3. Technisch ontwerp
3.1. Introduction
This Implementation Guide (IG) provides the technical specification of the additional exchange of long-term healthcare information (Dutch: Basisgegevens Langdurige Zorg or BgLZ) based on a selection of Dutch Health Care Information Models. The “expansion” of the long-term information standard is in first instance focused on Health Care Information Models of the information standard minimal eOverdracht version 4.0 The information standard minimal eOverdracht as published by Nictiz does not yet include a patient use case, this may change in the future. Up until then, the patient use case will be published by MedMij under the definition of additional dataset long-term care.
This IG is a technical counterpart of the functional design. The FHIR version used for this IG is HL7 FHIR STU3. This implementation guide assumes that the reader is familiar with this FHIR version.
Apart from this document, the guidelines as specified in general FHIR Implementation Guide apply. In particular, the reader should take note of the Use case overarching principles.
3.2. Actors involved
| Actors | Systems | FHIR Capability Statements | ||
|---|---|---|---|---|
| Name | Description | Name | Description | Description |
| Patient | The user of a personal healthcare environment | PHR (Document Consumer) | Personal health record | FHIR client requirements |
| Healthcare provider | The user of a XIS | XIS (Document Responder) | Healthcare information system | FHIR server requirements |
3.3. Boundaries and relationships
This FHIR IG includes use cases for the exchange of the additional dataset long-term care data between health care providers (e.g. nurses) and patients e.g. in a Personal Health Record setting (PHR). In this Implementation Guide we focus op exchange of healthcare data between an healthcare povider to a Personal Health Record (PHR) or in Dutch: persoonlijke gezondheidsomgeving or PGO.
This IG guide assumes that a PHR is able to connect with a XIS. It does not provide information on finding the right source system nor does it provide information about security. These infrastructure and interface specifications are described in the 'MedMij Afsprakenstelsel'.
The additional dataset long term care information exchange is overlapping with other standards such as the Basic Long-term care (BgLZ). The additional dataset long term care uses the same HCIM based FHIR profiles for exchanging information as used in other standards.
3.4. Use cases
The use cases in this IG are based as much as possible on the specifications described in the Nictiz information standard Minimale eOverdracht
We are not using the infrastructure profiles since we do not transfer messages between healthcare providers. In this Implementation Guide we focus op exchange of healthcare data between an healthcare povider to a Personal Health Record (PHR) or in Dutch: persoonlijke gezondheidsomgeving or PGO.
3.4.0.1. PHR: request Parameters
The PHR system requests the addditional data long-term care using individual search interactions. The addditional data long-term care consists of multiple FHIR resources with certain constraints. To obtain the patient's addditional data long-term care, the client can use multiple individual search operations based on specified search queries. The interactions are performed by an HTTP GET as shown:
GET [base]/[type]{?[parameters]}
The table below shows in the first four columns the sections, the HCIMs that constitute those sections and the specific content of the addditional data long-term care. The last column shows the FHIR search queries to obtain the long-term care information. These queries and expected responses are based on StructureDefinitions listed in ([TO DO] link)
3.4.0.2. XIS: Response message
The returned data to the PHR should conform to the profiles listed in the table below.
| Section | ZIB NL | HCIM EN | FHIR Resource | FHIR Profile | Search URL |
|---|---|---|---|---|---|
| 1 | zib betaler | Payer | Coverage | Payer | GET [base] coverage |
| 2 | zib contact | Contact | Encounter | Encounter | GET [base]/Encounter |
| 3 | zib bloeddruk | BloodPressure | Observation | BloodPressure | GET [base]/ Observation?code=http://loinc.org|85354-9 |
| 4 | zib Lichaamsgewicht | BodyWeigth | Observation | BodyWeight | GET [base]/ Observation?code=http://loinc.org|29463-7 |
| 5 | zib lichaamslengte | BodyHeight | Observation | BodyHeight | GET [base]/ Observation?code=http://loinc.org|8302-2 |
| 6 | zib Alert | Alert | Flag | Alert | GET [base]/Flag |
| 7 | zib Woonsituatie | LivingSituation | Observation | LivingSituation | GET [base]/ Observation?code=http://snomed.info/sct|365508006 |
| 8 | zib Voedingsadvies | NutritionAdvice | NutritionOrder | NutritionAdvice | GET [base]/ NutritionOrder |
| 9 | zib Lichaamstemperatuur | BodyTemperature | Observation | BodyTemperature | GET [base]/Observation?code=http://loinc.org|8310-5 |
| 10 | zib Vochtbalans | FluidBalance | Observation | FluidBalance | GET [base]/Observation?code=http://snomed.info/sct|364396009 |
| 11 | zib Ademhaling | Respiration | Observation | Respiration | GET [base]/Observation?code=http://snomed.info/sct|422834003 |
| 12 | zib Polsfrequentie | PulseRate | Observation | PulseRate | GET [base]/Observation?code=http://loinc.org|8893-0 |
| 13 | [n.t.b.] Dagrapportage | [n.t.b.] NursingReport | [n.t.b.] Observation | [n.t.b.] FHIR Profile | [n.t.b.] |
3.5. Release notes
Tabel 3 Release notes
| Versie | Datum | Omschrijving |
|---|---|---|
| 1.0.0-alpha.1 | 19-02-2025 | Eerste versie voor een Proof of Concept (POC) |
| 1.0.0-alpha.2 | 07-04-2025 | Weblink FHIR profielen toegevoegd |