SARI (Severe Acute Respiratory Infections)

Last Updated: 2023/12/20

A. Pendahuluan

Tahapan alur integrasi dan resource yang digunakan untuk integrasi pelaporan kasus SARI dapat dilihat pada gambar dibawah ini.

covid-skema-pelaporan-sari

Gambar 2. Alur Integrasi Pelaporan SARI

B. Strategi Pengiriman Data ke SATUSEHAT

SATUSEHAT menyediakan dua pilihan cara mengirimkan data use case ILI:

1. Berbasis Resource

Data dapat dikirimkan secara berurutan sesuai resource yang terlibat pada alur pelayanan terkait. Sebagai contoh: ketika mengirimkan data registrasi kasus saja yang berisikan resource Encounter dan Condition, maka implementor mengirimkan resource-resource tersebut ke SATUSEHAT secara berurutan sesuai dependensinya.

2. Berbasis Bundle

Data dapat dikirimkan seluruh resource yang terlibat pada alur pelayanan terkait dengan menggunakan satu langkah pengiriman data ke SATUSEHAT menggunakan profil FHIR bernama Bundle.

Resource-resource yang terlibat di setiap tahapan alur pelayanan untuk use case ILI adalah sebagai berikut:

Category No Resource Entry Mandatory
Base 1 Patient Required
2 Practitioner Required
3 Organization Required
4 Location Required
5 Encounter * Required
Clinical 6 Condition Required
7 Observation Required
8 ServiceRequest Required
9 Specimen Required
10 QuestionnaireResponse Required
11 DiagnosticReport Required
12 Composition Required


Notes:

  1. *) Profile Resource yang direkomendasikan tersedia pada proses pencatatan
  2. Required: Entry resource harus dilibatkan setiap kali mengirimkan bundle
  3. Optional: Entry resource dapat tidak dilibatkan setiap kali mengirimkan bundle

C. Langkah-Langkah Pengiriman Data ke SATUSEHAT

[Pre-Use Case Requirement] Pencarian Data Pasien

Apabila melakukan pengiriman data kesehatan melalui SATUSEHAT yang memiliki elemen data terkait pasien, maka diperlukan informasi {patient-ihs-number} dari pasien yang bersangkutan. {patient-ihs-number} seorang pasien didapatkan dari Master Patient Index (MPI) Kementerian Kesehatan. MPI menyimpan data-data demografi pasien berskala nasional, mulai dari nama, tanggal lahir, alamat, IDentitas resmi yang diterbitkan pemerintah, dan lain lain. Setelah mendapatkan {patient-ihs-number}, ID dapat disimpan secara di masing-masing sistem internal fasyankes maupun partner non-fasyankes. {patient-ihs-number} akan mempermudah pelaporan pelayanan kesehatan yang berhubungan dengan pasien, karena partner tidak diwajibkan menyertakan data diri setiap ada pengiriman data {patient-ihs-number} juga dapat digunakan untuk melihat data diri pasien secara menyeluruh.

CATATAN: Proses pencarian {patient-ihs-number} dari pasien dapat dilakukan melalui FHIR API dengan metode GET. Untuk metode pencarian data pasien di SATUSEHAT secara detail dapat dilihat dalam resource Patient dan terkait panduan/playbook MPI dapat dilihat dalam dokumen Master Patient Index.

Step 1. Pendataan Kunjungan Rawat Inap (Awal Masuk)

Kunjungan pasien dapat didefinisikan sebagai interaksi pasien terhadap suatu layanan fasyankes. Sebagai contoh, dalam satu rangkaian rawat jalan, seluruh rangkaian dapat didefinisikan sebagai satu “Encounter”. Data-data kunjungan pasien yang direkam meliputi kapan pertemuan tersebut mulai dan selesai, siapa tenaga kesehatan yang melayani, siapa subjek dari pelayanannya, dan informasi pendukung lainnya.

