example - bolus calculator (Pump_standard)
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_STANDARD | Recommended bolus | 5 IU = (meal correction : 2IU + BG correction : 3 IU) |
5 IU = (meal correction : 2IU + BG correction : 3 IU) |
5 IU = (meal correction : 2IU + BG correction : 3 IU) |
- | - | 5 IU | BG - 170 mg/dL Carb - 10g |
MedicationRequest resource containing primarily the Bolus calculation outcome (recommended, selected and conformed boluses) and the details of the dose like delivery type = PUMP_STANDARD, activation type = Recommended bolus.
MedicationAdministration resource containing the confirmed bolus and the details of the dose - delivery type = PUMP_STANDARD
MedicationRequest Sample :
{ "resourceType": "MedicationRequest", "id": "7f823ce1-5557-4b09-8c8a-db45d4ffd8f5", "meta": { "profile": [ "http://roche.com/fhir/iop/StructureDefinition/MedicationRequest" ] }, "status": "active", "intent": "789480007_recommended_bolus", // 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": [ // Bolus Delivery type { "system": "http://roche.com/fhir/iop/cs", "code": "789480007_bolus_standard", "display": "789480007_bolus_standard" } ] }, "doseAndRate": [ { "type": { "coding": [ { "system": "http://roche.com/fhir/iop/cs", "code": "789480007_correction_bolus_recommended", "display": "789480007_correction_bolus_recommended" } ] }, "doseQuantity": { "value": 3, "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": 2, "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": 5, "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": 3, "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": 2, "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": 5, "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": 3, "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": 2, "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": 5, "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } } ] }
MedicationAdministration (Bolus calculator Sample) having reference to MedicationRequest profile :
{ "resourceType": "MedicationAdministration", // Resource name value in FHIR for this profile "id": "823f46f2-2381-4528-a112-049662c92b33", "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_standard", "display": "789480007_bolus_standard" } ] } ], "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" }, "occurenceDateTime": "2020-02-27T11:14:00+00:00", "performer": [{ "actor": { "reference" : { "reference" : "Device/5f0990b9-1be2-4f69-9621-028b6abdf1b5", } } }], "request": { "reference": "MedicationRequest/7f823ce1-5557-4b09-8c8a-db45d4ffd8f5" }, "dosage": { //confirmed bolus "dose": { "value": "5.0", "unit": "[iU]", "system": "http://unitsofmeasure.org", "code": "[iU]" } }, }
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" } }