Skip to content
New issue

Have a question about this project? Sign up for a free GitHub account to open an issue and contact its maintainers and the community.

By clicking “Sign up for GitHub”, you agree to our terms of service and privacy statement. We’ll occasionally send you account related emails.

Already on GitHub? Sign in to your account

Zib-OutcomeOfCare #241

Draft
wants to merge 11 commits into
base: main
Choose a base branch
from
Draft
Show file tree
Hide file tree
Changes from all commits
Commits
File filter

Filter by extension

Filter by extension

Conversations
Failed to load comments.
Loading
Jump to
Jump to file
Failed to load files.
Loading
Diff view
Diff view
10 changes: 8 additions & 2 deletions known-issues.yml
Original file line number Diff line number Diff line change
Expand Up @@ -367,6 +367,9 @@ zib-NameInformation.GivenName:

zib-NursingIntervention:
zib deviations:
CarePlan.activity.outcomeReference:zibOutcomeOfCareReference:
- short: zib OutcomeOfCare reference
reason: Because this reference is reversed in FHIR, this profile needs to contain the mapping for the reference.
CarePlan.activity.detail.scheduled[x]:scheduledTiming.repeat.frequency:
- datatype: positiveInt
reason: zib concepts Interval and Frequency are represented by a combination of .frequency, .period and .periodUnit, not by a single element of Quantity datatype.
Expand All @@ -380,12 +383,15 @@ zib-NursingIntervention:
- cardinality: 0..1 instead of 0..*
reason: The value of the extension can only occur once, but the use of the extension itself is unlimited, making the effective cardinality 0..* as required by the zib.
ignored issues:
CarePlan.activity.outcomeReference:zibOutcomeOfCareReference:
- message: "Rule sd-zpg-03: 'References to other resource profiles should be added next to the HL7 base references.'"
reason: The restriction only applies to, and defines, this slice. The slicing is open so the base references can still be used.
CarePlan.contributor:requester:
- message: "Rule sd-zpg-03: 'References to other resource profiles should be added next to the HL7 base references.'"
reason: The slice is constrained on the target profile because this is what defines the slice. The HL7 base references are still available in the default slice.
reason: The restriction only applies to, and defines, this slice. The slicing is open so the base references can still be used.
CarePlan.activity.detail.performer:*:
- message: "Rule sd-zpg-03: 'References to other resource profiles should be added next to the HL7 base references.'"
reason: The slice is constrained on the target profile because this is what defines the slice. The HL7 base references are still available in the default slice.
reason: The restriction only applies to, and defines, this slice. The slicing is open so the base references can still be used.

zib-Patient:
zib deviations:
Expand Down
6 changes: 6 additions & 0 deletions release-notes.md
Original file line number Diff line number Diff line change
Expand Up @@ -160,6 +160,12 @@ This document contains release notes per zib, indicating differences with their
* New concept Indication mapped on the extension `NutritionOrder.extension:indication`.
* The comment extension has been replaced by a mapping to `NutritionOrder.note.text`.

## zib-OutcomeOfCare
* The code on `DiagnosticReport.code` has been changed to 423100009 and the system value to http://snomed.info/sct.
* Removed MeasurementValue mapping because this element does not exist anymore.
* Element HealthCondition::FunctionalOrMentalStatus with ID NL-CM:13.4.3 is mapped on `DiagnosticReport.result` instead of on its own slice.
Copy link
Contributor

Choose a reason for hiding this comment

The reason will be displayed to describe this comment to others. Learn more.

Shouldn't we keep this element on a separate slice so that it's possible to add other references next to the one defined in the zib?

* Intervention extension has been removed because the reference is reversed in FHIR. The NursingIntervention profile refers to this profile.