Pendataan Kunjungan Rawat Inap

{
    "resourceType": "Encounter",
    "identifier":  [
        {
            "use": "temp",
            "system": "http://sys-ids.kemkes.go.id/encounter/10000004",
            "value": "10085103"
        }
    ],
    "status": "in-progress",
    "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP",
        "display": "inpatient encounter"
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "participant":  [
        {
            "type":  [
                {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code": "ATND",
                            "display": "attender"
                        }
                    ]
                }
            ],
            "individual": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            }
        }
    ],
    "period": {
        "start": "2022-12-25T23:00:00+00:00"
    },
    "location":  [
        {
            "location": {
                "reference": "Location/fbd65f98-4864-48bd-a6f3-7b477a23e763",
                "display": "Bed 2, Ruang 210, Bangsal Rawat Inap Kelas 1, Layanan Penyakit Dalam, Lantai 2, Gedung Utama"
            }
        }
    ],
    "diagnosis":  [
        {
            "condition": {
                "reference": "Condition/35fa402e-76fc-4d34-9cfe-b24eb8b428d6",
                "display": "Fever, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "AD",
                        "display": "Admission diagnosis"
                    }
                ]
            },
            "rank": 1
        }
    ],
    "statusHistory":  [
        {
            "status": "in-progress",
            "period": {
                "start": "2022-12-24T23:00:00+00:00"
            }
        }
    ],
    "serviceProvider": {
        "reference": "Organization/3c8f6d64-7eec-4747-a980-3e2a0e54b026"
    }
}
{
    "resourceType": "Encounter",
    "identifier": [
        {
            "system": "http://sys-ids.kemkes.go.id/encounter/{{FACILITY_IHS_NUMBER}}",
            "value": "{{ENCOUNTER_LOCAL_CODE}}"
        }
    ],
    "status": "arrived",
    "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB",
        "display": "ambulatory"
    },
    "subject": {
        "reference": "Patient/{{PATIENT_IHS_NUMBER}}",
        "display": "{{PATIENT_NAME}}"
    },
    "participant": [
        {
            "type": [
                {
                    "coding": [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code": "ATND",
                            "display": "attender"
                        }
                    ]
                }
            ],
            "individual": {
                "reference": "Practitioner/{{DOCTOR_IHS_NUMBER}}",
                "display": "{{DOCTOR_NAME}}"
            }
        }
    ],
    "period": {
        "start": "{{ENCOUNTER_PERIOD1_START}}"
    },
    "location": [
        {
            "location": {
                "reference": "Location/{{ENCOUNTER_LOCATION_ID}}",
                "display": "{{ENCOUNTER_LOCATION_NAME}}"
            }
        }
    ],
    "statusHistory": [
        {
            "status": "arrived",
            "period": {
                "start": "{{ENCOUNTER_PERIOD1_START}}",
                "end": "{{ENCOUNTER_PERIOD1_END}}"
            }
        }
    ],
    "serviceProvider": {
        "reference": "Organization/{{FACILITY_IHS_NUMBER}}"
    }
}
Variabel Deskripsi
ENCOUNTER_LOCAL_CODE ID Lokal untuk Kunjungan/Encounter
PATIENT_IHS_NUMBER SATUSEHAT ID Number untuk Pasien
PATIENT_NAME Nama Pasien
DOCTOR_IHS_NUMBER SATUSEHAT ID untuk Dokter/Nakes
DOCTOR_NAME Nama Dokter/Nakes
FACILITY_IHS_NUMBER SATUSEHAT ID untuk FASYANKES
ENCOUNTER_PERIOD1_START Waktu mulai/check-in kunjungan
ENCOUNTER_PERIOD1_END Waktu mulai/check-out kunjungan
ENCOUNTER_LOCATION_ID ID Location tempat kunjungan dilakukan
ENCOUNTER_LOCATION_NAME Nama Location tempat kunjungan dilakukan
[none]

Diagnosa Awal Saat Masuk

{
    "resourceType": "Condition",
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://hl7.org/fhir/sid/icd-10",
                "code": "R50.9",
                "display": "Fever, unspecified"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "onsetDateTime": "2022-12-21T07:00:00+00:00",
    "recordedDate": "2022-12-23T07:00:00+00:00"
}
#tba
#tba
[none]

Step 2. Kondisi Pasien

Data terkait kondisi pasien pada modul ILI mencakup informasi sebagai berikut:
1. Suhu (resource Observation)
2. Riwayat Demam (resource Condition)
3. Gejala & Tanggal Mulai Gejala SARI (resource Condition)
4. Frekuensi napas (resource Observation)
5. Kondisi medis (resource Observation)
6. Faktor Penularan(resource QuestionnaireResponse)
7. Tanggal Wawancara (resource Observation)

Suhu

{
    "resourceType": "Observation",
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "vital-signs",
                    "display": "Vital Signs"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "8310-5",
                "display": "Body temperature"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-14T07:00:00+00:00",
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "valueQuantity": {
        "value": 38.5,
        "unit": "Celcius",
        "system": "http://unitsofmeasure.org",
        "code": "Cel"
    }
}
Variabel Deskripsi
PATIENT_IHS_NUMBER SATUSEHAT ID Number untuk Pasien
DOCTOR_IHS_NUMBER SATUSEHAT ID untuk Dokter/Nakes
ENCOUNTER_REFERENCE_ID SATUSEHAT ID untuk Encounter
ENCOUNTER_DISPLAY_TEXT Teks Keterangan untuk Encounter
OBSERVATION_EFFECTIVE_DATETIME Waktu Observation dilakukan
OBSERVATION_BODY_TEMPERATURE Hasil Observation suhu badan
[none]

