@startuml skinparam dpi 100 scale max 350 width skinparam ActivityDiamondBackgroundColor #RoyalBlue skinparam ArrowColor #RoyalBlue skinparam ArrowFontColor #RoyalBlue skinparam ArrowFontSize 12 skinparam ArrowMessageAlignment right skinparam BoxPadding 10 skinparam ClassFontSize 16 skinparam ClassFontStyle bold skinparam ClassStereotypeFontSize 16 skinparam dpi 300 skinparam FooterFontSize 14 skinparam FooterFontStyle italic skinparam LegendBackgroundColor #Snow skinparam LegendFontName Helvetica skinparam LegendFontSize 16 skinparam linetype ortho skinparam nodesep 70 skinparam NoteBackgroundColor #LightYellow skinparam NoteFontSize 15 skinparam NoteTextAlignment left skinparam ranksep 60 skinparam roundcorner 5 skinparam TitleFontSize 20 title "Shared Digital Health Record - FHIR data model" frame "Core Data Services" as SDHRFrame { class "SDHR:Encounter" as encounter <> #LightSalmon ##[bold] { Represents a SDHR encounter [[https://fhir-ig.digital.health.nz/sdhr/StructureDefinition-SDHREncounter.html]] Inherits FHIR ""Encounter"" ---- * **meta.source**: ~~1..1~~ "https://api.hip.digital.health.nz/fhir/hpi/v1/Location/{hpi-facilityid}}" * **meta.profile**: ~~1..1~~ "https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/SDHREncounter" * **status**: ~~1..1~~ Binding: EncounterStatus [[[http://hl7.org/fhir/R4/valueset-encounter-status.html]]] * **class**: ~~1..1~~ Binding: ActEncounterCode (extensible) [[[http://terminology.hl7.org/5.5.0/ValueSet-v3-ActEncounterCode.html]]] * **subject**: ~~1..1~~ Reference NHI Patient * **participant.individual**: ~~1..1~~ Reference Practitioner } class "SDHR:Condition" as condition <> #LightSalmon ##[bold] { Represents a SDHR condition [[https://fhir-ig.digital.health.nz/sdhr/StructureDefinition-SDHRCondition.html]] Inherits FHIR ""Condition"" ---- * **meta.source**: ~~1..1~~ "https://api.hip.digital.health.nz/fhir/hpi/v1/Location/{hpi-facilityid}}" * **meta.profile**: ~~1..1~~ "https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/SDHRCondition" * **extension**: ~~1..*~~ * **extentension[*].url** : "http://hl7.org.nz/fhir/StructureDefinition/long-term-condition" * **extension[*].valueBoolean**: boolean true|false * **extension[+].url** : "https://standards.digital.health.nz/ns/sdhr-client-last-updated" * **extension[+].valueDateTime**: "2023-11-26T10:02:45+13:00" * **code**: ~~1..1~~ Binding: Condition/Problem/DiagnosisCodes (preferred) [[[http://hl7.org/fhir/ValueSet/condition-code]]] * **subject**: ~~1..1~~ Reference NHI Patient * **onsetDateTime**: ~~0..1~~ Preferred * **recordedDateTime**: ~~0..1~~ Preferred * **recorder**: ~~0..1~~ Reference Practitioner (preferred) * **asserter**: ~~1..1~~ Reference Practitioner } class "SDHR:AllergyIntolerance" as allergyintolerance <> #LightSalmon ##[bold] { Represents a SDHR allergy intolerance [[https://fhir-ig.digital.health.nz/sdhr/StructureDefinition-SDHRAllergyIntolerance.html]] Inherits FHIR ""AllergyIntolerance"" ---- * **meta.source**: ~~1..1~~ "https://api.hip.digital.health.nz/fhir/hpi/v1/Location/{hpi-facilityid}}" * **meta.profile**: ~~1..1~~ "https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/SDHRAllergyIntolerance" * **clinicalStatus**: ~~1..1~~ Binding: AllergyIntoleranceClinicalStatus (required) [[[http://hl7.org/fhir/R4/valueset-allergyintolerance-clinical.html]]] * **code**: ~~1..1~~ Binding: Multiple bindings e.g. SNOMED CT, ReadCodes, MIMS * **patient**: ~~1..1~~ Reference NHI Patient * **category**: ~~0..