6.4. Scenario 3
6.4.1. Patient data
| NameInformation.FirstNames | Berend |
| NameInformation.Initials | |
| NameInformation.GivenName | Beer |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | van de |
| NameInformation.LastName.LastName | Stok |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| AddressInformation.Street | Bloemstraat |
| AddressInformation.HouseNumber | 25 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 5678 BB |
| AddressInformation.PlaceOfResidence | Bergen op Zoom |
| AddressInformation.Municipality | |
| AddressInformation.Country | Nederland (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Officieel adres (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31687654321 |
| ContactInformation.TelephoneNumbers.TelecomType | Mobiel telefoonnummer (code 'MC' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.NumberType | Telefoonnummer thuis (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | berendvandestok@gmail.com |
| ContactInformation.EmailAddresses.EmailAddressType | Privé e-mailadres (code 'HP' from code system 'AddressUse') |
| PatientIdentificationNumber | 999998304 (in identifier system 'Burgerservicenummer') |
| DateOfBirth | 04-05-1980 |
| Gender | Man (code 'M' from code system 'AdministrativeGender') |
| MultipleBirthIndicator | |
| DeathIndicator | Nee |
| DateOfDeath |
6.4.2. Health Professional data
| HealthProfessionalIdentificationNumber | 12000003 (in identifier system 'BIG register inschrijvingsnummer') |
| NameInformation.FirstNames | |
| NameInformation.Initials | B. |
| NameInformation.GivenName | |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | |
| NameInformation.LastName.LastName | Dijkstra |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| Speciality | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| Gender | |
| AddressInformation.Street | Stationsstraat |
| AddressInformation.HouseNumber | 18 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 4611 XX |
| AddressInformation.PlaceOfResidence | Bergen op Zoom |
| AddressInformation.Municipality | |
| AddressInformation.Country | Nederland (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31612345604 |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | Zakelijk telefoonnummer (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | dijkstra@orthodontiedijkstra.nl |
| ContactInformation.EmailAddresses.EmailAddressType | Zakelijk e-mailadres (code 'WP' from code system 'AddressUse') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| HealthProfessionalRole |
6.4.3. Healthcare Provider data
| HealthcareProviderIdentificationNumber | 13004567 (in identifier system 'Vektis AGB-zorgverlener tabel') |
| OrganizationName | Orthodontiepraktijk Dijkstra |
| DepartmentSpeciality | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | 0164123456 |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | Zakelijk telefoonnummer (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | info@orthodontiedijkstra.nl |
| ContactInformation.EmailAddresses.EmailAddressType | Zakelijk e-mailadres (code 'WP' from code system 'AddressUse') |
| AddressInformation.Street | Stationsstraat |
| AddressInformation.HouseNumber | 18 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 4611 XX |
| AddressInformation.PlaceOfResidence | Bergen op Zoom |
| AddressInformation.Municipality | |
| AddressInformation.Country | Nederland (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| OrganizationType | |
| OrganizationLocation.LocationName | |
| OrganizationLocation.LocationNumber |
6.4.4. Contact Person data
| NameInformation.FirstNames | Piet |
| NameInformation.Initials | |
| NameInformation.GivenName | |
| NameInformation.NameUsage | |
| NameInformation.LastName.Prefix | |
| NameInformation.LastName.LastName | Klaas |
| NameInformation.LastNamePartner.PartnerPrefix | |