Riwayat Demam

Riwayat Demam - Ya
{
    "resourceType": "Condition",
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code": "inactive",
                "display": "Inactive"
            }
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "problem-list-item",
                    "display": "Problem List Item"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "386661006",
                "display": "Fever"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "onsetDateTime": "2022-12-21T07:00:00+00:00",
    "recordedDate": "2022-12-23T07:00:00+00:00"
}
Variabel Deskripsi
PATIENT_IHS_NUMBER SATUSEHAT ID Number untuk Pasien
DOCTOR_IHS_NUMBER SATUSEHAT ID untuk Dokter/Nakes
ENCOUNTER_REFERENCE_ID SATUSEHAT ID untuk Encounter
ENCOUNTER_DISPLAY_TEXT Teks Keterangan untuk Encounter
OBSERVATION_EFFECTIVE_DATETIME Waktu Observation dilakukan
OBSERVATION_VALUE Hasil Observation
[none]

Gejala & Tanggal Mulai Gejala SARI

Gejala batuk
{
    "resourceType": "Condition",
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code": "inactive",
                "display": "Inactive"
            }
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "problem-list-item",
                    "display": "Problem List Item"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "386661006",
                "display": "Fever"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "onsetDateTime": "2022-12-21T07:00:00+00:00",
    "recordedDate": "2022-12-23T07:00:00+00:00"
}
#tba
#tba
[none]

Frekuensi Napas

{
    "resourceType": "Observation",
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "vital-signs",
                    "display": "Vital Signs"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "9279-1",
                "display": "Respiratory rate"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "issued": "2022-12-23T07:00:00+00:00",
    "valueQuantity": {
        "value": 20,
        "unit": "/min",
        "system": "http://unitsofmeasure.org",
        "code": "/min"
    }
}
#tba
#tba
[none]

Kondisi Medis

Merokok
{
    "resourceType": "Observation",
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "social-history",
                    "display": "Social History"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "80943009",
                "display": "Risk factor"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-14T07:00:00+00:00",
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "77176002",
                "display": "Smoker"
            }
        ]
    }
}
#tba
#tba
[none]

Faktor Penularan

Selain melakukan anamnesis dan pemeriksaan fisik, wawancara faktor penularan adalah kegiatan yang penting dilakukan untuk memberikan informasi epidemiologis. Data dari proses pemeriksaan dapat dikirimkan resource QuestionnaireResponse 
{
    "resourceType": "QuestionnaireResponse",
    "questionnaire": "https://fhir.kemkes.go.id/Questionnaire/Q0002",
    "status": "completed",
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/45e436ea-d6c7-4059-8cbe-e00fb2c665d8"
    },
    "authored": "2022-06-14T10:00:00+07:00",
    "author": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "source": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "item":  [
        {
            "linkId": "1",
            "text": "Apakah dalam Dua Minggu Terakhir, anda bepergian keluar negeri?",
            "answer":  [
                {
                    "valueBoolean": true
                }
            ]
        },
        {
            "linkId": "1.1",
            "text": "Sebutkan Negaranya",
            "answer":  [
                {
                    "valueString": "Malaysia"
                }
            ]
        },
        {
            "linkId": "2",
            "text": "Ada orang serumah yang menderita sakit sepulang dari bepergian ke luar negeri?",
            "answer":  [
                {
                    "valueBoolean": true
                }
            ]
        },
        {
            "linkId": "2.1",
            "text": "Sebutkan Negaranya",
            "answer":  [
                {
                    "valueString": "Thailand"
                }
            ]
        },
        {
            "linkId": "3",
            "text": "Dalam 2 minggu terakhir, apakah pernah kontak dg ayam/unggas sakit atau mati mendadak?",
            "answer":  [
                {
                    "valueBoolean": true
                }
            ]
        },
        {
            "linkId": "4",
            "text": "Apakah rumah pasien dekat dengan peternakan unggas (< 100m)?",
            "answer":  [
                {
                    "valueBoolean": true
                }
            ]
        }
    ]
}
#tba
#tba
[none]

Tanggal Wawancara

{
    "resourceType": "Observation",
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "survey",
                    "display": "Survey"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "91714-6",
                "display": "Date of interview"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "issued": "2022-12-23T07:00:00+00:00",
    "valueDateTime": "2022-12-23"
}
Variabel Deskripsi
PATIENT_IHS_NUMBER SATUSEHAT ID Number untuk Pasien
DOCTOR_IHS_NUMBER SATUSEHAT ID untuk Dokter/Nakes
ENCOUNTER_REFERENCE_ID SATUSEHAT ID untuk Encounter
ENCOUNTER_DISPLAY_TEXT Teks Keterangan untuk Encounter
OBSERVATION_EFFECTIVE_DATETIME Waktu Observation dilakukan
OBSERVATION_VALUE Hasil Observation
[none]

Step 3. Permintaan Pemeriksaan (Laboratorium Pemeriksa/Dituju)

Data mengenai permintaan pemeriksaan swab nasal ataupun tenggorokan dapat dikirimkan dengan resource ServiceRequest.

