="These codes are used in NZ to summarise the condition diagnosis"/>
    <definition
                value="These code values originate in SNOMED CT but are defined only in the SNOMED NZ Edition"/>
    <concept>
      <code value="302471000210100"/>
      <display
               value="Rheumatic heart disease with absence of signs and symptoms of acute rheumatic fever (situation)"/>
      <definition
                  value="Can be used to summarise the diagnosis of a patient with a rheumatic fever condition"/>
    </concept>
    <concept>
      <code value="299171000210109"/>
      <display
               value="History of acute rheumatic fever without heart disease"/>
      <definition
                  value="Can be used to summarise the diagnosis of a patient with a rheumatic fever condition"/>
    </concept>
  </concept>
  <concept>
    <code value="diagnostic-certainty-codes"/>
    <display value="Certainty of diagnosis classifiers"/>
    <definition
                value="As rheumatic fever can be difficult to diagnose, these codes provide a way to classify confidence in a particular case diagnosis"/>
    <concept>
      <code value="not-a-case"/>
      <display value="not a case"/>
    </concept>
    <concept>
      <code value="under-investigation"/>
      <display value="under investigation"/>
    </concept>
    <concept>
      <code value="borderline"/>
      <display value="borderline"/>
    </concept>
    <concept>
      <code value="possible"/>
      <display value="possible"/>
    </concept>
    <concept>
      <code value="probable"/>
      <display value="probable"/>
    </concept>
    <concept>
      <code value="definite"/>
      <display value="definite"/>
    </concept>
  </concept>
  <concept>
    <code value="rhd-severity-special-codes"/>
    <concept>
      <code value="300171000210106"/>
      <display value="Trivial (qualifier value)"/>
    </concept>
    <concept>
      <code value="59391000119102"/>
      <display value="History of heart valve repair (situation)"/>
    </concept>
    <concept>
      <code value="301561000210102"/>
      <display value="History of heart valve replacement (situation)"/>
    </concept>
  </concept>
  <concept>
    <code value="diagnosis-evidence-group-codes"/>
    <display value="Observation diagnosis evidence groupings"/>
    <definition
                value="These code values originate in SNOMED CT, two being defined only in the SNOMED NZ Edition"/>
    <concept>
      <code value="439238004"/>
      <display
               value="Echocardiography test interpretation (observable entity)"/>
    </concept>
    <concept>
      <code value="447541000210107"/>
      <display
               value="New Zealand Jones Criteria Assessment (observable entity)"/>
    </concept>
    <concept>
      <code value="448011000210101"/>
      <display value="Evidence of preceding Streptococcus group A infection"/>
    </concept>
  </concept>
  <concept>
    <code value="diagnosis-component-NZ-special-concepts"/>
    <display value="Special concepts in NZ RF diagnosis"/>
    <definition
                value="These code value originate in SNOMED CT, one being defined only in the SNOMED NZ Edition"/>
    <concept>
      <code value="448021000210106"/>
      <display value="Indolent carditis (disorder)"/>
    </concept>
  </concept>
  <concept>
    <code value="NZ-specific-role-codes"/>
    <concept>
      <code value="320731000210100"/>
      <display value="Support person"/>
      <definition
                  value="Role code used in patient whanau care team (RfPatient.contact)"/>
    </concept>
  </concept>
  <concept>
    <code value="NZ-specific-injection-site-codes"/>
    <display
             value="Specific injection sites in rheumatic fever secondary prophylaxis"/>
    <definition value="These code values originate in the SNOMED NZ Edition"/>
    <concept>
      <code value="299151000210101"/>
      <display
               value="Structure of left ventrogluteal region (body structure)"/>
    </concept>
    <concept>
      <code value="299161000210103"/>
      <display
               value="Structure of right ventrogluteal region (body structure)"/>
    </concept>
    <concept>
      <code value="299121000210105"/>
      <display
               value="Structure of left upper outer quadrant of buttock (body structure)"/>
    </concept>
    <concept>
      <code value="299141000210104"/>
      <display
               value="Structure of right upper outer quadrant of buttock (body structure)"/>
    </concept>
  </concept>
  <concept>
    <code value="nz-specific-medication-frequency-codes"/>
    <display
             value="Specific medication frequency in rheumatic fever secondary prophylaxis"/>
    <definition value="This code value originates in the SNOMED NZ Edition"/>
    <concept>
      <code value="447521000210101"/>
      <display value="Every thirteen weeks (qualifier value)"/>
    </concept>
  </concept>
  <concept>
    <code value="nz-specific-medication-allergy-codes"/>
    <display
             value="Specific allergy types relevant to rheumatic fever secondary prophylaxis"/>
    <definition value="These code values originate in the SNOMED NZ Edition"/>
    <concept>
      <code value="332571000210107"/>
      <display value="Allergy to benzathine penicillin"/>
    </concept>
    <concept>
      <code value="332581000210109"/>
      <display value="Allergy to pharmaceutical excipient"/>
    </concept>
  </concept>
  <concept>
    <code value="nz-national-system-identifier-type-codes"/>
    <display
             value="Codes for differentiating types of external identifiers in national system slice of FHIR resource Identifier"/>
    <definition
                value="These codes signify identifiers which originate in a national system but synchronised into FHIR.  The purpose of designating these codes is to provide a type discriminator for slicing Identifier in FHIR resource profiles"/>
    <concept>
      <code value="rfccs-careplan-id"/>
      <display
               value="Identifies a CarePlan (case number) object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-careplanactivity-id"/>
      <display
               value="Identifies a CarePlanActivity object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-condition-id"/>
      <display
               value="Identifies a patient Condition object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-careteam-id"/>
      <display
               value="Identifies a CareTeam object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-serviceappointment-id"/>
      <display
               value="Identifies a patient appointment object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-clinicalencounter-id"/>
      <display
               value="Identifies a secondary prophylaxis appointment encounter object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="rfccs-observation-id"/>
      <display
               value="Identifies an observation object in the NZ national RF Care Coordination System"/>
    </concept>
    <concept>
      <code value="episurv-number"/>
      <display
               value="Identifies a notifiable disease surveillance case number in ESR's EpiSurv national system"/>
    </concept>
  </concept>
</CodeSystem>