BSeR FHIR IG

BSeR Referral Feedback Supporting Bundle

The Referral Feedback Supporting Bundle is a collection of relevant clinical items provided as supporting information for the referral Feedback by the Referral Recipient. The clinical items included in an instance of this bundle vary by program area. The entries in this bundle are mutually exclusive program-specific clinical item bundles.

The base definition for this resource profile is the FHIR STU3 Bundle.

UML Expression

BSeR Referral Feedback Profile Bundles.jpg

Structure Definition Tree

Bundle		Bundle	There are no (further) constraints on this element Element id Bundle Data type Bundle
type	1..1		There are no (further) constraints on this element Element id type Short description type Definition SHALL contain exactly one [1..1] type (CONF:4383-548).
entry			There are no (further) constraints on this element Element id Bundle.entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-547) such that it Sliced: Unordered, Open, by resource(Value)
Obesity	1..1		There are no (further) constraints on this element Element id Bundle.entry:Obesity Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-542) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Obesity.resource Short description Obesity Definition SHALL contain exactly one [1..1] resource (CONF:4383-549). Data type Bundle
Arthritis	1..1		There are no (further) constraints on this element Element id Bundle.entry:Arthritis Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-543) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Arthritis.resource Short description Arthritis Definition SHALL contain exactly one [1..1] resource (CONF:4383-550). Data type Bundle
Hypertension	1..1		There are no (further) constraints on this element Element id Bundle.entry:Hypertension Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-544) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Hypertension.resource Short description Hypertension Definition SHALL contain exactly one [1..1] resource (CONF:4383-551). Data type Bundle
Nutrition	1..1		There are no (further) constraints on this element Element id Bundle.entry:Nutrition Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-545) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Nutrition.resource Short description Early Childhood Nutrition Definition SHALL contain exactly one [1..1] resource (CONF:4383-552). Data type Bundle
Diabetes	1..1		There are no (further) constraints on this element Element id Bundle.entry:Diabetes Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-546) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Diabetes.resource Short description Diabetes Prevention Definition SHALL contain exactly one [1..1] resource (CONF:4383-553). Data type Bundle
Tobacco	1..1		There are no (further) constraints on this element Element id Bundle.entry:Tobacco Short description entry Definition SHOULD contain exactly one [1..1] entry (CONF:4383-547) such that it
resource	1..1	Bundle	There are no (further) constraints on this element Element id Bundle.entry:Tobacco.resource Short description Tobacco Cessation Definition SHALL contain exactly one [1..1] resource (CONF:4383-554). Data type Bundle

Profile Structure

Bundle		..
Bundle.type		1..1
Bundle.entry		..
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1
Bundle.entry		1..1
Bundle.entry.resource	Bundle	1..1