A. Rujukan dari Faskes Sentinel ke Lab Terpilih

Permintaan Pemeriksaan COVID-19 PCR
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        },
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "3457005",
                    "display": "Patient referral"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "94500-6",
                "display": "SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Organization/10000004",
        "display": "Puskesmas Bagelen"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

Permintaan Pemeriksaan Influenza A
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92142-9",
                "display": "Influenza virus A RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

Permintaan Pemeriksaan Influenza B
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92141-1",
                "display": "Influenza virus B RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

B. Permintaan Pemeriksaan Laboratorium Dalam Faskes

Permintaan Pemeriksaan COVID-19 PCR
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "94500-6",
                "display": "SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

Permintaan Pemeriksaan Influenza A
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92142-9",
                "display": "Influenza virus A RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

Permintaan Pemeriksaan Influenza B
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "108252007",
                    "display": "Laboratory procedure"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92141-1",
                "display": "Influenza virus B RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8"
    },
    "occurrenceDateTime": "2022-07-14T10:00:00+07:00",
    "requester": {
        "reference": "Practitioner/N10000001",
        "display": "Dokter Bronsig"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "locationCode":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code": "HLAB",
                    "display": "hospital laboratory"
                }
            ]
        }
    ],
    "locationReference":  [
        {
            "reference": "Location/612fcf96-843a-45c7-a6f7-ff3a08eb7c88",
            "display": "Laboratorium"
        }
    ],
    "reasonCode":  [
        {
            "text": "Suspect ILI"
        }
    ]
}
#tba
#tba
[none]

Step 4. Spesimen

A. Spesimen Swab Tenggorok & Swab Hidung

Specimen Keadaan Baik
{
    "resourceType": "Specimen",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/specimen/10000004",
            "value": "00001",
            "assigner": {
                "reference": "Organization/10000004"
            }
        }
    ],
    "status": "available",
    "type": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "258500001",
                "display": "Nasopharyngeal swab"
            }
        ]
    },
    "collection": {
        "collectedDateTime": "2022-06-14T08:15:00+00:00",
        "extension":  [
            {
                "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/CollectorOrganization",
                "valueReference": {
                    "reference": "Organization/10083042"
                }
            }
        ]
    },
    "processing":  [
        {
            "timeDateTime": "2022-06-15T08:23:00+00:00"
        }
    ],
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "request":  [
        {
            "reference": "ServiceRequest/6c37226f-cac3-4731-93ed-60fc9c74e399"
        }
    ],
    "extension":  [
        {
            "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/TransportedTime",
            "valueDateTime": "2022-06-14T09:23:00+00:00"
        }
    ],
    "receivedTime": "2022-11-14T15:25:00+00:00",
    "note":  [
        {
            "authorReference": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            },
            "time": "2022-06-14T09:30:00+00:00",
            "text": "Waktu Entry Spesimen"
        }
    ]
}
#tba
#tba
[none]

Specimen Keadaan Tidak Baik
{
    "resourceType": "Specimen",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/specimen/10000004",
            "value": "00001",
            "assigner": {
                "reference": "Organization/10000004"
            }
        }
    ],
    "status": "unsatisfactory",
    "type": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "258500001",
                "display": "Nasopharyngeal swab"
            }
        ]
    },
    "collection": {
        "collectedDateTime": "2022-06-14T08:15:00+00:00",
        "extension":  [
            {
                "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/CollectorOrganization",
                "valueReference": {
                    "reference": "Organization/10083042"
                }
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "request":  [
        {
            "reference": "ServiceRequest/6c37226f-cac3-4731-93ed-60fc9c74e399"
        }
    ],
    "extension":  [
        {
            "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/TransportedTime",
            "valueDateTime": "2022-06-14T09:23:00+00:00"
        }
    ],
    "receivedTime": "2022-11-14T15:25:00+00:00",
    "note":  [
        {
            "authorReference": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            },
            "time": "2022-06-14T09:30:00+00:00",
            "text": "Waktu Entry Spesimen"
        }
    ]
}
#tba
#tba
[none]