## zib-Patient
* Includes Nationality, MaritalStatus, LanguageProficiency.
* Cardinality of `Patient.extension:nationality` left at 0..* due to the nature of the nationality core extension (which allows for a period to be placed next to the nationality and thus allows for different nationalities over time).
Expand Down
8 changes: 8 additions & 0 deletions resources/nl-core/nl-core-NursingIntervention.xml
Original file line number Diff line number Diff line change
Expand Up @@ -62,6 +62,14 @@
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-TreatmentObjective" />
</type>
</element>
<element id="CarePlan.activity.outcomeReference:zibOutcomeOfCareReference">
<path value="CarePlan.activity.outcomeReference" />
<sliceName value="zibOutcomeOfCareReference" />
<type>
<code value="Reference" />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-OutcomeOfCare" />
</type>
</element>
<element id="CarePlan.activity.detail.extension">
<path value="CarePlan.activity.detail.extension" />
<slicing>
Expand Down
57 changes: 57 additions & 0 deletions resources/nl-core/nl-core-OutcomeOfCare.xml
Original file line number Diff line number Diff line change
@@ -0,0 +1,57 @@
<?xml version="1.0" encoding="utf-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="nl-core-OutcomeOfCare" />
<url value="http://nictiz.nl/fhir/StructureDefinition/nl-core-OutcomeOfCare" />
<name value="NlcoreOutcomeOfCare" />
<title value="nl core OutcomeOfCare" />
<status value="draft" />
<publisher value="Nictiz" />
<contact>
<name value="Nictiz" />
<telecom>
<system value="url" />
<value value="https://www.nictiz.nl" />
<use value="work" />
</telecom>
</contact>
<description value="The OutcomeOfCare concept describes the determined status of the patient in terms of a certain problem. Comparing the healthcare result with the treatment objective provides insight into the effectivity of the nursing interventions/activities carried out for this problem. It is a part of the nursing process, together with nursing diagnoses/problems, the treatment objective and nursing interventions." />
<purpose value="A derived profile from [zib-OutcomeOfCare](http://nictiz.nl/fhir/StructureDefinition/zib-OutcomeOfCare) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
<fhirVersion value="4.0.1" />
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<uri value="https://zibs.nl/wiki/OutcomeOfCare-v3.2(2020EN)" />
<name value="zib OutcomeOfCare-v3.2(2020EN)" />
</mapping>
<kind value="resource" />
<abstract value="false" />
<type value="DiagnosticReport" />
<baseDefinition value="http://nictiz.nl/fhir/StructureDefinition/zib-OutcomeOfCare" />
<derivation value="constraint" />
<differential>
<element id="DiagnosticReport">
<path value="DiagnosticReport" />
<comment value="Please note that on a functional level, zib OutcomeOfCare references zib NursingIntervention, but in FHIR this direction is reversed. Therefore, the concept Intervention (NL-CM:13.4.4) is mapped on `CarePlan.activity.outcomeReference` in profile [nl-core-NursingIntervention](http://nictiz.nl/fhir/StructureDefinition/nl-core-NursingIntervention) instead of in this profile." />
<alias value="nl-core-OutcomeOfCare" />
</element>
<element id="DiagnosticReport.subject">
<path value="DiagnosticReport.subject" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" />
</type>
</element>
<element id="DiagnosticReport.result">
<path value="DiagnosticReport.result" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-FunctionalOrMentalStatus" />
</type>
</element>
</differential>
</StructureDefinition>
36 changes: 35 additions & 1 deletion resources/zib/zib-NursingIntervention.xml
Original file line number Diff line number Diff line change
Expand Up @@ -23,6 +23,11 @@
<uri value="https://zibs.nl/wiki/NursingIntervention-v3.2(2020EN)" />
<name value="zib NursingIntervention-v3.2(2020EN)" />
</mapping>
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<uri value="https://zibs.nl/wiki/OutcomeOfCare-v3.2(2020EN)" />
<name value="zib OutcomeOfCare-v3.2(2020EN)" />
</mapping>
<kind value="resource" />
<abstract value="true" />
<type value="CarePlan" />
Expand All @@ -38,7 +43,6 @@
<severity value="error" />
<human value="The start and/or end date of a repeating schedule should be communicated in CarePlan.encounter as well." />
<expression value="activity.detail.scheduledTiming.repeat.boundsPeriod.exists() implies (period = activity.detail.scheduledTiming.repeat.boundsPeriod)" />
<source value="http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention" />
</constraint>
<mapping>
<identity value="zib-nursingintervention-v3.2-2020EN" />
Expand Down Expand Up @@ -196,6 +200,33 @@
<comment value="A nursing intervention in the Dutch realm always consists of a single activity. For this reason, the cardinality of `.activity` is restricted to 0..1." />
<max value="1" />
</element>
<element id="CarePlan.activity.outcomeReference">
<path value="CarePlan.activity.outcomeReference" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="CarePlan.activity.outcomeReference:zibOutcomeOfCareReference">
<path value="CarePlan.activity.outcomeReference" />
<sliceName value="zibOutcomeOfCareReference" />
<short value="zib OutcomeOfCare reference" />
Copy link
Contributor

Choose a reason for hiding this comment

The reason will be displayed to describe this comment to others. Learn more.

This should be put on a separate slice, conform the profiling guidelines.

