Referenties tussen medicatiebouwstenen in FHIR in ecosysteem met HL7v3

• Voor Nictiz drie issues

  • MP FHIR IG aanvullen met informatie dat sommige relaties tussen medicatiebouwstenen (MA/VV/TA etc.) gedaan kan worden met

    • alleen een logical reference (identifier)

    • een logical reference EN literal reference (obv uuid of absolute/relative url)

    • alleen een literal reference wanneer de resource waarnaar er verwezen wordt ook is geincludeerd in de bundle

  • Nictiz FHIR IG 2.5 aanvullen met dat combinatie logical en literal reference mogelijk is

  • HL7-Mappings documentatie uitbreiden met dat de stylesheets een aanname doet dat alle resources waarnaar er wordt gerefereerd (via een literal reference) in de bundle zit

• VZVZ: Opnemen als eis in de implementatiehandleiding (AoF of MO)

  • bij resources op basis van literal references hebben we ook specificaties nodig mbt welk laag we gaan

Met VZVZ is er afgesproken dat het refereren naar onderstaande medicatiebouwstenen op drie verschillende manieren gedaan kan worden wanneer er uitgewisseld wordt tussen v3 en fhir systemen:

-MedicationAgreement / Medicatieafspraak

-DispenseRequest / Verstrekkingsverzoek

-MedicationDispense / Medicatieverstrekking

-MedicationUse / Medicatiegebruik

-MedicationAdministration / Medicatietoediening

-VariableDosingRegimen / Wisselend Doseerschema

In de MP9.3 situatie kan in FHIR een reference naar een ander medicatiebouwsteen gedaan worden met:

• alleen een logical reference (identifier)

• een logical reference EN literal reference (obv uuid of absolute/relative url)

• alleen een literal reference wanneer de resource waarnaar er verwezen wordt ook is geïncludeerd in de bundle

De FHIR implementation guide is aangevuld met bovenstaande informatie:

• Section 2.2 Mappings between profiles and data set is gewijzigd en aangevuld

  • van “ Relations between different building blocks exist in transactions by means of concepts with a name starting with ‘Relation…’ (Dutch: ‘Relatie…’) and an underlying concept 'Identification' of data type Identification, for example RelationAdministrationAgreement (mp-dataelement9x-1328) in building block MedicationAgreement. These relations are mapped to the FHIR data type ‘Reference’. Implementers SHOULD use literal references (using .reference) instead of logical references (using .identifier) where possible, see the general FHIR IG on the Reference data type.”

  • naar “Relations between different building blocks exist in transactions by means of concepts with a name starting with ‘Relation…’ (Dutch: ‘Relatie…’) and an underlying concept 'Identification' of data type Identification, for example RelationAdministrationAgreement (mp-dataelement9x-1328) in building block MedicationAgreement. These relations are mapped to the FHIR data type ‘Reference’. Implementers SHOULD use literal references (using .reference) instead of logical references (using .identifier) when it's possible to resolve the reference, see the general FHIR IG on the Reference data type. However, when HL7v3 systems are involved, it is advised to use one of the following types of references:

    • Only a logical reference .identifier).

    • Both a logical .identifier) and literal reference .reference).

    • Only a literal reference .reference) when the resource which is being referred is included in the bundle.”

• Section 2.1.3.1 Bundle Profiles is aangevuld

  • van “All building blocks defined in the functional specification of a transaction have been added as slices on .entry. This is not a limited list, a sending system has the option to include more referenced resources if needed. Note that where the functional specification of a transaction specifies a minimum cardinality of 1 for a building block, the minimum cardinality in a Bundle profile has been set to 0. Because there are different ways in FHIR to reference to building blocks, senders are not required to include it in the Bundle.”

  • naar “All building blocks defined in the functional specification of a transaction have been added as slices on fhir|.entry. This is not a limited list, a sending system has the option to include more referenced resources if needed. Note that where the functional specification of a transaction specifies a minimum cardinality of 1 for a building block, the minimum cardinality in a Bundle profile has been set to 0. Because there are different ways in FHIR to reference to building blocks, senders are not required to include it in the Bundle. The different ways to reference building blocks in MP9 can be found in the last paragraph of [[mp:V3.0.0_MedicationProcess9_FHIR#Mapping_between_profiles_and_data_set|section 2.2]].

It has been agreed with VZVZ that referencing medication building blocks can be done in three different ways when exchanging between v3 and fhir systems. The medication building blocks are:

-MedicationAgreement / Medicatieafspraak

-DispenseRequest / Verstrekkingsverzoek

-MedicationDispense / Medicatieverstrekking

-MedicationUse / Medicatiegebruik

-MedicationAdministration / Medicatietoediening

-VariableDosingRegimen / Wisselend Doseerschema

In the MP9.3 situation, a reference to another medication building block can be done in FHIR with:

• only a logical reference (identifier)

• a logical reference AND a literal reference (based on uuid or absolute/relative url)

• only a literal reference when the referenced resource is also included in the bundle.

The FHIR implementation guide is updated with the following information:

• Section 2.2 Mappings between profiles and data set is changed

  • from “ Relations between different building blocks exist in transactions by means of concepts with a name starting with ‘Relation…’ (Dutch: ‘Relatie…’) and an underlying concept 'Identification' of data type Identification, for example RelationAdministrationAgreement (mp-dataelement9x-1328) in building block MedicationAgreement. These relations are mapped to the FHIR data type ‘Reference’. Implementers SHOULD use literal references (using .reference) instead of logical references (using .identifier) where possible, see the general FHIR IG on the Reference data type.”

  • to “Relations between different building blocks exist in transactions by means of concepts with a name starting with ‘Relation…’ (Dutch: ‘Relatie…’) and an underlying concept 'Identification' of data type Identification, for example RelationAdministrationAgreement (mp-dataelement9x-1328) in building block MedicationAgreement. These relations are mapped to the FHIR data type ‘Reference’. Implementers SHOULD use literal references (using .reference) instead of logical references (using .identifier) when it's possible to resolve the reference, see the general FHIR IG on the Reference data type. However, when HL7v3 systems are involved, it is advised to use one of the following types of references:

    • Only a logical reference .identifier).

    • Both a logical .identifier) and literal reference .reference).

    • Only a literal reference .reference) when the resource which is being referred is included in the bundle.”

• Section 2.1.3.1 Bundle Profiles is changed

  • from “All building blocks defined in the functional specification of a transaction have been added as slices on .entry. This is not a limited list, a sending system has the option to include more referenced resources if needed. Note that where the functional specification of a transaction specifies a minimum cardinality of 1 for a building block, the minimum cardinality in a Bundle profile has been set to 0. Because there are different ways in FHIR to reference to building blocks, senders are not required to include it in the Bundle.”

  • to “All building blocks defined in the functional specification of a transaction have been added as slices on fhir|.entry. This is not a limited list, a sending system has the option to include more referenced resources if needed. Note that where the functional specification of a transaction specifies a minimum cardinality of 1 for a building block, the minimum cardinality in a Bundle profile has been set to 0. Because there are different ways in FHIR to reference to building blocks, senders are not required to include it in the Bundle. The different ways to reference building blocks in MP9 can be found in the last paragraph of [[mp:V3.0.0_MedicationProcess9_FHIR#Mapping_between_profiles_and_data_set|section 2.2]].