MedMij FHIR Implementation Guide BgZ

https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/
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MedMij FHIR Implementation Guide for exchanging patient summary (BgZ) information between personal...
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### Retrieve Immunization Recommendations

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This GET request fetches all ImmunizationRecommendation resources. These are used to represent planned immunizations.

```http
GET [base]/ImmunizationRecommendation

```

--------------------------------

### Search for Booked, Pending, or Proposed Appointments

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This GET request retrieves Appointment resources with statuses 'booked', 'pending', or 'proposed'. This is used for finding planned encounters.

```http
GET [base]/Appointment?status=booked,pending,proposed

```

--------------------------------

### Search for Active Procedure Requests

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This GET request retrieves all active ProcedureRequest resources. It is used to find planned medical procedures that are currently active.

```http
GET [base]/ProcedureRequest?status=active

```

--------------------------------

### Search for Medication Dispenses

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This GET request searches for medication dispensations categorized as 'dispensing' and in 'in-progress' or 'preparation' status, including the associated medication. This is relevant for planned medication administrations.

```http
GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication

```

--------------------------------

### Search for Active Device Requests

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This GET request retrieves all active DeviceRequest resources, including the associated device. This is used to represent planned medical device orders.

```http
GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device

```

--------------------------------

### Last N Observations Query Example

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

Demonstrates the concept of the $lastn operation in FHIR STU3 and R4 for retrieving the most recent observations for a patient. It highlights differences in sorting mechanisms and potential return variations based on observation codes.

```text
The $lastn query meets the common need for searching for the most recent or last n=number of observations for a subject. For example, retrieving the last 5 temperatures for a patient to view trends or fetching the most recent laboratory results or vital signs.
In FHIR R4, when using $lastn, the `effective[x]` element is used for sorting of Observations, sorted from most recent to the oldest.
The $lastn can actually return more than one Observation. This is due to the fact that queries with $lastn returns the last n Observations _after_ grouping by the value on `Observatin.code`.
```

--------------------------------

### Planned Care Activities

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This section outlines the FHIR resources used to represent various planned care activities, as the HCIM model's 'planned' status is not directly supported in FHIR.

```APIDOC
## Planned Care Activity FHIR Mappings

### Description
Planned care activities are mapped to specific FHIR resources to represent their planned status.

### Method
GET

### Endpoint
- `[base]/Appointment`
- `[base]/ProcedureRequest`
- `[base]/ImmunizationRecommendation`
- `[base]/DeviceRequest`

### Query Parameters
- `status` (string) - Required/Optional - The status of the resource (e.g., 'active', 'booked', 'pending', 'proposed', 'in-progress', 'preparation').
- `_include` (string) - Optional - Used to include related resources (e.g., `MedicationDispense:medication`, `DeviceRequest:device`).
- `category` (string) - Optional - Used for filtering, e.g., `http://snomed.info/sct|422037009` for MedicationDispense.

### Request Example
```json
GET [base]/ProcedureRequest?status=active
GET [base]/ImmunizationRecommendation
GET [base]/MedicationDispense?category=http://snomed.info/sct|422037009&status=in-progress,preparation&_include=MedicationDispense:medication
GET [base]/DeviceRequest?status=active&_include=DeviceRequest:device
GET [base]/Appointment?status=booked,pending,proposed
```

### Response
#### Success Response (200)
- The response will contain resources conforming to the specified FHIR profiles for each respective endpoint.

#### Response Example
(Response examples depend on the specific endpoint queried and data available.)
```

--------------------------------

### General Practitioner

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

Information regarding the representation of a patient's General Practitioner.

```APIDOC
## General Practitioner Resource

### Description
This entry refers to the `HealthProfessional` resource, which represents the General Practitioner of the patient.

### Method
See Patient Resource

### Endpoint
Refer to the documentation for the Patient resource.

### Notes
For details on how to search for or represent a General Practitioner, consult the specific documentation related to the Patient resource and its associated profiles.
```

--------------------------------

### The $lastn Operation

Source: https://informatiestandaarden.nictiz.nl/wiki/MedMij:V2020.01/FHIR_BGZ_2017

This operation allows for querying the last N observations for a subject, useful for trend analysis or retrieving the most recent data.

```APIDOC
## $lastn Operation for Observations

### Description
The `$lastn` operation retrieves the last 'n' observations for a given subject. It is particularly useful for analyzing trends or fetching the most recent data points like vital signs or lab results.

### Method
GET (as an operation on the Observation resource)

### Endpoint
`GET [base]/Observation/$lastn`

### Parameters
#### Query Parameters
- **_id** (string) - Required - The ID of the subject for whom to retrieve observations.
- **_count** (integer) - Required - The number 'n' of the most recent observations to retrieve.

#### Sorting Mechanism
- **FHIR R4:** Observations are sorted by the `effective[x]` element, from most recent to oldest.
- **FHIR STU3:** The sorting mechanism is less defined, but `effective[x]` is generally used.

### Considerations
- The `$lastn` operation may return more than 'n' observations if multiple observations share the same `Observation.code` and fall within the last 'n' after grouping. This is intended behavior for distinguishing different types of data (e.g., different body height measurements).

### Request Example
```json
GET [base]/Observation/$lastn?_id=patient-123&_count=5
```

### Response
#### Success Response (200)
- A Bundle containing the last 'n' Observation resources for the specified subject, sorted by `effective[x]`.

#### Response Example
```json
{
  "resourceType": "Bundle",
  "entry": [
    {
      "resourceType": "Observation",
      "id": "obs-101",
      "effectiveDateTime": "2023-10-27T10:00:00Z",
      "code": {
        "text": "Body Height"
      },
      "valueQuantity": {
        "value": 175,
        "unit": "cm"
      }
    },
    {
      "resourceType": "Observation",
      "id": "obs-100",
      "effectiveDateTime": "2023-10-26T10:00:00Z",
      "code": {
        "text": "Body Height"
      },
      "valueQuantity": {
        "value": 174,
        "unit": "cm"
      }
    }
  ]
}
```
```
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