Te Whatu Ora Shared Care FHIR API
0.3.9 - release
Te Whatu Ora Shared Care FHIR API
0.3.9 - release
Te Whatu Ora Shared Care FHIR API - Local Development build (v0.3.9) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Fixed Capability Statement broken links.
Updated AntiviralEligibilityQuestionnaire to version 1.0.1
answerValueSet canonical Url in question 3 (link Id “criteria”) has been corrected to have the hyphen - in ‘COVID-19’QuestionnaireResponse examples yes,no
changed to use the NZHTS rather than standards.digital.health.nz form of canonical Url for the defined terminology ValueSetsAdded state transition diagrams for the expected states of secondary prophylaxis resources.
Update to existing diagram illustrating appointment planning and recording the number of planned Appointments has been reduced to one.
Developer guidance expanded about validation of resources using versioned profiles
#active rather than #proposed consent, to make it more realistic.In consent-based access control, a diagram and description has been added for the Consent-on-behalf scenario (consent obtained from a related person). Other minor improvements to the description.
Fixed a few broken links in this changelog.
The SNOMED code required by the rheumatic fever profile of CareTeam was incorrect and has now been revised to 320741000210108.
Note this is a new SNOMED code for the New Zealand edition and is not yet visible in SNOMED CT browsers as of this update.
As of this IG, a business version of “1.0.0” has been set in definitions and canonical instances. Future updates from this point will increment these version numbers in the applicable artifacts using semantic versioning.
All four rheumatic fever canonical Questionnaire instances now have a business version set to “1.0.0”.
The example QuestionnaireResponses for these Questionnaires now use versioned FHIR “questionnaire” references eg.
"https:/build.fhir.org/ig/cinc-fhir-ig/Questionnaire/MedicationsAndFollowUpGuidanceQuestionnaire|1.0.0"
The five rheumatic fever resource profiles of CarePlan | Patient | Condition | CareTeam | MedicationRequest now have a business version set to “1.0.0” instead of the IG version.
Corresponding example instances of these profiled types now use a versioned FHIR canonical reference in their metadata eg.
{
"resourceType" : "CarePlan",
"meta" : {
"versionId" : "2",
"lastUpdated" : "2023-11-07T04:00:00Z",
"profile" : [
🔗 "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/StructureDefinition/nz-sharedcare-rheumaticfever-careplan|1.0.0"
]
},
...
ValueSets defined in this IG now have their own business version numbers set to “1.0.0” as of this IG release.
A couple of example instances now claim their resource profile as the profile (version “1.0.0”) in this IG whereas previously they claimed the base FHIR R4B profile:
RheumaticFeverCareTeam)RheumaticFeverMedicationRequest)One further extension is now defined, in the RheumaticFeverCondition profile of Condition resource. The new extension named assessmentDate enables API consumers to record the date of RHD severity assessment separately from the date of diagnosis (recordedDate).
The corresponding example instance has been updated to demonstrate usage of this extension. The FHIR data model and rheumatic fever data documentation has been revised to show the additional extension element.
All identifier references to the two HPI pilot service provider orgs have been corrected to G0M086 / G0M087. Previously the second character of these identifiers was incorrectly specified as upper case letter ‘O’ rather than ‘0’ zero.
A warning message about this is now displayed in the IG home page and in rheumatic fever resource profile pages.
One further type code has been added to the ExternalSystemIdentifierTypeValueSet ValueSet to enable clients to designate identifiers to external encounter objects.
In the rheumatic fever section of the documentation, the FHIR design diagrams (which were moved onto their own page in IG v0.3.5) are no longer duplicated on the rheumatic fever data mappings and translation page.
Current official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/
In an upcoming version of this IG, the Official URL (aka canonical URL) will change to a different hostname in the digital.health.nz domain. In addition the name of this IG will change.
Developers of client applications are advised to parameterize all instances of the official URL to prepare for this upcoming change.
As a result of a design decision to constrain values of medication frequency to a standard set of frequencies (coded) used in NZ rheumatic fever secondary prophylaxis:
Dosage.additionalInstruction is no longer to be used for medication frequency).MedicationRequest named RheumaticFeverMedicationRequest has been introduced to incorporate the new extension from (2). It builds on NzMedicationRequest from the NZ Base IG.The example MedicationRequest now claims conformance with its new profile in this IG as outlined above.
The example MedicationStatement now claims conformance with NzMedicationStatement from the NZ Base IG.
partOf reference to its contained instance to avoid a Publisher QA FHIR validation error.There is now a new example Bundle showing how secondary prophylaxis encounter info can be created as three POST requests in one transaction (Encounter + MedicationStatement + QuestionnaireResponse).