B. Specimen Lainnya

{
    "resourceType": "Specimen",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/specimen/10000004",
            "value": "00001",
            "assigner": {
                "reference": "Organization/10000004"
            }
        }
    ],
    "status": "available",
    "type": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "258604001",
                "display": "Upper respiratory specimen"
            }
        ],
        "text": "Aspirat Trakea"
    },
    "collection": {
        "collectedDateTime": "2022-06-14T08:15:00+00:00",
        "extension":  [
            {
                "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/CollectorOrganization",
                "valueReference": {
                    "reference": "Organization/10083042"
                }
            }
        ]
    },
    "processing":  [
        {
            "timeDateTime": "2022-06-15T08:23:00+00:00"
        }
    ],
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "request":  [
        {
            "reference": "ServiceRequest/6c37226f-cac3-4731-93ed-60fc9c74e399"
        }
    ],
    "extension":  [
        {
            "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/TransportedTime",
            "valueDateTime": "2022-06-14T09:23:00+00:00"
        }
    ],
    "receivedTime": "2022-11-14T15:25:00+00:00",
    "note":  [
        {
            "authorReference": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            },
            "time": "2022-06-14T09:30:00+00:00",
            "text": "Waktu Entry Spesimen"
        }
    ]
}
[none]
[none]

Step 5. Hasil Pemeriksaan Laboratorium

COVID-19 PCR

COVID-19 PCR - Positif
{
    "resourceType": "Observation",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "94500-6",
                "display": "SARS-CoV-2 (COVID-19) RNA [Presence] in Respiratory specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/5dd79cf6-b799-44b0-ae13-db0a95d63f77"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "LA6576-8",
                "display": "Positive"
            }
        ]
    }
}
#tba
#tba
[none]

B. Influenza A

Influenza A - Positif
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92142-9",
                "display": "Influenza virus A RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "LA6576-8",
                "display": "Positive"
            }
        ]
    }
}
#tba
#tba
[none]

Influenza A - Subtype
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "22827-0",
                "display": "Influenza virus A subtype [Identifier] in Specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "449024000",
                "display": "Pandemic Influenza A (H1N1) 2009"
            }
        ]
    }
}
#tba
#tba
[none]

Influenza A - Invalid
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "92142-9",
                "display": "Influenza virus A RNA [Presence] in Respiratory system specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "dataAbsentReason": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "LA15841-2",
                "display": "Invalid"
            }
        ]
    },
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ]
}
#tba
#tba
[none]

Step 6. Laporan Hasil Pemeriksaan Laboratorium (Waktu Verifikasi Hasil)

A. Covid 19

Covid 19 - Positif
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "22827-0",
                "display": "Influenza virus A subtype [Identifier] in Specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "449024000",
                "display": "Pandemic Influenza A (H1N1) 2009"
            }
        ]
    }
}
#tba
#tba
[none]

B. Influenza A

Influenza A - Positif
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "22827-0",
                "display": "Influenza virus A subtype [Identifier] in Specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "449024000",
                "display": "Pandemic Influenza A (H1N1) 2009"
            }
        ]
    }
}
#tba
#tba
[none]

Influenza A Subtype
{
    "resourceType": "Observation",
    "status": "final",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/observation/10000004",
            "value": "O111111"
        }
    ],
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "laboratory",
                    "display": "Laboratory"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "22827-0",
                "display": "Influenza virus A subtype [Identifier] in Specimen by NAA with probe detection"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        },
        {
            "reference": "Organization/10000004"
        }
    ],
    "encounter": {
        "reference": "Encounter/66533eb2-723d-4e7c-b7aa-500cd67dd4c8",
        "display": "Pemeriksaan Budi Santoso di hari Selasa, 14 Juni 2022"
    },
    "effectiveDateTime": "2022-10-15T08:23:00+00:00",
    "specimen": {
        "reference": "Specimen/bf55c11b-f42a-4098-ad56-723e25526060"
    },
    "basedOn":  [
        {
            "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
        }
    ],
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "449024000",
                "display": "Pandemic Influenza A (H1N1) 2009"
            }
        ]
    }
}
#tba
#tba
[none]

Step 7. Update Kunjungan Rawat Inap (Status Keluar)

7.1. Diagnosis Akhir

Diagnosa Primer
{
    "resourceType": "Condition",
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://hl7.org/fhir/sid/icd-10",
                "code": "A01.0",
                "display": "Typhoid fever"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "onsetDateTime": "2022-12-21T07:00:00+00:00",
    "recordedDate": "2022-12-26T07:00:00+00:00"
}
#tba
#tba
[none]

Diagnosa Sekunder
{
    "resourceType": "Condition",
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://hl7.org/fhir/sid/icd-10",
                "code": "J45.9",
                "display": "Asthma, unspecified"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "onsetDateTime": "2022-12-21T07:00:00+00:00",
    "recordedDate": "2022-12-26T07:00:00+00:00"
}
#tba
#tba
[none]