| NameInformation.LastNamePartner.PartnerLastName | |
| NameInformation.Titles | |
| ContactInformation.TelephoneNumbers.TelephoneNumber | |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType | |
| AddressInformation.Street | |
| AddressInformation.HouseNumber | |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | |
| AddressInformation.PlaceOfResidence | |
| AddressInformation.Municipality | |
| AddressInformation.Country | |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | |
| Role | Eerste relatie/contactpersoon (code '01' from code system 'COD472-VEKT') |
| Relationship | Vader (code 'FTH' from code system 'RoleCode') |
6.4.5. ASA Score data
| IdentificationNumber | 0892c80d-df37-438a-ae24-20243feec745 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| EffectiveDateTime | 01-01-2024 10:43 |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| ASAScoreValue | ASA-score 3 (code '413497009' from code system 'SNOMED CT') |
| Performer | B. Dijkstra, Orthodontist |
| Comment | Allergisch voor gluten, heeft nierziekte en bloedarmoede |
6.4.6. Caries Risk data
| IdentificationNumber | 7d351e57-3ee3-4a7c-8e93-2c3789d0314a (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| EffectiveDateTime | 01-01-2024 10:43 |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| CariesRiskValue | verhoogd (code '35105006' from code system 'SNOMED CT') |
| Performer | B. Dijkstra, Orthodontist |
| Comment | Verhoogd risico mede i.v.m. comorbiditeit (nierziekte, bloedarmoede). |
6.4.7. Encounter data
| IdentificationNumber | bb9c5cf0-25e5-47e4-a9a9-350ec964fc6d (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| ContactType | Poliklinisch (code 'AMB' from code system 'ActCode') |
| ContactWith | B. Dijkstra, Orthodontist |
| Location | Orthodontiepraktijk Dijkstra |
| StartDateTime | 01-08-2025 09:00 |
| EndDateTime | 01-08-2025 09:30 |
| ContactReason.Problem | |
| ContactReason.Procedure | |
| ContactReason.DeviatingResult | |
| ContactReason.CommentContactReason | |
| Origin | |
| Destination |
6.4.8. Oral Hygiene data
| IdentificationNumber | f8d64a19-1350-4c20-9567-9395b8ba0978 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| EffectiveDateTime | 01-01-2024 10:43 |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen'), Mondhygiënisten (code '8700' from code system 'Vektis AGB-medische specialismen') |
| OralHygieneValue | goed (code '20572008' from code system 'SNOMED CT') |
| Performer | B. Dijkstra, Orthodontist |
| Comment | Goede mondhygiëne; eerdere parodontitis met stabiele restpockets. |
6.4.9. Parafunctional Activity data
| IdentificationNumber | 87ecdf20-f2b0-4024-aaf7-67548be399a4 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| EffectiveDateTime | 01-01-2024 10:43 |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| ParafunctionalActivityValue | Tanden knarsen tijdens slaap |
| Performer | B. Dijkstra, Orthodontist |
| Comment |
6.4.10. Payer data
6.4.10.1. Payer - Berend van de Stok
| IdentificationNumber | d2987f88-2494-4bf5-aca4-7838c0d84d54 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| PayerPerson.PayerName | Berend van de Stok |
| PayerPerson.BankInformation.BankName | ABNA |
| PayerPerson.BankInformation.BankCode | ABNA00NL |
| PayerPerson.BankInformation.AccountNumber | NL00ABNA0001234567 |
| InsuranceCompany.Insurance.StartDateTime | |
| InsuranceCompany.Insurance.EndDateTime | |
| InsuranceCompany.Insurance.InsuranceType | |
| InsuranceCompany.IdentificationNumber | |
| InsuranceCompany.OrganizationName | |
| InsuranceCompany.InsurantNumber | |
| AddressInformation.Street | Bloemstraat |
| AddressInformation.HouseNumber | 25 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 5678 BB |
| AddressInformation.PlaceOfResidence | Bergen op Zoom |
| AddressInformation.Municipality | |
| AddressInformation.Country | Nederland (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Officieel adres (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | +31687654321 |
