Inpatient - Klebsiella Pneumoniae mit Resistenz

Beispiel Fund von Klebsiella pneumoniae eines stationär aufgenommenen Patienten, inklusive Empfindlichkeitstestung.

Es ist als technisches Beispiel zu verstehen, zur Veranschaulichung der FHIR-Spezifikation.


Bundle
<Bundle xmlns="http://hl7.org/fhir">
<id value="BundleExample-Inpatient-KlebsiellaPneumoniae" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Bundle" />
</meta>
<identifier>
<system value="https://demis.rki.de/fhir/NamingSystem/NotificationBundleId" />
<value value="1" />
</identifier>
<type value="document" />
<timestamp value="2023-06-13T17:52:31.000+01:00" />
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Composition/e0081181-a119-ba25-4852-d247f2b47caf" />
<resource>
<Composition>
<id value="e0081181-a119-ba25-4852-d247f2b47caf" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Composition" />
</meta>
<status value="final" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/900000000000207008/version/20241001" />
<code value="4241000179101" />
</coding>
</type>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<date value="2023-06-13T17:52:31.000+01:00" />
<author>
<reference value="Device/c6ef893b-a572-495e-b91e-806957eefd1d" />
</author>
<title value="Laboratory Report" />
<section>
<code>
<coding>
<system value="http://loinc.org" />
<code value="11502-2" />
<display value="Laboratory report" />
</coding>
</code>
<entry>
<reference value="DiagnosticReport/961e1c0e-b8ad-462d-bdb6-108481ad014d" />
</entry>
</section>
<section>
<code>
<coding>
<system value="http://loinc.org" />
<code value="11336-5" />
<display value="History of Hospitalization Narrative" />
</coding>
</code>
<entry>
<reference value="Encounter/Einrichtungskontakt-986b2866-1ee1-b1d0-e7f5-6f1f148c0c2a" />
</entry>
<entry>
<reference value="Encounter/Abteilungskontakt-692ff5a1-839f-59a9-77f9-c36f9fbd86c5" />
</entry>
<entry>
<reference value="Encounter/Versorgungsstellenkontakt-b4b4e29c-2d86-28f5-bd15-d31818d64dc2" />
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Organization/730d269c-109c-4b3a-86a6-408f22989aa9" />
<resource>
<Organization>
<id value="730d269c-109c-4b3a-86a6-408f22989aa9" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/DataSender" />
</meta>
<identifier>
<system value="https://demis.rki.de/fhir/NamingSystem/DemisParticipantId" />
<value value="999999999" />
</identifier>
<type>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/organizationType" />
<version value="1.4.2" />
<code value="laboratory" />
</coding>
</type>
<name value="Beispiellabor GmbH" />
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Device/c6ef893b-a572-495e-b91e-806957eefd1d" />
<resource>
<Device>
<id value="c6ef893b-a572-495e-b91e-806957eefd1d" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Software" />
</meta>
<manufacturer value="Softwarehersteller BSP GmbH" />
<deviceName>
<name value="MyBeispielLIS" />
<type value="user-friendly-name" />
</deviceName>
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="706687001" />
<display value="Software (physical object)" />
</coding>
</type>
<version>
<value value="1.0" />
</version>
<owner>
<reference value="Organization/730d269c-109c-4b3a-86a6-408f22989aa9" />
</owner>
</Device>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/DiagnosticReport/961e1c0e-b8ad-462d-bdb6-108481ad014d" />
<resource>
<DiagnosticReport>
<id value="961e1c0e-b8ad-462d-bdb6-108481ad014d" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/DiagnosticReport" />
</meta>
<basedOn>
<reference value="ServiceRequest/cc06ea66-2dcf-49f5-a4c8-e363936d03e1" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://loinc.org" />
<version value="2.79" />
<code value="11502-2" />
</coding>
</code>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<result>
<reference value="Observation/e5b6d4eb-e055-468a-4d03-96c5fcd9ddf7" />
</result>
<result>
<reference value="Observation/b5cee33d-29c6-4209-877f-9369d14f87bf" />
</result>
<result>
<reference value="Observation/baf8fd45-5c3a-b1a2-e221-fee38df64cf5" />
</result>
<result>
<reference value="Observation/1c3d4ca4-af8b-4142-b257-f0ec49f7c68f" />
</result>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/ServiceRequest/cc06ea66-2dcf-49f5-a4c8-e363936d03e1" />
<resource>
<ServiceRequest>
<id value="cc06ea66-2dcf-49f5-a4c8-e363936d03e1" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/ServiceRequest" />
</meta>
<status value="completed" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="168186002" />
</coding>
</code>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<insurance>
<reference value="Coverage/7d31688f-8e42-4742-be37-a066376f19cb" />
</insurance>
<specimen>
<reference value="Specimen/3a2f563f-a155-498f-a5b2-a2959e2380a1" />
</specimen>
</ServiceRequest>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
<resource>
<Patient>
<id value="43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Patient" />
</meta>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="ANON" />
</coding>
</type>
<system value="https://demis.rki.de/fhir/sid/SurveillancePatientPseudonym" />
<value value="f68ae1e4b4fb59f68b6e30ac51618aa8c5e7249735517ab5344fb900484e2a47" />
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="ANON" />
</coding>
</type>
<system value="https://demis.rki.de/fhir/sid/SurveillancePatientPseudonym" />