The various Consent resource examples now claim conformance with the ManaakiNgaTahiConsent profile in this IG.
Added a section to the API Developer Guide about validation of FHIR resource references.
Updates to FHIR Resource Data Model:
Base FHIR type is now consistently identified using the UML stereotype of the class
MedicationRequest resource is now shown as profiled RheumaticFeverMedicationRequest`
Usage of sliced identifiers in profiled resources is now shown more clearly.
The model now shows references going from the RheumaticFeverCondition resource to the Episurv national notifiable disease system.
Tweaked the RF Terminology page.
Added a few resource types to server Capability Statement
Current official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/
In an upcoming version of this IG, the Official URL (aka canonical URL) will change to a different hostname in the digital.health.nz domain. In addition the name of this IG will change.
Developers of client applications are advised to parameterise all instances of the official URL to prepare for this upcoming change.
Patient.contact[]Whanau care teams are now represented directly in the RheumaticFeverPatient resource, as .contact[] members.
The RheumaticFeverCareTeam resource profile will now be used only for secondary prophylaxis care teams. So all instances of RheumaticFeverCareTeam resources are categorised sct#320741000210108 “Secondary prophylaxis team”
A new example RheumaticFeverPatient instance has been added showing how to model whanau members as contacts
MadeleineMeringueAndWhanau
RheumaticFeverPatient profile changesPatient.contact now has three new extensions capturing role (coded), relationship (string) and primary contact nature for each member of a patient’s whanau/trusted delegates care team.Secondary Prophylaxis Health Assessment Questionnaire
Various items removed and one new item added [Example QR]QuestionnaireResponse-RFPatientHealthAssessmentQuestionnaireResponse.html) updated to match.
Medications and Follow-Up Guidance Questionnaire
One item changed from boolean to yes/no/unknown coded answer. Example QR updated to match.
Patient Medication Allergy Questionnaire
One item removed. Example QR updated to match.
The example SecondaryProphylaxisCareTeam has been adjusted to properly represent a secondary prophylaxis care team
The example WhanauCareTeam has been deleted.
Appointment examples updated to reflect changes to data dictionary, including the addition of another code for salesforce CarePlanActivity identifiers in ExternalSystemIdentifierTypeValueSet.
A new example has been added demonstrating consent by a person related to a patient. See ConsentByRelatedPersonExample.
The example rheumatic fever patient MadeleineMeringue also now has some sample ContactPoint entries in Patient.telecom[].
documentation
Reorganised top nav with two new sections for COVID CINC artifacts and Consent documentation and examples.
The IG now allows for .contained resource instances in Consents (ManaakiNgaTahiConsent )
This is needed for rheumatic fever in which consent is commonly obtained from the patient’s parent or another relative.
Three new extensions defined for use on Patient.contact
IG FHIR Shorthand (fsh) source code improvements
ContactPoint elements used by patient.telecom and patient.contact.telecom examples.Consent resource examples
Examples now include the .organization element as the custodian of the consent, set to the same org as .performer
An example of an #active status Consent has been added. This example demonstrates how clients should form a valid Consent instance representing when a patient’s consent has been actually obtained.
In the RheumaticFeverCarePlan resource profile, .addresses now has cardinality zero to many (0..*)
In the RheumaticFeverCondition resource profile, the diagnosticCertainty extension now uses codes defined in a code system in this IG because clients cannot expand the ValueSet
published on the New Zealand Health Terminology Service to codes at this time.
In the four rheumatic fever extensions defined by this IG, the context, which constrains which type(s) the extension can be used on has been changed to the applicable base type instead of the profiled type. This change means clients can use the extensions without encountering hapi validator errors / Bad Request 400 errors.
Identifiers from EPISurv, the national system which tracks notifiable disease events, are no longer to be recorded on RheumaticFeverCarePlan and have moved instead to the RheumaticFeverCondition profile. Relevant example instances have been updated.
validation errors in example resources – updates to address certain errors raised by the FHIR Validator:
In example resources which have a Reference(Organization) the reference type is now the base type Organization instead of "type" : "NzOrganization"
In CarePlan examples, subject references are now of base "type" : "Patient" instead of "type" : "NzPatient"
Also in CarePlan examples, addresses has changed from a singleton reference to an array of References (length 1) with each entry of "type": "Condition"
Renamed the API described by this Implementation Guide from Care In The Community FHIR API to Te Whatu Ora Shared Care FHIR API reflecting recent expansion.
