example - bolus calculator (Pump_Multiwave)
Sample scenario
| Bolus delivery type | Bolus Activation type | Recommended total bolus |
Selected total bolus |
Confirmed total bolus | extended, /delayed bolus |
extended/ delayed duration |
immediate bolus |
BG/Carb used for Bolus calculation |
|---|---|---|---|---|---|---|---|---|
| PUMP_MULTIWAVE | Manually changed recommended bolus | 6 IU = (meal correction : 0 IU + BG correction : 6 IU |
8 IU = (meal correction : 0 IU + BG correction : 8 IU |
8 IU = (meal correction : 0 IU + BG correction : IU |
6 IU | 1200000 ms | 2 IU | BG - 170 mg/dL Carb - 10g |
MedicationRequest resource containing primarily the Bolus calculation outcome (recommended, selected and confirmed boluses) and the details of the dose like delivery type = PUMP_MULTIWAVE, activation type = Manually changed recommended bolus.
MedicationAdministration resource containing the confirmed bolus and the details of the dose like delivery type = PUMP_MULTIWAVE, activation type = Manually changed recommended bolus.
MedicationRequest Sample :
{
"resourceType": "MedicationRequest",
"id": "13f0823f-d3d8-40c2-9155-10e098a48b0f",
"meta": {
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/MedicationRequest"
]
},
"status": "active",
"intent": "789480007_manually_changed_recommended_bolus", // Activation type
"medication": {
"concept": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "67866001_short_acting",
"display": "67866001_short_acting"
}
]
}
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"authoredOn": "2020-02-27T11:14:00+00:00",
"performer": [
{
"reference": "Device/5f0990b9-1be2-4f69-9621-028b6abdf1b5"
}
],
"reason": [
{
"reference": "Observation/8u4efa51-f023-4623-b007-6c31dec0d766"
}
],
"dosageInstruction": [
{
"method": {
"coding": [ // Delivery type
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_bolus_multiwave",
"display": "789480007_bolus_multiwave"
}
]
},
"doseAndRate": [
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_correction_bolus_recommended",
"display": "789480007_correction_bolus_recommended"
}
]
},
"doseQuantity": {
"value": 6,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_meal_bolus_recommended",
"display": "789480007_meal_bolus_recommended"
}
]
},
"doseQuantity": {
"value": 0,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_total_bolus_recommended",
"display": "789480007_total_bolus_recommended"
}
]
},
"doseQuantity": {
"value": 6,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_correction_bolus_selected",
"display": "789480007_correction_bolus_selected"
}
]
},
"doseQuantity": {
"value": 8,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_meal_bolus_selected",
"display": "789480007_meal_bolus_selected"
}
]
},
"doseQuantity": {
"value": 0,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_total_bolus_selected",
"display": "789480007_total_bolus_selected"
}
]
},
"doseQuantity": {
"value": 8,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_correction_bolus_confirmed",
"display": "789480007_correction_bolus_confirmed"
}
]
},
"doseQuantity": {
"value": 8,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_meal_bolus_confirmed",
"display": "789480007_meal_bolus_confirmed"
}
]
},
"doseQuantity": {
"value": 0,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_total_bolus_confirmed",
"display": "789480007_total_bolus_confirmed"
}
]
},
"doseQuantity": {
"value": 8,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_immediate",
"display": "789480007_immediate"
}
]
},
"doseQuantity": {
"value": 2,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_delayed",
"display": "789480007_delayed"
}
]
},
"doseQuantity": {
"value": 6,
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
{
"type": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_delayed_duration",
"display": "789480007_delayed_duration"
}
]
},
"doseQuantity": {
"value": 1200000,
"unit": "ms",
"system": "http://unitsofmeasure.org",
"code": "ms"
}
}
]
}
]
}
MedicationAdministration Profiles (Bolus calculator Sample) having reference to MedicationRequest profile:
{
"resourceType": "MedicationAdministration", // Resource name value in FHIR for this profile
"id": "69456d66-a558-4d4c-8c7a-77e1c2b3b0b6",
"meta": { // used for validation of the profile
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/MedicationAdministration"
]
},
"status": "completed", // FHIR hardcorded value for status
"category": [
{
"coding": [ // Bolus Delivery type
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_bolus_multiwave",
"display": "789480007_bolus_multiwave"
}
]
}
],
"medication": { // code for type of medication