<definition value="A description of the nursing intervention of which the effectivity is evaluated with the healthcare result." />
<comment value="Please note that on a functional level, zib OutcomeOfCare references zib NursingIntervention, but in FHIR this direction is reversed." />
<alias value="UitkomstVanZorg" />
<type>
<code value="Reference" />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-OutcomeOfCare" />
</type>
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<map value="NL-CM:13.4.4" />
<comment value="Reversed reference for zib OutcomeOfCare.Intervention" />
</mapping>
</element>
<element id="CarePlan.activity.detail.extension">
<path value="CarePlan.activity.detail.extension" />
<slicing>
Expand Down Expand Up @@ -238,6 +269,9 @@
<definition value="A nursing intervention is a treatment carried out by a nurse based on an expert opinion and clinical knowledge for the benefit of the person requesting healthcare. The intervention is targeted towards a certain problem (diagnosis) and has a predetermined healthcare result. It is possible to build a hierarchy of nursing interventions (where one intervention is part of another)." />
<alias value="Interventie" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="CarePlanActivityType" />
</extension>
<strength value="required" />
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.18--20200901000000" />
</binding>
Expand Down
81 changes: 81 additions & 0 deletions resources/zib/zib-OutcomeOfCare.xml
Original file line number Diff line number Diff line change
@@ -0,0 +1,81 @@
<?xml version="1.0" encoding="utf-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="zib-OutcomeOfCare" />
<url value="http://nictiz.nl/fhir/StructureDefinition/zib-OutcomeOfCare" />
<name value="ZibOutcomeOfCare" />
<title value="zib OutcomeOfCare" />
<status value="draft" />
<publisher value="Nictiz" />
<contact>
<name value="Nictiz" />
<telecom>
<system value="url" />
<value value="https://www.nictiz.nl" />
<use value="work" />
</telecom>
</contact>
<description value="The OutcomeOfCare concept describes the determined status of the patient in terms of a certain problem. Comparing the healthcare result with the treatment objective provides insight into the effectivity of the nursing interventions/activities carried out for this problem. It is a part of the nursing process, together with nursing diagnoses/problems, the treatment objective and nursing interventions." />
<purpose value="This DiagnosticReport resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) OutcomeOfCare v3.2(2020EN)](https://zibs.nl/wiki/OutcomeOfCare-v3.2(2020EN))." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
<fhirVersion value="4.0.1" />
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<uri value="https://zibs.nl/wiki/OutcomeOfCare-v3.2(2020EN)" />
<name value="zib OutcomeOfCare-v3.2(2020EN)" />
</mapping>
<kind value="resource" />
<abstract value="true" />
<type value="DiagnosticReport" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
<derivation value="constraint" />
<differential>
<element id="DiagnosticReport">
Copy link
Contributor

Choose a reason for hiding this comment

The reason will be displayed to describe this comment to others. Learn more.

A comment related to the reversed reference to Intervention should be added here, in line with the profiling guidelines.

<path value="DiagnosticReport" />
<short value="OutcomeOfCare" />
<comment value="Please note that on a functional level, zib OutcomeOfCare references zib NursingIntervention, but in FHIR this direction is reversed. Therefore, the concept Intervention (NL-CM:13.4.4) is mapped on `CarePlan.activity.outcomeReference` in profile [zib-NursingIntervention](http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention) instead of in this profile." />
<alias value="UitkomstVanZorg" />
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<map value="NL-CM:13.4.1" />
<comment value="OutcomeOfCare" />
</mapping>
</element>
<element id="DiagnosticReport.code">
<path value="DiagnosticReport.code" />
<patternCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="423100009" />
</coding>
</patternCodeableConcept>
</element>
<element id="DiagnosticReport.result">
<path value="DiagnosticReport.result" />
<short value="HealthCondition" />
<definition value="A description of the patient’s health condition in the form of a functional and/or mental status." />
<alias value="Gezondheidstoestand" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus" />
</type>
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<map value="NL-CM:13.4.3" />
<comment value="HealthCondition" />
</mapping>
</element>
<element id="DiagnosticReport.conclusion">
<path value="DiagnosticReport.conclusion" />
<short value="HealthcareResult" />
<definition value="The textual account of the healthcare result. If HealthcareResult cannot be entered as a functional/mental status, it can be described as free text in the healthcare result." />
<alias value="Zorgresultaat" />
<mapping>
<identity value="zib-outcomeofcare-v3.2-2020EN" />
<map value="NL-CM:13.4.5" />
<comment value="HealthcareResult" />
</mapping>
</element>
</differential>
</StructureDefinition>