7.2. Status Keluar

7.1.1. Apabila Pasien dipulangkan
{
    "resourceType": "Encounter",
    "id": "34f8006c-5d3a-4140-96ea-f4a009a8e4d4",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/encounter/10000004",
            "value": "10085103"
        }
    ],
    "status": "finished",
    "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP",
        "display": "inpatient encounter"
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "participant":  [
        {
            "type":  [
                {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code": "ATND",
                            "display": "attender"
                        }
                    ]
                }
            ],
            "individual": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            }
        }
    ],
    "period": {
        "start": "2022-12-25T23:00:00+00:00",
        "end": "2022-12-26T09:30:27+07:00"
    },
    "location":  [
        {
            "location": {
                "reference": "Location/fbd65f98-4864-48bd-a6f3-7b477a23e763",
                "display": "Bed 2, Ruang 210, Bangsal Rawat Inap Kelas 1, Layanan Penyakit Dalam, Lantai 2, Gedung Utama"
            }
        }
    ],
    "diagnosis":  [
        {
            "condition": {
                "reference": "Condition/35fa402e-76fc-4d34-9cfe-b24eb8b428d6",
                "display": "Fever, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "AD",
                        "display": "Admission diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/85a22cfb-550d-483d-80c7-19016b37385f",
                "display": "Typhoid fever"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/42ad7faa-e9a2-4e7e-a603-c4384fddc433",
                "display": "Asthma, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 2
        }
    ],
    "statusHistory":  [
        {
            "status": "in-progress",
            "period": {
                "start": "2022-12-24T23:00:00+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        },
        {
            "status": "finished",
            "period": {
                "start": "2022-12-26T09:30:27+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        }
    ],
    "hospitalization": {
        "dischargeDisposition": {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                    "code": "home",
                    "display": "Home"
                }
            ],
            "text": "Anjuran dokter untuk pulang dan kontrol kembali 1 bulan setelah minum obat"
        }
    },
    "serviceProvider": {
        "reference": "Organization/3c8f6d64-7eec-4747-a980-3e2a0e54b026"
    }
}
#tba
#tba
[none]

7.1.2. Apabila Pasien dirujuk
Update Status Kunjungan
{
    "resourceType": "Encounter",
    "id": "34f8006c-5d3a-4140-96ea-f4a009a8e4d4",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/encounter/10000004",
            "value": "10085103"
        }
    ],
    "status": "finished",
    "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP",
        "display": "inpatient encounter"
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "participant":  [
        {
            "type":  [
                {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code": "ATND",
                            "display": "attender"
                        }
                    ]
                }
            ],
            "individual": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            }
        }
    ],
    "period": {
        "start": "2022-12-25T23:00:00+00:00",
        "end": "2022-12-26T09:30:27+07:00"
    },
    "location":  [
        {
            "location": {
                "reference": "Location/fbd65f98-4864-48bd-a6f3-7b477a23e763",
                "display": "Bed 2, Ruang 210, Bangsal Rawat Inap Kelas 1, Layanan Penyakit Dalam, Lantai 2, Gedung Utama"
            }
        }
    ],
    "diagnosis":  [
        {
            "condition": {
                "reference": "Condition/35fa402e-76fc-4d34-9cfe-b24eb8b428d6",
                "display": "Fever, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "AD",
                        "display": "Admission diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/85a22cfb-550d-483d-80c7-19016b37385f",
                "display": "Typhoid fever"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/42ad7faa-e9a2-4e7e-a603-c4384fddc433",
                "display": "Asthma, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 2
        }
    ],
    "statusHistory":  [
        {
            "status": "in-progress",
            "period": {
                "start": "2022-12-24T23:00:00+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        },
        {
            "status": "finished",
            "period": {
                "start": "2022-12-26T09:30:27+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        }
    ],
    "hospitalization": {
        "dischargeDisposition": {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                    "code": "other-hcf",
                    "display": "Other healthcare facility"
                }
            ],
            "text": "Dirujuk ke RSUP"
        }
    },
    "serviceProvider": {
        "reference": "Organization/3c8f6d64-7eec-4747-a980-3e2a0e54b026"
    }
}
#tba
#tba
[none]

Create Permintaan Rujukan
{
    "resourceType": "ServiceRequest",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/servicerequest/10000004",
            "value": "00001"
        }
    ],
    "status": "active",
    "intent": "original-order",
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "3457005",
                "display": "Patient referral"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "occurrenceDateTime": "2022-12-23T07:00:00+00:00",
    "requester": {
        "reference": "Organization/10000004",
        "display": "Puskesmas Bagelen"
    },
    "performer":  [
        {
            "reference": "Organization/10083042",
            "display": "IHS Hospital"
        }
    ],
    "reasonCode":  [
        {
            "text": "Perburukan"
        }
    ]
}
#tba
#tba
[none]

