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HdBe-Alerte

WARNING This page contains a draft CBB, as raw output from the zib export and automatic conversion to CBB. It requires thorough review and adaption to the Belgian realm. This CBB is merely added for informative use.

CBBConceptStatus
HdBe-Alert

Une alerte décrit un fait clinique ou administratif porté à l'attention des utilisateurs des systèmes cliniques, à prendre en compte lors de l'élaboration de la politique diagnostique et thérapeutique ou lors de la prise en charge du patient, généralement en raison d'un risque de sécurité. Les affections décrivant la sensibilité du corps à une substance qui entraîne une réaction physiologique spécifique après exposition à cette substance sont appelées allergies. Elles sont décrites dans un modèle d'information distinct. Les avertissements concernant des affections non allergiques peuvent porter sur :

  • Une affection, un état ou un diagnostic pouvant être considéré comme une contre-indication à se soumettre à un certain type de traitement, tel que la grossesse ou le syndrome du QT long ;

  • Le dysfonctionnement d'un système d'organes (insuffisance cardiaque, altération de la fonction hépatique ou rénale, affaiblissement du système immunitaire) ;

  • Un risque de propagation de certains micro-organismes (bactéries multirésistantes, bacille de la tuberculose, VIH, VHB, virus Ebola) ;

  • Autres risques

Purpose

Documenter et saisir les affections ou les états qui nécessitent de l'attention est une part importante de l'enregistrement médical. Cela concerne l'essence de la sécurité des patients. Dans l'exécution de l'examen et du traitement, ces caractéristiques du patient - qui sont notées comme un avertissement - doivent constamment être prises en compte. Elles fournissent des informations importantes pour l'état du patient et les options dont un professionnel de la santé dispose pour la thérapie. Les affections enregistrées ou transférées comme une Alerte peuvent également être décrites comme un Problème. La différence réside dans le fait que le professionnel de la santé considère le problème comme une Alerte = avertissement. Dans de nombreux cas, le transfert sera soumis à des règles strictes en matière de confidentialité, car l'avertissement ne suscitera pas toujours une réaction adéquate dans l'environnement informé.

Instructions

S'il existe une contre-indication qui est également importante pour l'innocuité des médicaments, elle doit également être enregistrée via ContreIndicationMédicament.

active

id0..1string
extensionI0..*Extension
EndDateTime0..1dateTime
ConditionI0..1Reference(HdBe-Problem)
AlertNameI0..1CodeableConceptBinding
StartDateTime0..1dateTime
AlertType0..1CodeableConceptBinding
Comment0..1string

Alert0..*
Alert.EndDateTimedateTime0..1
Alert.ConditionReference(HdBe-Problem)0..1
Alert.AlertNameCodeableConcept0..1
Alert.StartDateTimedateTime0..1
Alert.AlertTypeCodeableConcept0..1
Alert.Commentstring0..1


Alert
DefinitionRoot concept of the Alert information model. This root concept contains all data elements of the Alert information model.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • HdBe-Alert-1: One concept from Condition and AlertName must be selected.
    Condition.exists() xor AlertName.exists()
Mappings
  • rim: n/a
Alert.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Alert.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Alert.EndDateTime
DefinitionThe date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Alert.Condition
DefinitionThe patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.
Cardinality0...1
TypeReference(HdBe-Problem)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Alert.AlertName
DefinitionA warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert.
Cardinality0...1
TypeCodeableConcept
Binding

AlertName codes

AlertName (extensible)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Alert.StartDateTime
DefinitionThe date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Alert.AlertType
DefinitionIndicates the type of alert, meaning a rough description of the cause or origin of the warning.
Cardinality0...1
TypeCodeableConcept
Binding

AlertType codes

AlertType (required)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Alert.Comment
DefinitionExplanatory comments to the alert that cannot be expressed in any of the other elements.
Cardinality0...1
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a

Example instances

alert
EndDateTime 2012-12-30
condition.Problem Listeriosis
AlertName
StartDateTime 2012-09-15
AlertType 75323-6 - Condition (code by LOINC)
Comment

zib Alert-v4.1 difference

Concept Category Description
AlertName textual Removed the notion of allowing free text in the definition because this is confusing and we want to stimulate the use of codes. The ValueSet binding is extensible, meaning that other codes or a text as fall back can be used.
AlertName terminology Replaced NullFlavor Other and Unkown with SNOMED equivelant codes.



Terminology Bindings

PathNameStrengthURL
AlertNameAlertNameextensiblehttps://fhir.healthdata.be/ValueSet/AlertName
AlertTypeAlertTyperequiredhttps://fhir.healthdata.be/ValueSet/AlertType