Example Referral Request Bundle

The following is an example of a rerral request bundle

<Bundle xmlns="http://hl7.org/fhir">
    <id value="DiabetesFeedbackReferralResponseBundle" />
    <meta>
        <versionId value="2" />
        <lastUpdated value="2019-01-13T16:53:12.000+00:00" />
        <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/DiabetesPreventionReferralfeedbackMessageBundle" />
    </meta>
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:337e22ab-0ced-480a-9be7-450094e7267c" />
        <resource>
            <MessageHeader>
                <event>
                    <system value="http://loinc.org" />
                    <code value="TBD4" />
                    <display value="Referral Feedback" />
                </event>
                <receiver>
                    <extension url="https://eip-fhir.experimental.aimsplatform.com/hapi-fhir/baseDstu3/StructureDefinition/Practioner-Role">
                        <valueReference>
                            <reference value="urn:uuid:538791da-3555-460e-9e7f-76d25988a546" />
                        </valueReference>
                    </extension>
                    <reference value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
                </receiver>
                <sender>
                    <extension url="http://expample.org/practitioner-role">
                        <valueReference>
                            <reference value="urn:uuid:ffa2bf53-ee09-43a1-b11a-73ed0f1cd73b" />
                        </valueReference>
                    </extension>
                    <reference value="urn:uuid:421269ad-abef-49bc-8cac-d3a5d4b00299" />
                </sender>
                <timestamp value="2019-01-11T07:05:11Z" />
                <source>
                    <name value="RedCap" />
                    <endpoint value="https://YMCAsandbox.RedCap.com:9443/demoAPIServer" />
                </source>
                <reason>
                    <coding>
                        <system value="https://www.hl7.org/fhir/valueset-message-reason-encounter" />
                        <code value="interim feedback report" />
                        <display value="interim feedback report" />
                    </coding>
                </reason>
                <focus>
                    <reference value="urn:uuid:6b2fd643-a3b1-47af-bbce-027103ed3c1d" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:6b2fd643-a3b1-47af-bbce-027103ed3c1d" />
        <resource>
            <Composition>
                <identifier>
                    <system value="urn:oid:1.3.6.1.4.1.26580.190.12457709" />
                    <value value="1234561" />
                </identifier>
                <status value="final" />
                <type>
                    <coding>
                        <system value="http://hl7.org/fhir/v3/NullFlavor" />
                        <code value="UNC" />
                        <display value="Referral Feedback" />
                    </coding>
                </type>
                <subject>
                    <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                </subject>
                <date value="2019-01-11" />
                <author>
                    <!-- This should be the practitioner who recived ther request -->
                    <reference value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
                </author>
                <title value="Interim Referral Feedback Report" />
                <section>
                    <title value="Interim Feedback Supporting Information" />
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="InterimFeedbackSupportingInformation" />
                        </coding>
                    </code>
                    <text>
                        <status value="additional" />
                        <div xmlns="http://www.w3.org/1999/xhtml">
                     This is where the referral feedback note goes. The content of text can be expressed in plain text or make use of xhtml formatting tags.
                  </div>
                    </text>
                    <entry>
                        <!--  FeedbackReferralStatusObservation Instance Example -->
                        <reference value="urn:uuid:91a42efb-ddaf-4cbe-8fa4-7ead01d05fb6" />
                    </entry>
                </section>
                <section>
                    <title value="Referral Feedback Supporting Bundle" />
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="ReferralFeedbackSupportingBundle" />
                        </coding>
                    </code>
                    <entry>
                        <reference value="urn:uuid:34cfcf90-3c83-4886-a68c-acc73ac64f07" />
                    </entry>
                </section>
            </Composition>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:91a42efb-ddaf-4cbe-8fa4-7ead01d05fb6" />
        <resource>
            <Observation>
                <status value="final" />
                <code>
                    <coding>
                        <system value="http://hl7.org/fhir/v3/NullFlavor" />
                        <code value="UNC" />
                        <display value="Feedback Referral Status Observation" />
                    </coding>
                </code>
                <component>
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Referral Activity Status" />
                        </coding>
                    </code>
                    <valueCodeableConcept>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Intake Completed" />
                        </coding>
                    </valueCodeableConcept>
                </component>
                <component>
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Referral Activity Status Reason" />
                        </coding>
                    </code>
                    <valueCodeableConcept>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Patient met all intake requirements" />
                        </coding>
                    </valueCodeableConcept>
                </component>
                <component>
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Referral Type" />
                        </coding>
                    </code>
                    <valueCodeableConcept>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Diabetes" />
                        </coding>
                    </valueCodeableConcept>
                </component>
                <component>
                    <code>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Referral Status" />
                        </coding>
                    </code>
                    <valueCodeableConcept>
                        <coding>
                            <system value="http://hl7.org/fhir/v3/NullFlavor" />
                            <code value="UNC" />
                            <display value="Active" />
                        </coding>
                    </valueCodeableConcept>
                </component>
                <component>
                    <!--  Better represented by a Procedure resource instance that is referenced elsewhere  -->
                    <!-- 
                    <coding>
                        <system value="http://hl7.org/fhir/observation-category"/>
                        <code value="procedure"/>
                        <display value="Procedure"/>
                  </coding> 
                   -->
                    <code>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="298057009" />
                            <display value="Number of Appointments Attended" />
                        </coding>
                    </code>
                    <!--  Added valueQuantity showing 3 appointments  -->
                    <valueQuantity>
                        <value value="3" />
                        <unit value="1" />
                    </valueQuantity>
                </component>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
        <resource>
            <Patient>
                <id value="cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/PatientRole" />
                </meta>
                <identifier>
                    <type>
                        <coding>
                            <system value="http://hl7.org/fhir/v2/0203" />
                            <code value="MR" />
                            <display value="Medical Record Number" />
                        </coding>
                    </type>
                    <system value="urn:oid:2.16.840.1.113883.4.3.17" />
                    <value value="F255-9215-0094" />
                </identifier>
                <name>
                    <use value="official" />
                    <family value="Beal" />
                    <given value="Bradley" />
                </name>
                <telecom>
                    <system value="phone" />
                    <value value="(999) 607-2500" />
                </telecom>
                <gender value="male" />
                <birthDate value="1950-03-22" />
                <address>
                    <line value="609 Lizeth Streets" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60609" />
                </address>
                <communication>
                    <language>
                        <coding>
                            <system value="urn:ietf:bcp:47" />
                            <code value="en-US" />
                            <display value="English (United States)" />
                        </coding>
                    </language>
                    <preferred value="true" />
                </communication>
            </Patient>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:34cfcf90-3c83-4886-a68c-acc73ac64f07" />
        <!--  DiabetesFeedbackSupportBundleInstanceExample  -->
        <resource>
            <Bundle>
                <type value="collection" />
                <entry>
                    <fullUrl value="urn:uuid:70a5b9d0-3153-45cb-adce-672edeace7c2" />
                    <resource>
                        <Observation>
                            <id value="70a5b9d0-3153-45cb-adce-672edeace7c2" />
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="39156-5" />
                                    <display value="Body mass index (BMI) [Ratio]" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2019-01-11" />
                            <valueQuantity>
                                <value value="29.9" />
                                <unit value="kg/m2" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="kg/m2" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:30bcd878-ce0a-4558-95a4-365287155895" />
                    <resource>
                        <Observation>
                            <id value="30bcd878-ce0a-4558-95a4-365287155895" />
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="29463-7" />
                                    <display value="Body Weight" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2019-01-11" />
                            <valueQuantity>
                                <value value="100" />
                                <unit value="kg" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="kg" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:9c332515-b833-4529-975b-3007578dc4cd" />
                    <resource>
                        <Observation>
                            <id value="9c332515-b833-4529-975b-3007578dc4cd" />
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="4548-4" />
                                    <display value="Hemoglobin A1c/Hemoglobin.total in Blood" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2019-01-11" />
                            <valueQuantity>
                                <value value="123" />
                                <unit value="mg/dL" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="mg/dL" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:ac1199e5-d0dc-4294-ba66-37628bc45654" />
                    <resource>
                        <Observation>
                            <id value="ac1199e5-d0dc-4294-ba66-37628bc45654" />
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="8302-2" />
                                    <display value="Body height" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2018-12-11" />
                            <valueQuantity>
                                <value value="182.88" />
                                <unit value="cm" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="cm" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
            </Bundle>
        </resource>
    </entry>
</Bundle>