"concept": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "67866001_short_acting",
"display": "67866001_short_acting"
}
]
}
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"occurencePeriod": {
"start": "2020-02-27T11:14:00+00:00",
"end": "2020-02-27T11:34:00+00:00"
},
"performer": [
{
"actor": {
"reference": {
"reference": "Device/5f0990b9-1be2-4f69-9621-028b6abdf1b5"
}
}
}
],
"request": {
"reference": "MedicationRequest/13f0823f-d3d8-40c2-9155-10e098a48b0f"
},
"dosage": {
"dose": {
"value": "8.0",
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
},
"contained": [
{
"resourceType": "MedicationAdministration", // Resource name value in FHIR for this profile
"id": "5da7938d-c3bb-4d8e-86ac-3b18ae6687e5",
"meta": { // used for validation of the profile
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/MedicationAdministration"
]
},
"partOf": [
{
"reference": "MedicationAdministration/69456d66-a558-4d4c-8c7a-77e1c2b3b0b6"
}
],
"status": "completed",
"medication": {
"concept": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "67866001_short_acting",
"display": "67866001_short_acting"
}
]
}
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"occurenceDateTime": "2020-02-27T11:14:00+00:00",
"performer": [
{
"actor": {
"reference": {
"reference": "Device/5f0990b9-1be2-4f69-9621-028b6abdf1b5"
}
}
}
],
"request": {
"reference": "MedicationRequest/13f0823f-d3d8-40c2-9155-10e098a48b0f"
},
"dosage": {
"method": {
"coding": [ //Immediate bolus
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_immediate",
"display": "789480007_immediate"
}
]
},
"dose": {
"value": "2.0",
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
}
}
},
{
"resourceType": "MedicationAdministration",
"id": "d25e76f2-8748-4d97-b7ae-355dba381496",
"meta": {
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/MedicationAdministration"
]
},
"partOf": [
{
"reference": "MedicationAdministration/69456d66-a558-4d4c-8c7a-77e1c2b3b0b6"
}
],
"status": "completed",
"medication": {
"concept": {
"coding": [
{
"system": "http://roche.com/fhir/iop/cs",
"code": "67866001_short_acting",
"display": "67866001_short_acting"
}
]
}
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"occurenceDateTime": "2020-02-27T11:14:00+00:00",
"performer": [
{
"actor": {
"reference": {
"reference": "Device/5f0990b9-1be2-4f69-9621-028b6abdf1b5"
}
}
}
],
"request": {
"reference": "MedicationRequest/13f0823f-d3d8-40c2-9155-10e098a48b0f"
},
"dosage": {
"method": {
"coding": [ //Delayed bolus
{
"system": "http://roche.com/fhir/iop/cs",
"code": "789480007_delayed",
"display": "789480007_delayed"
}
]
},
"rateRatio": {
"numerator": {
"value": "6.0",
"unit": "[iU]",
"system": "http://unitsofmeasure.org",
"code": "[iU]"
},
"denominator": {
"value": 1200000,
"unit": "ms",
"system": "http://unitsofmeasure.org",
"code": "ms"
}
}
}
}
]
}
BG Sample for Capillary Glycemia with Carbs association :
Note : The Guidance Response profile will help the reference of Observation (BG value & its associated carb) with Medication Request profile as a response for bolus calculator usescase.
{
"resourceType": "Observation",// Resource name value in FHIR for this profile
"id": "8u4efa51-f023-4623-b007-6c31dec0d766",
"meta": { // used for validation of the profile
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/BG_Observation"
]
},
"status": "final", // FHIR hardcorded value for status
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "32016-8",
"display": "Glucose [Mass/volume] in Capillary blood" // code for Capillary Glycemia
}
]
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"effectiveTiming": {
"event": "2020-10-14T02:00:00.000+00:00"
},
"valueQuantity": {
"value": 170.0,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"device": {
"reference": "Device/8954c958-41c5-4a24-82ef-693218c2f625"
},
"hasMember": { // Reference to Observation (carbs)
"reference": "Observation/78687b6e-291a-45ba-8d0a-b16000b31c71"
}
}
Carbs Sample :
{
"resourceType": "Observation", // Resource name value in FHIR for this profile
"id": "78687b6e-291a-45ba-8d0a-b16000b31c71",
"meta": { // used for validation of the profile
"profile": [
"http://roche.com/fhir/iop/StructureDefinition/Observation"
]
},
"status": "final", // FHIR hardcorded value for status
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "9059-7",
"display": "Carbohydrate intake Estimated" // code for carbs
}
]
},
"subject": {
"reference": "Patient/34605fdc-74aa-4587-a5f0-92e6c5f64527"
},
"effectiveDateTime": "2017-10-03T06:32:00+01:00",
"valueQuantity": {
"value": 10,
"unit": "g",
"system": "http://unitsofmeasure.org",
"code": "g"
},
"device": {
"reference": "Device/8954c958-41c5-4a24-82ef-693218c2f625"
}
}