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
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
canonical instance definitions
LeadProvidersGroup |
Group which identifies all NZ lead provider organisations for rheumatic fever secondary prevention |
Medications and Follow-up Guidance Questionnaire |
Gathers information in secondary prophylaxis planning which guides subsequent medication appointments and follow-up |
Oral Secondary Prophylaxis Health Assessment Questionnaire |
Gathers information about patient health at an oral secondary prophylaxis medication appointment |
Patient & whanau goals and preferences questionnaire |
Gathers patient and whanau preferences and goals for rheumatic fever care |
Secondary Prophylaxis Health Assessment Questionnaire |
Gathers information about patient health at a secondary prophylaxis medication appointment |
Secondary prophylaxis medication allergy questionnaire |
Describes any known patient allergies to medications used in rheumatic fever secondary prophylaxis |
Consent profiles/definitions and examples
Consent-Data-Active-AfterAppointments |
An active, 3 year, patient DATA consent obtained by the Te Tai Tokerau Rheumatic Fever Service, with sample |
Consent-Data-Active-AfterDiagnosisAndPlanning |
An active, 3 year, patient DATA consent obtained by the Te Tai Tokerau Rheumatic Fever Service, with sample |
Consent-Data-Active-Initial |
An initial record of patient 3-year DATA consent obtained by the Te Tai Tokerau Rheumatic Fever Service |
Consent-Data-OnBehalfByRelatedPerson |
An active, 3 year, patient DATA consent given on patient's behalf by their relative, as obtained by the Te Tai Tokerau Rheumatic Fever Service, with sample |
Consent-Data-OptOut |
Example of consent when the patient OPTED OUT of data sharing on 01/09/2023 |
Consent-Data-Provisional |
A provisional patient DATA consent recorded by Te Tai Tokerau Rheumatic Fever Service in anticipation of pending patient signed consent form |
The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.
Rheumatic Fever FHIR API Capability Statement |
New Zealand rheumatic fever FHIR API capability statement |
These define constraints on FHIR resources for systems conforming to this implementation guide.
Rheumatic Fever Care Team |
Identifies parties involved in secondary prophylaxis (preventative treatment) for a patient. Members typically comprise rheumatic fever service Organizations and Practitioners especially nurses |
Rheumatic Fever CarePlan |
Profiles shared care plans used in NZ for management of rheumatic fever cases with suspected acute rheumatic fever |
Rheumatic Fever Condition |
Extends NzCondition to add classifiers for RHD severity, diagnostic certainty and symptomatic status and specifies groups of diagnosic evidence that can be attached. |
Rheumatic Fever Diagnosis Group |
This profile constrains the codes valid on an Observation so it can represent groups of rheumatic fever diagnosis data. |
Rheumatic Fever Medication Request |
Describes medication planned for a rheumatic fever patient over a period of time. Referenced as an activity in rheumatic fever care plans. Includes an extension defining the medication frequency which determines the scheduling intervals for Appointments. |
Rheumatic Fever Patient |
NzPatient-based FHIR resource for representing rheumatic fever patients |
These define constraints on FHIR data types for systems conforming to this implementation guide.
Care Plan status change history |
Captures metadata about a change in careplan status |
Certainty of rheumatic fever diagnosis |
Certainty of rheumatic fever diagnosis |
Codifies role taken by a whanau member of patient's care team |
Codifies role this whanau member plays in a patient's care team |
Date of assessment of rheumatic heart disease severity |
Tracks the RF-specific date when rheumatic heart disease severity was assessed. |
Denotes if the member is to be used a primary contact |
Set to true if this whanau member acts as a primary contact for the patient |
Frequency of rheumatic fever medication |
Frequency of rheumatic fever medication to be set when medication is planned for an RF patient |
Lifelong secondary prophylaxis recommended? |
Indicates that a rheumatic fever patient has been recommended lifelong prophylaxis |
Relationship of whanau member to patient in care team |
In patient care teams, codifies this whanau member's relationship to the patient |
Severity of rheumatic heart disease |
Severity of rheumatic heart disease determines the severity of a patient's rheumatic fever condition. |
Symptom status at diagnosis |
Symptom status at time of rheumatic fever diagnosis |
These define sets of codes used by systems conforming to this implementation guide.
Codes for component observations of NZ rheumatic fever diagnosis |
This value set combines SNOMED internaional codes with a handful of special codes for NZ RF diagnosis observation data coding |
Codes for rheumatic fever diagnosis observation grouping |
This value set defines SNOMED codes which represent groupings of diagnosis data captured by rheumatic fever Observation instances |
Codes for rheumatic heart disease symptom status at time of diagnosis |
This value set defines codes which describe whether a patient was symptomatic at the time of rheumatic fever diagnosis |
Codes for summary diagnosis of the rheumatic fever condition |
This value set defines the codes that summarise the diagnosis of a patient with a rheumatic fever condition |
External identifier type codes |
This value set defines the codes that differentiate types of external identifiers held in FHIR resource Identifiers |
Generic QuestionnaireResponse yes/no question answer codes |
This value set defines valid answer codes for a yes/no-type questions where it's important to be able to record an unknown or data not available response |
Rheumatic fever certainty of diagnosis codes |
This value set defines the codes that represent the certainty of a diagnosis of rheumatic fever in a patient. |
Rheumatic fever medication allergy codes |
This value set includes codes for the RF secondary prophylaxis medications / substances a patient has an allergic reaction to |
Rheumatic fever patient care team participant role codes |
This value set defines relationships people can take in a rheumatic fever patient care team, and can also be used to define a consent-on-behalf relationship |
Rheumatic fever planned medication frequency codes |
This value set defines codes for standard frequencies of secondary prophylaxis medication planning (that is, appointment intervals) |
Rheumatic heart disease severity codes |
This value set defines codes for the severity of rheumatic heart disease which determines the severity of a patient's rheumatic fever condition |
These define new code systems used by systems conforming to this implementation guide.