<value value="2d00467c311c659aed5f64b3daeb61be7793ef5410545c3b69634a18c7c7b429" />
</identifier>
<gender value="male" />
<birthDate value="1983-06" />
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Coverage/7d31688f-8e42-4742-be37-a066376f19cb" />
<resource>
<Coverage>
<id value="7d31688f-8e42-4742-be37-a066376f19cb" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Coverage" />
</meta>
<status value="active" />
<type>
<coding>
<system value="http://fhir.de/CodeSystem/versicherungsart-de-basis" />
<version value="1.5.3" />
<code value="GKV" />
</coding>
</type>
<beneficiary>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</beneficiary>
<payor>
<display value="unknown" />
</payor>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Specimen/3a2f563f-a155-498f-a5b2-a2959e2380a1" />
<resource>
<Specimen>
<id value="3a2f563f-a155-498f-a5b2-a2959e2380a1" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Specimen" />
</meta>
<accessionIdentifier>
<system value="http://www.beispiellabor.de/identifiers/specimen/accessionIdentifier" />
<value value="23BLN001234" />
</accessionIdentifier>
<type>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="866033003" />
</coding>
<text value="Blutkulturflasche aerob" />
</type>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<receivedTime value="2023-06-13" />
<request>
<reference value="ServiceRequest/CC06EA66-2DCF-49F5-A4C8-E363936D03E1" />
</request>
<collection>
<collector>
<reference value="PractitionerRole/59bc88f9-8ef8-4a04-8c19-5e2c5065e9eb" />
</collector>
<collectedDateTime value="2023-06-10" />
<bodySite>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="52124006" />
</coding>
<text value="Blutstrom" />
</bodySite>
</collection>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/PractitionerRole/59bc88f9-8ef8-4a04-8c19-5e2c5065e9eb" />
<resource>
<PractitionerRole>
<id value="59bc88f9-8ef8-4a04-8c19-5e2c5065e9eb" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/PractitionerRoleInpatientOrganization" />
</meta>
<organization>
<reference value="Organization/797f680a-9340-4dc3-94ee-4395acc30779" />
</organization>
<specialty>
<coding>
<system value="http://fhir.de/CodeSystem/dkgev/Fachabteilungsschluessel" />
<version value="1.5.3" />
<code value="0300" />
</coding>
</specialty>
<location>
<reference value="Location/21883c9f-8da0-eb4b-4c34-1072527c1a26" />
</location>
</PractitionerRole>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Organization/e6f3ef23-c17d-0ffb-817e-073100c35f41" />
<resource>
<Organization>
<id value="e6f3ef23-c17d-0ffb-817e-073100c35f41" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Hospital" />
</meta>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="XX" />
</coding>
</type>
<system value="https://demis.rki.de/fhir/sid/InekStandortId" />
<value value="770015" />
</identifier>
<type>
<coding>
<system value="https://demis.rki.de/fhir/CodeSystem/organizationType" />
<version value="1.4.2" />
<code value="hospital" />
</coding>
</type>
<name value="Krankenhaus Wald und Wiesen Standort Mitte" />
<address>
<postalCode value="10123" />
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Location/21883c9f-8da0-eb4b-4c34-1072527c1a26" />
<resource>
<Location>
<id value="21883c9f-8da0-eb4b-4c34-1072527c1a26" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Ward" />
</meta>
<identifier>
<system value="http://www.beispiellabor.de/identifiers/ward" />
<value value="3A-NO" />
</identifier>
<name value="Station 3a" />
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" />
<version value="2014-03-26" />
<code value="HU" />
</coding>
</type>
<managingOrganization>
<reference value="Organization/e6f3ef23-c17d-0ffb-817e-073100c35f41" />
</managingOrganization>
</Location>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Encounter/Einrichtungskontakt-986b2866-1ee1-b1d0-e7f5-6f1f148c0c2a" />
<resource>
<Encounter>
<id value="Einrichtungskontakt-986b2866-1ee1-b1d0-e7f5-6f1f148c0c2a" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Encounter" />
</meta>
<status value="finished" />
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode" />
<version value="4.0.1" />
<code value="IMP" />
</class>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/Kontaktebene" />
<version value="1.5.3" />
<code value="einrichtungskontakt" />
</coding>
</type>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<period>
<start value="2023-05-01" />
<end value="2023-05-01" />
</period>
<serviceProvider>
<reference value="Organization/e6f3ef23-c17d-0ffb-817e-073100c35f41" />
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Encounter/Abteilungskontakt-692ff5a1-839f-59a9-77f9-c36f9fbd86c5" />
<resource>
<Encounter>
<id value="Abteilungskontakt-692ff5a1-839f-59a9-77f9-c36f9fbd86c5" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Encounter" />
</meta>
<status value="finished" />
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode" />
<version value="4.0.1" />
<code value="IMP" />
</class>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/Kontaktebene" />
<version value="1.5.3" />
<code value="abteilungskontakt" />
</coding>
</type>
<serviceType>
<coding>
<system value="http://fhir.de/CodeSystem/dkgev/Fachabteilungsschluessel" />
<version value="1.5.3" />
<code value="0300" />
</coding>
</serviceType>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