Revised Identifier slicing in CarePlan, Condition and CareTeam resource profiles to allow multiple references to external identifiers and capture the types of identifier being referred to.
Revised the patient medication allergy ValueSet to now use SNOMED terminology which pinpoints the medication allergy instead of substance concepts.
Patient Medication Allergy Questionnaire revised questions to codify answer yes|no|unknown, and add third question to capture Other Allergy detail as free text.
Secondary Prophylaxis Health Assessment Questionnaire revised questions in line with data dictionary changes, and [QuestionnaireResponse example]QuestionnaireResponse-RFPatientHealthAssessmentQuestionnaireResponse.html) updated to match.
Corrected rheumatic heart disease severity ValueSet to add missing code #301561000210102 History of heart valve replacement (situation)
Introduced new terminology QualifiedYesNoAnswerValueSet. This set of SNOMED codes applies to yes/no-type questions where it is important to be able to record an ‘unknown’ or ‘information not available’ response in a FHIR QuestionnaireResponse item.
Introduced new terminology ExternalSystemIdentifierTypeValueSet. This extends the set of FHIR Identifier type codes to define new codes for known external identifiers in NZ national systems that integrate with the Te Whatu Ora Shared Care FHIR API.
All Rheumatic fever terminology now appears in the rheumatic fever section of the Profiles tab.
Key salesforce <-> FHIR mappings are now defined in the rheumatic fever data page.
Added Consent tab describing patient-consent-based access controls implemented by the Te Whatu Ora Shared Care API.
ManaakiTahiConsent profile updated to reactivate some data elements of *provision.**Consent examples illustrating how provisional consent can be represented to enable pilot Salesforce/Mulesoft access to FHIR data (‘ProposedConsentBaseExample’, ‘ProposedConsentCoverageExample’)CareTeam example identifying the group of all rheumatic fever lead-provider organisationsUpdated API Capability Statement with RheumaticFever profiled resource API
Added (this) Changelog page, linked from IG Support tab
Changed subject references in CarePlan examples to be relative references to the local Rheumatic Fever Patient (Patient) instance, instead of NHI identifier-based logical refs.
Added the four extensions to the Rheumatic Fever group at the top of the Profiles tab.
Questionnaire now uses NZ published terminology for eligibility criteria questions 1 and 3
Permitted answers for these questions are now defined in answerValueSets instead of local codes in no CodeSystem
enableWhen logic comparator operands now use codes instead of valueStrings
valueSet references utilise a StructureDataCapture extension for specifiying the preferred terminology server. This lets FHIR clients such as the NLM Form Builder obtain codes correctly using ValueSet $expand operation.
| Revised the two sample Yes | No QuestionnaireResponses to correctly use published CodeSystem codes |
Questionnaire and QuestionnaireResponse profiles as these are not required. A QuestionnaireResponse is defined by it’s parent Questionnaire therefore the profile is not required.| Fixed the two sample Yes | No QuestionnaireResponses to match |
PlanDefinition instance COVIDMVPCareplanTemplate (renamed from prior file):
.definitionCanonical incorrect reference to a Canonical,COVIDMVPCarePlanTemplate added alongside legacy identifier COVIDRegularHealthCheckQuestionnaireMeasurementProcedureRequestTemplate (renamed from prior file):
.url element corrected to set an official URL.MeasurementProcedureRequestTemplate added alongside legacy identifierCOVIDInitialHealthAssessmentQuestionnaire [was QuestionTemplate-CitC-COVID19-InitialAssessment]COVIDRegularHealthCheckQuestionnaire [was QuestionTemplate-CitC-COVID19-RegularHealthCheck]COVIDVaccinationSurveyQuestionnaire [was Questionnaire-COVID-VaccinationSurveyQuestionnaire]
All the above identifiers are categorised “use”:”official”, with a use.period starting from 2023-07-19
The former legacy identifiers remain, but in “use”:”temp” status with their use.period.end date set to 2023-07-19
After these revisions, all four COVID Questionnaires now have consistent identifier values (COVIDPublicHealthHistoryQuestionnaire being the fourth and most recent addition)
Revised official URLs for the same three COVID Questionnaires to:
https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/*Questionnaire-COVID-InitialHealthAssessment
https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/*Questionnaire-COVID-RegularHealthCheck
https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/*Questionnaire-COVID-VaccinationSurvey
..to be consistent with the recently-added Questionnaire:
https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire-COVID-PublicHealthHistory
Observation.note to the Observation resourceObservation.encounter to the Observation resource