7.1.3. Apabila Pasien Meninggal
Update Status Kunjungan
{
    "resourceType": "Encounter",
    "id": "34f8006c-5d3a-4140-96ea-f4a009a8e4d4",
    "identifier":  [
        {
            "system": "http://sys-ids.kemkes.go.id/encounter/10000004",
            "value": "10085103"
        }
    ],
    "status": "finished",
    "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "IMP",
        "display": "inpatient encounter"
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "participant":  [
        {
            "type":  [
                {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code": "ATND",
                            "display": "attender"
                        }
                    ]
                }
            ],
            "individual": {
                "reference": "Practitioner/N10000001",
                "display": "Dokter Bronsig"
            }
        }
    ],
    "period": {
        "start": "2022-12-25T23:00:00+00:00",
        "end": "2022-12-26T09:30:27+07:00"
    },
    "location":  [
        {
            "location": {
                "reference": "Location/fbd65f98-4864-48bd-a6f3-7b477a23e763",
                "display": "Bed 2, Ruang 210, Bangsal Rawat Inap Kelas 1, Layanan Penyakit Dalam, Lantai 2, Gedung Utama"
            }
        }
    ],
    "diagnosis":  [
        {
            "condition": {
                "reference": "Condition/35fa402e-76fc-4d34-9cfe-b24eb8b428d6",
                "display": "Fever, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "AD",
                        "display": "Admission diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/85a22cfb-550d-483d-80c7-19016b37385f",
                "display": "Typhoid fever"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 1
        },
        {
            "condition": {
                "reference": "Condition/42ad7faa-e9a2-4e7e-a603-c4384fddc433",
                "display": "Asthma, unspecified"
            },
            "use": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/diagnosis-role",
                        "code": "DD",
                        "display": "Discharge diagnosis"
                    }
                ]
            },
            "rank": 2
        }
    ],
    "statusHistory":  [
        {
            "status": "in-progress",
            "period": {
                "start": "2022-12-24T23:00:00+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        },
        {
            "status": "finished",
            "period": {
                "start": "2022-12-26T09:30:27+00:00",
                "end": "2022-12-26T09:30:27+00:00"
            }
        }
    ],
    "hospitalization": {
        "dischargeDisposition": {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                    "code": "exp",
                    "display": "Expired"
                }
            ],
            "text": "Meninggal"
        }
    },
    "serviceProvider": {
        "reference": "Organization/3c8f6d64-7eec-4747-a980-3e2a0e54b026"
    }
}
#tba
#tba
[none]

Tanggal Meninggal
{
    "resourceType": "Observation",
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "survey",
                    "display": "Survey"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://loinc.org",
                "code": "81956-5",
                "display": "Date and time of death [TimeStamp]"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009"
    },
    "performer":  [
        {
            "reference": "Practitioner/N10000001"
        }
    ],
    "encounter": {
        "reference": "Encounter/447222f4-32bc-4ec0-9a53-3be1506a8e8a"
    },
    "issued": "2022-12-23T07:00:00+00:00",
    "valueDateTime": "2022-12-26"
}
#tba
#tba
[none]