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<period>
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<end value="2023-05-01" />
</period>
<partOf>
<reference value="Encounter/Einrichtungskontakt-986b2866-1ee1-b1d0-e7f5-6f1f148c0c2a" />
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</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Encounter/Versorgungsstellenkontakt-b4b4e29c-2d86-28f5-bd15-d31818d64dc2" />
<resource>
<Encounter>
<id value="Versorgungsstellenkontakt-b4b4e29c-2d86-28f5-bd15-d31818d64dc2" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Encounter" />
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<status value="finished" />
<class>
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<version value="4.0.1" />
<code value="IMP" />
</class>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/Kontaktebene" />
<version value="1.5.3" />
<code value="versorgungsstellenkontakt" />
</coding>
</type>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/kontaktart-de" />
<version value="1.5.3" />
<code value="normalstationaer" />
</coding>
</type>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<period>
<start value="2023-05-01" />
<end value="2023-05-01" />
</period>
<location>
<location>
<reference value="Location/21883c9f-8da0-eb4b-4c34-1072527c1a26" />
</location>
<physicalType>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/location-physical-type" />
<code value="wa" />
</coding>
</physicalType>
</location>
<partOf>
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</partOf>
</Encounter>
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</entry>
<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Observation/e5b6d4eb-e055-468a-4d03-96c5fcd9ddf7" />
<resource>
<Observation>
<id value="e5b6d4eb-e055-468a-4d03-96c5fcd9ddf7" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Observation" />
</meta>
<status value="final" />
<code>
<coding>
<system value="http://loinc.org" />
<version value="2.79" />
<code value="41852-5" />
<display value="Microorganism or agent identified in Specimen" />
</coding>
</code>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<issued value="2023-06-14T00:00:00.000+01:00" />
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="56415008" />
</coding>
<text value="Klebsiella pneumoniae" />
</valueCodeableConcept>
<interpretation>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="10828004" />
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</interpretation>
<method>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="83581000052107" />
</coding>
<text value="MALDI-TOF" />
</method>
<specimen>
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</Observation>
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<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Observation/b5cee33d-29c6-4209-877f-9369d14f87bf" />
<resource>
<Observation>
<id value="b5cee33d-29c6-4209-877f-9369d14f87bf" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Observation" />
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<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy">
<extension url="observation">
<valueReference>
<reference value="Observation/e5b6d4eb-e055-468a-4d03-96c5fcd9ddf7" />
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<extension url="type">
<valueCode value="reflex" />
</extension>
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<status value="final" />
<code>
<coding>
<system value="http://loinc.org" />
<version value="2.79" />
<code value="29576-6" />
<display value="Bacterial susceptibility panel" />
</coding>
</code>
<subject>
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<issued value="2023-06-14T00:00:00.000+01:00" />
<specimen>
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</specimen>
<hasMember>
<reference value="Observation/baf8fd45-5c3a-b1a2-e221-fee38df64cf5" />
</hasMember>
<hasMember>
<reference value="Observation/1c3d4ca4-af8b-4142-b257-f0ec49f7c68f" />
</hasMember>
</Observation>
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<entry>
<fullUrl value="https://demis.rki.de/fhir/ars/Observation/1c3d4ca4-af8b-4142-b257-f0ec49f7c68f" />
<resource>
<Observation>
<id value="1c3d4ca4-af8b-4142-b257-f0ec49f7c68f" />
<meta>
<profile value="https://demis.rki.de/fhir/ars/StructureDefinition/Observation" />
</meta>
<status value="final" />
<code>
<coding>
<system value="http://loinc.org" />
<version value="2.79" />
<code value="18932-4" />
<display value="Imipenem [Susceptibility]" />
</coding>
</code>
<subject>
<reference value="Patient/43511fe3-aa5f-73fb-7e59-2313ba0ca76c" />
</subject>
<issued value="2023-06-14T00:00:00.000+01:00" />
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="1306581009" />
<display value="EUCAST-Kategorie 2019 - R (resistent)" />
</coding>
</valueCodeableConcept>
<interpretation>
<coding>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/11000274103/version/20250515" />
<code value="1306581009" />
<display value="EUCAST-Kategorie 2019 - R (resistent)" />
</coding>
</interpretation>
<method>
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{
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},
{
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}
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{
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