| ContactInformation.TelephoneNumbers.TelecomType | Mobiel telefoonnummer (code 'MC' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.NumberType | Telefoonnummer thuis (code 'HP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | berendvandestok@gmail.com |
| ContactInformation.EmailAddresses.EmailAddressType | Privé e-mailadres (code 'HP' from code system 'AddressUse') |
6.4.10.2. Payer - Verzekeraar Helderzicht
| IdentificationNumber | 27c25ab9-9ec7-4f2e-b125-adad8694ca1f (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| PayerPerson.PayerName | |
| PayerPerson.BankInformation.BankName | |
| PayerPerson.BankInformation.BankCode | |
| PayerPerson.BankInformation.AccountNumber | |
| InsuranceCompany.Insurance.StartDateTime | 01-01-2024 |
| InsuranceCompany.Insurance.EndDateTime | 01-01-2026 |
| InsuranceCompany.Insurance.InsuranceType | Tandverzekering (los) (code 'T' from code system 'Verzekeringssoort') |
| InsuranceCompany.IdentificationNumber | |
| InsuranceCompany.OrganizationName | Verzekeraar Helderzicht |
| InsuranceCompany.InsurantNumber | 12345679 |
| AddressInformation.Street | Parksingel |
| AddressInformation.HouseNumber | 8 |
| AddressInformation.HouseNumberLetter | |
| AddressInformation.HouseNumberAddition | |
| AddressInformation.HouseNumberIndication | |
| AddressInformation.Postcode | 9995 XX |
| AddressInformation.PlaceOfResidence | Den Helder |
| AddressInformation.Municipality | |
| AddressInformation.Country | Nederland (code 'NL' from code system 'ISO 3166-1 (alpha-2)') |
| AddressInformation.AdditionalInformation | |
| AddressInformation.AddressType | Werkadres (code 'WP' from code system 'AddressUse') |
| ContactInformation.TelephoneNumbers.TelephoneNumber | |
| ContactInformation.TelephoneNumbers.TelecomType | |
| ContactInformation.TelephoneNumbers.NumberType | |
| ContactInformation.TelephoneNumbers.Comment | |
| ContactInformation.EmailAddresses.EmailAddress | |
| ContactInformation.EmailAddresses.EmailAddressType |
6.4.11. Periodic Periodontal Screening Score data
| IdentificationNumber | 04f2e128-5ce8-491f-b518-b6afe4c69447 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| EffectiveDateTime | 01-01-2024 10:43 |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| PeriodicPeriodontalScreeningScoreValue | Pockets groter dan of gelijk aan 6 millimeter = wellicht niet in orde (code 'ppsscore3' from code system 'PeriodicPeriodontalScreeningScore') |
| Performer | B. Dijkstra, Orthodontist |
| Comment | Verwezen naar paro; orthodontische behandeling pas na paro-stabilisatie (jan–feb 2024). |
6.4.12. Procedure data
| IdentificationNumber | 1b48b2b6-2a04-41b6-a86b-06652937a253 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | Orthodontiepraktijk Dijkstra |
| StartDateTime | 01-01-2024 |
| EndDateTime | |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| ProcedureType | Eerste consult (code 'F121A' from code system 'Vektis Prestatiecodelijst Mondzorg') |
| ProcedureMethod | |
| ProcedureAnatomicalLocation.Location | |
| ProcedureAnatomicalLocation.Laterality | |
| Indication.ProblemType | |
| Indication.ProblemName | |
| Indication.FurtherSpecificationProblemName | |
| Indication.ProblemAnatomicalLocation.Location | |
| Indication.ProblemAnatomicalLocation.Laterality | |
| Indication.ProblemStartDate | |
| Indication.ProblemEndDate | |
| Indication.ProblemStatus | |
| Indication.VerificationStatus | |
| Indication.Comment | |
| Location | Orthodontiepraktijk Dijkstra |
| Performer | B. Dijkstra, Orthodontist |
6.4.13. Treatment Objective data
6.4.13.1. Treatment Objective - Trekken snijtand linksboven
| IdentificationNumber | fa406aee-3588-4c45-b282-c4a3fb5464de (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | |
| EffectiveDateTime | |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| DesiredHealthcareResult | Trekken snijtand linksboven |
| DesiredHealthCondition.StatusName | |
| DesiredHealthCondition.StatusValue | |
| DesiredHealthCondition.StatusDate | |
| DesiredHealthCondition.Comment | |
| DesiredHealthCondition.MedicalDevice | |
| Problem | Malocclusie met scheefstand van de snijtand linksboven |
| Priority | Hoge prioriteit (code 'high-priority' from code system 'GoalPriority') |
6.4.13.1.1. Problem - Malocclusie met scheefstand van de snijtand linksboven
| ProblemType | Diagnose (code '282291009' from code system 'SNOMED CT') |
| ProblemName | malocclusie van tanden en/of kiezen (code '47944004' from code system 'SNOMED CT') |
| FurtherSpecificationProblemName | Malocclusie met scheefstand van de snijtand linksboven |
| ProblemAnatomicalLocation.Location | bovenste tandboog (code '39481002' from code system 'SNOMED CT') |
| ProblemAnatomicalLocation.Laterality | |
| ProblemStartDate | 15-11-2023 |
| ProblemEndDate | |
| ProblemStatus | Actueel (code '55561003' from code system 'SNOMED CT') |
| VerificationStatus | Bevestigd (code '410605003' from code system 'SNOMED CT') |
| Comment | Malocclusie met scheefstand van de snijtand linksboven; orthodontische behandeling met vaste beugel gepland na paro-stabilisatie en extractie. |
6.4.13.2. Treatment Objective - Wortelpuntoperatie (apexresectie)
| IdentificationNumber | 594f942b-f84f-43db-85e8-f473b7187428 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | |
| EffectiveDateTime | |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| DesiredHealthcareResult | Wortelpuntoperatie (apexresectie) |
| DesiredHealthCondition.StatusName | |
| DesiredHealthCondition.StatusValue | |
| DesiredHealthCondition.StatusDate | |
| DesiredHealthCondition.Comment | |
| DesiredHealthCondition.MedicalDevice | |
| Problem | |
| Priority | Lage prioriteit (code 'low-priority' from code system 'GoalPriority') |
6.4.13.3. Treatment Objective - Gewenste gezondheidstoestand: kan kauwen, specifiek doel: geen probleem met kauwen
| IdentificationNumber | 9fe343ae-b170-4a5f-9491-9fb9eaebca23 (in identifier system 'https://orthodontiepraktijk-dijkstra.nl/fhir/NamingSystem/resource-business-identifier') |
| HealthcareProvider | |
| EffectiveDateTime | |
| CareType | Tandartsspecialisten dentomaxillaire orthopaedie (code '1300' from code system 'Vektis AGB-medische specialismen') |
| DesiredHealthcareResult | |
| DesiredHealthCondition.StatusName | kan kauwen (code '288919008' from code system 'SNOMED CT') |
| DesiredHealthCondition.StatusValue | geen probleem met kauwen (code '162019007' from code system 'SNOMED CT') |
| DesiredHealthCondition.StatusDate | 01-08-2025 |
| DesiredHealthCondition.Comment | Na extractie snijtand linksboven en orthodontische behandeling met vaste beugel moet het kauwen weer klachtenvrij zijn. |
| DesiredHealthCondition.MedicalDevice | Vaste multibracket-beugel bovenboog |
| Problem | Malocclusie met scheefstand van de snijtand linksboven |
| Priority | Hoge prioriteit (code 'high-priority' from code system 'GoalPriority') |
6.4.13.3.1. Medical Device - Vaste multibracket-beugel bovenboog
| Product.ProductID | (01)08712345678906(11)240115(17)290115(10)ORTHO24A(21)BVDS0001 |
| Product.ProductType | orthodontische apparatuur (code '25742001' from code system 'SNOMED CT') |
| ProductDescription | Vaste multibracket-beugel voor de bovenboog |
| AnatomicalLocation.Location | bovenste tandboog (code '39481002' from code system 'SNOMED CT') |
| AnatomicalLocation.Laterality | |
| Indication | Malocclusie met scheefstand van de snijtand linksboven |
| StartDate | 01-02-2024 |
| EndDate | 01-08-2025 |
| Comment | Vaste multibracket-beugel in de bovenboog geplaatst na paro-stabilisatie en extractie; controle elke zes weken. |
| Location | Orthodontiepraktijk Dijkstra |
| HealthProfessional | B. Dijkstra, Orthodontist |