Step 8. Kuesioner Kasus SARI

{
    "resourceType": "Composition",
    "identifier": {
        "system": "http://sys-ids.kemkes.go.id/composition/10000004",
        "value": "2361720002"
    },
    "status": "final",
    "type": {
        "coding":  [
            {
                "system": "http://terminology.kemkes.go.id/CodeSystem/composition-type",
                "code": "COM000002",
                "display": "Form Lahir Mati"
            }
        ]
    },
    "subject": {
        "reference": "Patient/100000030009",
        "display": "Budi Santoso"
    },
    "encounter": {
        "reference": "Encounter/8571fcf0-a699-4c73-81c5-bae97b6e68ad"
    },
    "date": "2022-06-14T08:15:00+00:00",
    "author":  [
        {
            "reference": "Practitioner/N10000001",
            "display": "Dokter Bronsig"
        }
    ],
    "title": "Kuesioner Kasus SARI",
    "attester":  [
        {
            "mode": "legal",
            "party": {
                "reference": "Organization/10000004",
                "display": "Puskesmas Sangat Waras"
            }
        }
    ],
    "section":  [
        {
            "title": "Keadaan Saat Masuk",
            "focus": {
                "reference": "Patient/100000030009",
                "display": "Budi Santoso"
            },
            "entry":  [
                {
                    "display": "Suhu",
                    "reference": "Observation/d8aad3cd-188a-439d-ac20-e055ad386c26"
                },
                {
                    "display": "Riwayat Demam",
                    "reference": "Condition/5cb67341-9636-41c4-a871-f4d46b06fd64"
                },
                {
                    "display": "Frekuensi Nafas",
                    "reference": "Observation/91f7cf4a-470a-49cb-ba24-ed055fa116f1"
                },
                {
                    "display": "Gejala dan Tanda Mulai Gejala",
                    "reference": "Condition/6d4bf02b-1913-4af5-bbb7-b351c7399132"
                }
            ]
        },
        {
            "title": "Kondisi Medis/Faktor Risiko",
            "focus": {
                "reference": "Patient/100000030009",
                "display": "Budi Santoso"
            },
            "entry":  [
                {
                    "display": "Kondisi Medis",
                    "reference": "Observation/02c40c71-8912-4f6e-b821-eec578b8cfb7"
                },
                {
                    "display": "Faktor Penularan",
                    "reference": "QuestionnaireResponse/791224e2-9145-47c3-a0f8-4ce323bc7399"
                },
                {
                    "display": "Tanggal Wawancara",
                    "reference": "Observation/56000b4b-9024-40c4-8701-d7ef0a99c1c5"
                }
            ]
        },
        {
            "title": "Pengambilan Spesimen",
            "focus": {
                "reference": "Patient/100000030009",
                "display": "Budi Santoso"
            },
            "entry":  [
                {
                    "display": "Alasan Tidak Mau Diambil Spesimen",
                    "reference": "QuestionnaireResponse/791224e2-9145-47c3-a0f8-4ce323bc7399"
                },
                {
                    "display": "Permintaan Pemeriksaan COVID-19 PCR",
                    "reference": "ServiceRequest/5dd79cf6-b799-44b0-ae13-db0a95d63f77"
                },
                {
                    "display": "Permintaan Pemeriksaan Influenza A",
                    "reference": "ServiceRequest/0391a2e5-ca06-4a73-b3c9-bf1770d90275"
                },
                {
                    "display": "Permintaan Pemeriksaan Influenza B",
                    "reference": "ServiceRequest/db1ea185-8836-4e2c-9468-4e4b43475a4a"
                },
                {
                    "display": "Spesimen",
                    "reference": "Specimen/2ae3a5e8-416d-4dab-b5c9-cfcef5fd0471"
                }
            ]
        },
        {
            "title": "Hasil Pemeriksaan Laboratorium",
            "focus": {
                "reference": "Patient/100000030009",
                "display": "Budi Santoso"
            },
            "entry":  [
                {
                    "display": "Hasil Pemeriksaan Laboratorium COVID-19 PCR",
                    "reference": "Observation/56c3135e-8659-4b02-a73e-3aaa10f48e7f"
                },
                {
                    "display": "Hasil Pemeriksaan Laboratorium Influenza A",
                    "reference": "Observation/0a074e30-0816-4f13-8e77-55f20704e4f7"
                },
                {
                    "display": "Hasil Pemeriksaan Laboratorium Influenza A subtype",
                    "reference": "Observation/89db8afb-c09d-4184-a512-f3f7a61e72a5"
                },
                {
                    "display": "Hasil Pemeriksaan Laboratorium Influenza B",
                    "reference": "Observation/7ddc5fe6-64a6-4cb7-877e-1f9fd37d4814"
                },
                {
                    "display": "Hasil Pemeriksaan Laboratorium Influenza B subtype",
                    "reference": "Observation/5e574975-3ae0-4bfe-96c1-cb5b4d30c18f"
                },
                {
                    "display": "Laporan Hasil Pemeriksaan Laboratorium COVID-19 PCR",
                    "reference": "DiagnosticReport/a60b9fb4-cfc0-4568-9524-31a7921b67e8"
                },
                {
                    "display": "Laporan Hasil Pemeriksaan Laboratorium Influenza A",
                    "reference": "DiagnosticReport/c0543144-2fff-4365-81c6-053d6323b057"
                },
                {
                    "display": "Laporan Hasil Pemeriksaan Laboratorium Influenza A Subtype",
                    "reference": "DiagnosticReport/cd98a04a-99ae-41d8-a844-3a55bb19dac6"
                },
                {
                    "display": "Laporan Hasil Pemeriksaan Laboratorium Influenza B",
                    "reference": "DiagnosticReport/df498577-e61b-458d-8001-146af6be610d"
                },
                {
                    "display": "Laporan Hasil Pemeriksaan Laboratorium Influenza B Subtype",
                    "reference": "DiagnosticReport/7d6a9f6c-158c-4c51-8195-cb7be87a6721"
                }
            ]
        },
        {
            "title": "Form Keluar",
            "focus": {
                "reference": "Patient/100000030009",
                "display": "Budi Santoso"
            },
            "entry":  [
                {
                    "display": "Diagnosis Primer",
                    "reference": "Condition/85a22cfb-550d-483d-80c7-19016b37385f"
                },
                {
                    "display": "Diagnosis Sekunder",
                    "reference": "Condition/42ad7faa-e9a2-4e7e-a603-c4384fddc433"
                },
                {
                    "display": "Permintaan Rujukan",
                    "reference": "ServiceRequest/d3b0d43a-c1ff-4e17-8372-49e2bae6d1af"
                },
                {
                    "display": "Tanggal Meninggal",
                    "reference": "Observation/ea7ef5b1-0cef-4ecf-835f-e61a9141f977"
                }
            ]
        }
    ]
}
#tba
#tba
[none]