NZ-specific terminology in rheumatic fever data representation |
This system defines standard codes used throughout this Implementation Guide for New Zealand rheumatic fever data representation |
These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.
BenzathineMedication |
Example of medication used in rheumatic fever secondary prophylaxis (prevention) as NZMT terminology |
Care plan closed after one appointment completed |
Example of a RF care plan CLOSED after the patient recently went overseas. |
Care plan in initial state after Sage Westbrook registered |
RF care plan where patient registered and basic questionnaires completed, but no detail diagnosis or appointments yet. |
Care plan in initial state after Sage Westbrook registered (R-labelled) |
RF care plan where patient registered and basic questionnaires completed, but no detail diagnosis or appointments yet. |
Care plan on-hold after first appointment completed |
Example of an RF care plan that has been put ON-HOLD after the first secondary prophylaxis appointment, because the patient is overseas. |
Care plan ready to go with all medication planned and appointments booked |
Example of an RF care plan with secondary prophylaxis medication planned and three appointments booked. |
Care plan with secondary propylaxis underway - two appointments completed |
An RF care plan after the first secondary prophylaxis and follow-up appointments attended. |
DentalFollowUpEncounter |
Example of a rheumatic fever patient encounter for dental specialist follow-up |
DiagnosisDetail-ECHO |
Illustrates collection of ECHO cardiogram diagnosis evidence in a rheumatic fever case |
DiagnosisDetail-JonesCriteria |
Illustrates a FHIR Observation describing a Jones (twelve) criteria diagnosis for a rheumatic fever patient |
DiagnosisDetail-StrepEvidence |
Illustrates primary strep diagnosis evidence (Strepococcus group A infection is the cause of rheumatic fever) |
DiagnosisDetail-StrepEvidence-Secondary |
Illustrates second strep diagnosis evidence from repeated ASOT and Anti-Dnase B tests |
DiagnosisEncounter |
Encounter capturing context of a patient's rheumatic fever diagnosis |
FollowUp-Dental-August-Booked |
Example of a planned patient follow-up with the dentist |
FollowUp-Dental-August-Fulfilled |
Example of a planned patient follow-up with the dentist |
HealthAssessmentAtOralProphylaxisEncounter |
Example of patient health assessment from an encounter for oral secondary prophylaxis medication. |
HealthAssessmentAtSecondaryProphylaxisEncounter |
Example assessment of Sage's health at her August secondary prophylaxis appointment. |
MedicationStatement-August |
Illustrates details of secondary prophylaxis medication given to a patient at an appointment |
MedicationsAndFollowUpGuidanceQuestionnaireResponse |
Example payload demonstrating guidance defined for secondary prophylaxis patient medication and follow-up. |
PaniaPunga |
An example rheumatic fever patient who is Māori ethnicity and speaks Māori |
PatientMedicationAllergyQuestionnaireResponse |
Example payload demonstrating data collected about a patient's allergies to RF medication. |
PatientWhanauGoalsPreferencesQuestionnaireResponse |
Example payload demonstrating patient/whanau expressed preferences and goals for rheumatic fever care. |
PlannedBenzathineMedication |
Illustrates a request for active secondary prophylaxis medication that can appear in a rheumatic fever care plan |
PlannedBenzathineMedicationWithLignocaine |
Illustrates planning of benzathine prophylaxis medication with a second embedded MedicationRequest for lignocaine pain relief |
SageWestbrook |
Example rheumatic fever patient who is a teenager of NZ European ethnicity, lives near Whangārei |
SageWestbrookAndWhanau |
Example of a teenager patient with whanau members defined as patient contacts |
SecondaryProphylaxisAppointment-August-Booked |
Example of a booked patient appointment for rheumatic fever secondary prophylaxis treatment (injection) |
SecondaryProphylaxisAppointment-August-Fulfilled |
Example of a fulfilled (completed) patient appointment for rheumatic fever secondary prophylaxis treatment (injection) |
SecondaryProphylaxisAppointment-September-Booked |
Example of a booked patient appointment for RF secondary prophylaxis treatment with the shared care provider |
SecondaryProphylaxisAugustEncounterBundle |
Example of a Bundled POST which creates instances of Encounter, MedicationStatement and QuestionnaireResponse in one operation |
SecondaryProphylaxisCareTeam |
Example of secondary prophylaxis care team membership |
SecondaryProphylaxisEncounter |
Example where RF secondary prophylaxis delivered at a Whangarei medical centre |
SevereRfCondition |
An example of a rheumatic fever condition as initially diagnosed at registration |
SevereRfConditionWithDiagnosisEvidence |
An example of a severe rheumatic fever Condition with linked evidence as 3 profiled Observation instances. |
TeTaiTokerauRFSecondaryPreventionService |
Identifies the Te Tai Tokerau rheumatic fever secondary prevention provider organization |
VirtualEncounter |
Example of a rheumatic fever patient encounter at a virtual location |
WaikatoRFSecondaryPreventionService |
Identifies the Waikato rheumatic fever secondary prevention provider organization |