*~~ Binding: AllergyIntoleranceCategory (preferred) [[[http://hl7.org/fhir/R4/valueset-allergy-intolerance-category.html]]] * **recordedDateTime**: 0..1 (preferred) * **recorder**: 0..1 Reference Practitioner (preferred) } class "SDHR:Observation" as observation <> #LightSalmon ##[bold] { Represents a SDHR observation [[https://fhir-ig.digital.health.nz/sdhr/StructureDefinition-SDHRObservation.html]] Inherits FHIR ""Observation"" ---- * **meta.source**: ~~1..1~~ "https://api.hip.digital.health.nz/fhir/hpi/v1/Location/{hpi-facilityid}}" * **meta.profile**: ~~1..1~~ "https://fhir-ig.digital.health.nz/sdhr/StructureDefinition/SDHRObservation" * **code**: Binding: LOINCCodes (preferred) [[[http://hl7.org/fhir/ValueSet/observation-codes]]] * **subject**: ~~1..1~~ Reference NHI Patient * **effectiveDateTime**: Preferred * **value[x]**: Binding: Multiple bindings e.g. SNOMED CT, ReadCodes, MIMS * **interpretation**: Binding: ObservationInterpretation (extensible) [[[http://hl7.org/fhir/R4/valueset-observation-interpretation.html]]] * **status**: Binding: ObservationStatus (required) [[[http://hl7.org/fhir/R4/valueset-observation-status.html]]] } frame "Te Whatu Ora NHI/HPI" as NationalIdentifier { class "Patient (NHI)" as Patient <> #SkyBlue { * logical id: NHI } class "HPI" as HPI <> #SkyBlue { org identifier format ""GXXNNN-C"" HPI Org Id } Patient -[hidden]l- HPI } rectangle "Notes" as Notes { note as N1 **Notes** The following resources are sourced from primary care systems: - AllergyIntolerance - Condition - Encounter - Observation The following resources are existing national data services: - Immunization (AIR) - Patient (NHI) - Practitioner/Organizaion/Location (HPI) - MedicationRequest/MedicationDispense (MDR) **Coding/Terminology:** In some cases an attempt may be made to map a source code to a standard code such as read code --> SNOMEDCT. In these scenarios the "source" code will always be preserved and marked as "user selected". e.g. { "code" : { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "373784005", "display" : "Penicillin allergy", "userSelected" : false }, { "system" : "http://mims.co.nz", "code" : "m00286", "display" : "Penicillins", "userSelected" : true } ] } } end note } } ' ******** ' * Entities outside any frame are in other bounded contexts ' ******** ' plantuml positioning ' ******** ' * resource linkages encounter "subject" -[#SkyBlue,dashed]up-- Patient encounter "participant" -[#SkyBlue,dashed]up-- HPI condition "subject" -[#SkyBlue,dashed]down-- Patient condition "recorder | asserter" --[#SkyBlue,dashed]down-- HPI allergyintolerance "subject" -[#SkyBlue,dashed]up-- Patient allergyintolerance "recorder" -[#SkyBlue,dashed]up-- HPI observation "subject" -[#SkyBlue,dashed]down-- Patient observation "performer" --[#SkyBlue,dashed]down-- HPI Notes -[hidden]left- Patient 'NationalIdentifier -[hidden]- SDHRFrame legend right **Notes** - (preferred) indicates that whilst not mandatory it highly desirable. '- Arrows show direction of FHIR reference. '- Solid/open bullets indicate mandatory/optional data elements. **Key to datatype colours** |= colour |= stereotype | | ghost white\n | Standard FHIR resource in TWO IG | | salmon\n | Profiled FHIR resource | | orange red\n | Canonical shared resource defined by TWO | | sky blue\n| Logical identifier reference to records in national systems | endlegend footer "Health NZ/Te Whatu Ora. Generated from PlantUML source on %date('dd/MM/yyyy')" @enduml