<status value="active" /> <date value="2023-10-26T12:54:50.1353924+00:00" /> <publisher value="NICE" /> <contact> <name value="NICE" /> <telecom> <system value="email" /> <value value="vragen@stichting-nice.nl" /> </telecom> </contact> <description value="This profile is for submitting the patient's lowest and highest heart rate in beats/min to the NICE." /> <purpose value="This profile is used to submit heart rate related information to the Dutch National Intensive Care Evaluation (NICE). It was derived from the Nictiz Health and Care Information Model (HCIM; Dutch: Zorginformatiebouwsteen or ZIB) HeartRate, 2017 release version 3.1" /> <copyright value="CC0" /> <fhirVersion value="3.0.2" /> <mapping> <identity value="NICE-Datadictionary-MDS" /> <uri value="https://www.stichting-nice.nl/dd/#528" /> <name value="NICE-Datadictionary-MDS" /> <comment value="The Minimal Data Set (MDS)" /> </mapping> <mapping> <identity value="NICE-Datadictionary-Sepsis" /> <uri value="https://www.stichting-nice.nl/dd/#646" /> <name value="NICE-Datadictionary-Sepsis" /> <comment value="The sepsis registration" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://nictiz.nl/fhir/StructureDefinition/zib-HeartRate" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <definition value="This profile defines how to represent heart rate observations in FHIR using a standard LOINC code and UCUM units of measure. The heart frequency is the number of heartbeats per minute. This profile should be used to submit the following: - The lowest and the highest heart frequencies during the first 24 hours of IC admission. - The highest heart rate during suspected sepsis in order to identify the presence of tachycardia. For more information on this subject the NICE Datadictionary can be consulted." /> </element> <element id="Observation.extension"> <path value="Observation.extension" /> <min value="2" /> </element> <element id="Observation.extension:ExtremeValueType"> <path value="Observation.extension" /> <sliceName value="ExtremeValueType" /> <short value="Value extremum" /> <definition value="A range of specific NICE Datadictionary elements require to submit a lowest and/or highest measurement. This extension element should be used to differentiate between those two measurement types. The following NICE Datadictionary element requires lowest and/or highest measurements: - Lowest/Highest heart rate (MDS)" /> <min value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ExtremeValueType-2022Q1" /> </type> </element> <element id="Observation.extension:ExtremeValueType.valueCodeableConcept:valueCodeableConcept"> <path value="Observation.extension.valueCodeableConcept" /> <sliceName value="valueCodeableConcept" /> <definition value="Submit "L" for the lowest or "H" for the highest score during the ScoreDay." /> </element> <element id="Observation.extension:Verified"> <path value="Observation.extension" /> <sliceName value="Verified" /> <short value="Specifying validation status" /> <min value="1" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1" /> </type> </element> <element id="Observation.status"> <path value="Observation.status" /> <short value="final" /> <definition value="The status of the result value. Only final observations are relevant for NICE." /> <requirements value="Other values are not relevant. Values should be validated by a practitioner." /> <fixedCode value="final" /> </element> <element id="Observation.category"> <path value="Observation.category" /> <slicing> <discriminator> <type value="value" /> <path value="coding" /> </discriminator> <description value="Multiple types of categories can exists. In case of a HeartRate, the category SHALL always be 'vital-signs'" /> <rules value="open" /> </slicing> <short value="Classification of type of observation" /> <definition value="Two types of heartrate can be submitted: (1) The heart frequency that should be submitted for the minimal dataset and (2) the heart frequency that should be submitted for the sepsis registration. The measurement type shall be differentiated by means of this category element: - If the heart rate concerns the minimal dataset, the category:HeartRateSepsis **shall NOT** be submitted. - If the heart rate concerns the sepsis registration, the category:HeartRateSepsis **shall** be submitted." /> <binding> <strength value="required" /> <description value="Codes for the heartrate category measurement" /> <valueSetReference> <reference value="https://fhir.stichting-nice.nl/ValueSet/NICE-HeartRateCategoryCodeList" /> </valueSetReference> </binding> </element> <element id="Observation.category:HeartRate"> <path value="Observation.category" /> <sliceName value="HeartRate" /> <max value="1" /> </element> <element id="Observation.category:HeartRate.coding.system"> <path value="Observation.category.coding.system" /> <fixedUri value="https://fhir.stichting-nice.nl/NICE-codes" /> </element> <element id="Observation.category:HeartRate.coding.code"> <path value="Observation.category.coding.code" /> <fixedCode value="VS" /> </element> <element id="Observation.category:HeartRateSepsis"> <path value="Observation.category" /> <sliceName value="HeartRateSepsis" /> <definition value="This coding is used to identify the presence of tacycardia during suspected sepsis. The **highest** heart rate during suspected sepsis shall be submitted." /> <max value="1" /> </element> <element id="Observation.category:HeartRateSepsis.coding.system"> <path value="Observation.category.coding.system" /> <fixedUri value="https://fhir.stichting-nice.nl/NICE-codes" /> </element> <element id="Observation.category:HeartRateSepsis.coding.code"> <path value="Observation.category.coding.code" /> <fixedCode value="VS-SEPSIS" /> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Patient-2022Q1" /> </type> </element> <element id="Observation.context"> <path value="Observation.context" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Encounter-2022Q1" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]:effectiveDateTime"> <path value="Observation.effectiveDateTime" /> <sliceName value="effectiveDateTime" /> <definition value="Date and time of the heartrate measurement." /> <type> <code value="dateTime" /> </type> </element> <element id="Observation.valueQuantity:valueQuantity"> <path value="Observation.valueQuantity" /> <sliceName value="valueQuantity" /> <short value="Heartrate" /> <definition value="The heart frequency measured as the number of heartbeats per minute. Two types of heartrate can be submitted: - The heart frequency that should be submitted for the minimal dataset. **Additional information about the measurement type (highest or lowest) should be submitted by means of the extension.ExtremeValueType element.** - The heart frequency that should be submitted for the sepsis registration. In this case, the **highest** heart rate around the time that sepsis was suspected should be submitted. In case the highest heart rate is higher than 90 (beats/minute), it is scored as tachycardia. The measurement type shall be differentiated by means of the category element." /> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#148" /> <comment value="Lowest heart rate" /> </mapping> <mapping> <identity value="NICE-Datadictionary-MDS" /> <map value="https://www.stichting-nice.nl/dd/#147" /> <comment value="Highest heart rate" /> </mapping> <mapping> <identity value="NICE-Datadictionary-Sepsis" /> <map value="https://www.stichting-nice.nl/dd/#662" /> <comment value="Tachycardia" /> </mapping> </element> </differential> </StructureDefinition>