Shared Care Planning (SCP) Implementation Guide
0.2.0 - ci-build
Shared Care Planning (SCP) Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
A cardiologist, Caroline van Dijk, from Hospital X diagnoses heart failure for patient Patrick Egger and explains about home monitoring at 'Medical service centre' (MSC). Caroline gets informed consent from Patrick to enroll him for home monitoring at MSC. Because Patrick gives informed consent for the enrollment, consent for the processing of the relevant data by MSC can be implied (implied consent).
Caroline makes a (service-)request for 'home monitoring' in the EHR. The diagnosis heart failure is linked to the request for context. Caroline clicks on the 'share request'-button to enroll Patrick.
A pop-up window appears. In this window, an existing multidisciplinary CarePlan could be selected from a dropdown menu. However, for Patrick there are no known Careplans, therefore Caroline can only pick 'create new Careplan' from the dropdown menu.
The pop-up window now displays questions to determine if the patient is eligible for telemonitoring treatment at MSC. Caroline checks with Patrick if: he has a smartphone, he reads email from his smartphone, he can install apps on his smartphone, he is proficient in Dutch language and that he is in possession of scales and a blood pressure meter. Caroline submits the answers.
In the background, the MSC checks the answers. If Patrick wouldn't be eligible for telemonitoring at the MSC, the request would be rejected here.
The pop-up window now displays questions for basic contact information on patient Patrick and cardiologist Caroline (e.g. name, telephone number and email address). This information has been auto-populated from the EHR. Caroline just has to check and submit.
In the background, the MSC checks the answers for completeness. The MSC automatically accepts the request and sends the patient an invite for a monitoring app.
The pop-up windows now responds that the MSC has accepted the request and has invited the patient to download a monitoring app. The telemonitoring request has been successfully assigned.
Caroline monitors the (shared) request in the EHR and sees that a few days later the status is updated to “in progress”, meaning that Patrick has downloaded and started to use the monitoring app.
Patients, healthcare organizations and healthcare professionals are identified using nationwide logical identifiers that are specific to the Netherlands.
According to Authentication, healthcare organizations and healthcare professionals are authenticated using Organization Credentials and PractitionerRole Credentials.
The NutsUraCredential (JSON-LD context) is a Verifiable Credential that contains the following properties:
The credential is to be issued by a party trusted in the particular SCP use case, as currently, there's no governing body that issues it. It can be represented in both JWT and JSON-LD format. The JSON-LD version of the credential can look as follows:
{
"@context": [
"https://www.w3.org/2018/credentials/v1",
"https://nuts.nl/credentials/2024"
],
"id": "did:web:ministryofhealth.example.com:issuer#1",
"type": ["VerifiableCredential", "NutsUraCredential"],
"issuer": "did:web:example.com:issuer#1",
"issuanceDate": "2024-01-01T00:00:00Z",
"expirationDate": "2025-01-01T00:00:00Z",
"credentialSubject": {
"id": "did:web:hospital.example.com:holder#1",
"organization": {
"ura": "3732",
"name": "Example Hospital",
"city": "Amsterdam"
}
}
}
This then translates to the following Organization resource:
{
"resourceType": "Organization",
"identifier": [
{
"system": "http://fhir.nl/fhir/NamingSystem/ura",
"value": "3732"
}
],
"name": "Example Hospital",
"address": [
{
"city": "Amsterdam"
}
]
}
This Organization resource can then be used for authorizing access to SCP services.
The NutsEmployeeCredential is specified in this RFC.
assumption no CarePlan was found (so no Task.basedOn), create a Bundle with a new Task and a copy of the referred ServiceRequest and Condition:
get the Task and referenced data
post bundle with new (sub-) task that contains a questionnaire
get sub-task and questionnaire
fill in QuestionnaireResponse and update the (sub-)Task
post bundle with new (sub-) task that contains a questionnaire
get sub-task and questionnaire
cUrl GET Questionnaire practitioner details from cps-base-url fill in QuestionnaireResponse and update the (sub-)Task