Patient-v2.0.1(2015EN)

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General information

Name: nl.nfu.Patient NL.png
Version: 2.0.1
HCIM Status:Final
Release: 2015
Release status: Published
Release date: 1-4-2015


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Metadata

DCM::CoderList Kerngroep Registratie aan de Bron
DCM::ContactInformation.Address *
DCM::ContactInformation.Name *
DCM::ContactInformation.Telecom *
DCM::ContentAuthorList Projectgroep Generieke Overdrachtsgegevens & Kerngroep Registratie aan de Bron
DCM::CreationDate 14-6-2012
DCM::DeprecatedDate
DCM::DescriptionLanguage nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name NFU
DCM::EndorsingAuthority.Telecom
DCM::Id 2.16.840.1.113883.2.4.3.11.60.40.3.0.1
DCM::KeywordList Patient, zorgverlener, contact
DCM::LifecycleStatus Final
DCM::ModelerList Kerngroep Registratie aan de Bron
DCM::Name nl.nfu.Patient
DCM::PublicationDate 1-4-2015
DCM::PublicationStatus Published
DCM::ReviewerList Projectgroep Generieke Overdrachtsgegevens & Kerngroep Registratie aan de Bron
DCM::RevisionDate 22-5-2015
DCM::Superseeds
DCM::Version 2.0.1
HCIM::PublicationLanguage EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (15-02-2013) -

Publicatieversie 1.1 (01-07-2013)

ZIB-33 Wijzigingsverzoek betreffende Generieke Overdrachtsgegevens

Publicatieversie 2.0 (01-04-2015)

ZIB-62 commentaar op bouwsteen: nl.nfu.OverdrachtPatient?v1.1: dubbel id 0.1.33
ZIB-67 Wijzigingsverzoek Klinische Bouwsteen Patient document
ZIB-96 Cardinaliteit PatientIdentificatienummer in OverdrachtPatient anapassen naar 0..*
ZIB-97 Concept Voornamen opsplitsen in Voornamen en Initialen in OverdrachtPatient
ZIB-98 Achternaam en voorvoegsel als losse concepten uitwerken in OverdrachtPatient
ZIB-99 Example of the Instrument in OverdrachtPatient aanpassen qua naam Soort adres
ZIB-100 VIP indicator in OverdrachtPatient laten vervallen
ZIB-102 DCM::ExampleValue toevoegne bij concept MeerlingIndicator in OverdrachtPatient
ZIB-121 In de bouwsteen OverdrachtPatient het concept Aanhef laten vervallen.
ZIB-257 In de klinische bouwsteen OverdrachtPatient DCM::ValueSet Postcodetabel van concept Postcode aangepast naar tagged value DCM::CodeSystem.
ZIB-258 In de klinische bouwsteen OverdrachtPatient DCM::ValueSet GBA tabel 33 van concept Gemeente aangepast naar tagged value DCM::CodeSystem.
ZIB-259 In de klinische bouwsteen OverdrachtPatient DCM::ValueSet GBA Tabel 34 van concept Land aangepast naar tagged value DCM::CodeSystem GBA tabel 34 (Landentabel).
ZIB-260 In de klinische bouwsteen OverdrachtPatient DCM::ValueSet ISO 3166-2 van concept Land aangepast naar tagged value DCM::CodeSystem.
ZIB-261 In de klinische bouwsteen OverdrachtPatient DCM::ValueSet Burger Service Nummer van concept PatientIdentificatienummer aangepast naar tagged value DMC::AssigningAuthority.
ZIB-262 AdressoortCodelijst bevatte hoofdletter L, dit aangepast naar Codelijst.
ZIB-303 foutje in bouwsteen patient
ZIB-308 Prefix Overdracht weggehaald bij de generieke bouwstenen
ZIB-349 VIPIndicator uit bouwsteen OverdrachtPatient verwijderd
ZIB-350 Aanpassing concept namen in container Naamgegevens
ZIB-351 NaamgebruikCodelijst aangevuld met descriptions
ZIB-353 Tagged values DCM::CodeSystem aanpassen naar DCM::ValueSet incl. gekoppelde codelijst.

Incl. algemene wijzigingsverzoeken:

ZIB-94 Aanpassen tekst van Disclaimer, Terms of Use & Copyrights
ZIB-154 Consequenties opsplitsing Medicatie bouwstenen voor overige bouwstenen.
ZIB-200 Naamgeving SNOMED CT in tagged values klinische bouwstenen gelijk getrokken.
ZIB-201 Naamgeving OID: in tagged value notes van klinische bouwstenen gelijk getrokken.
ZIB-309 EOI aangepast
ZIB-324 Codelijsten Name en Description beginnen met een Hoofdletter
ZIB-326 Tekstuele aanpassingen conform de kwaliteitsreview kerngroep 2015

Publicatieversie 2.0.1 (22-05-2015)

ZIB-385 Inconsistent gebruik van de naam AdresSoortCodelijst.
ZIB-374 Het concept AanduidingBijHuisnummer is afgeleid van ST, maar heeft een valueset; dit zou CD moeten zijn.

Concept

A person who receives medical care.

Purpose

Recording relevant information to identify the patient for administrative purposes and process support.

Evidence Base

The name and address information is based on the information set of the Municipal Personal Records Database (GBA) and on the Dutch Implementation Guide: HL7v3 Basic Components.

The information for the legally required verification of a social security number provided by the SBV-Z also follows GBA specifications.

Furthermore, the AZR (AWBZ-wide healthcare registration) data set used in AWBZ healthcare served as a base in determining the set.

Use of patient and personal details must follow the Personal Data Protection Act. This law prohibits processing non-essential personal data and mandates decent and reasonable processing of obtained personal data (Kohnstamm, 2006). Patient data recorded in (electronic) patient records or in digital messages must be handled in the context of the Personal Data Protection Act. Furthermore, healthcare centers must meet the Information Security NEN 7510 standard. Observance of the PDPA is monitored by the Dutch Data Protection Authority (CBP). The CBP and the Healthcare Inspectorate (IGZ) are jointly responsible for monitoring information security in healthcare (CBP, IGZ, 2008).
For those reasons, some personal data, seen in some countries as administrative data, are not included in this building block but in the building blocks for the Social Anamnesis.

Information Model


#10759#10760#10756#10800#10762#GenderCodelist#10793#10764#10758#10769#10761Patient-v2.0.1Model(2015EN).png
#10775#10781#10782#10783#10780#NameUsageCodelist#10772#10778#10770#10779#10774#10769Naamgegevens-v2.0.1Model(2015EN).png
#CountryGBACodelist#CountryISOCodelist#HouseNumberIndicationCodelist#10787#10792#10791#10786#AddressTypeCodelist#10790#10788#10784#10796#10795#10797#10785#10793Adresgegevens-v2.0.1Model(2015EN).png
#EmailAddressTypeCodelist#NumberTypeCodelist#10803#10805#10802#10804#10798#10806#10800Contactgegevens-v2.0.1Model(2015EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:0.1.1 Arrowdown.pngPatient Root concept of the Patient building block. This root concept contains all data elements of the Patient building block.
Folder.png NL-CM:0.1.5 Arrowdown.pngContactInformation 0..1 Container of the ContactInformation concept. This container contains all data elements of the ContactInformation concept.
Folder.png NL-CM:0.1.21 Arrowdown.pngTelephoneNumbers 0..* Container of the TelephoneNumbers concept. This container contains all data elements of the TelephoneNumbers concept.
ST.png NL-CM:0.1.23 Arrowright.pngTelephoneNumber 1 The patient’s telephone number.
CD.png NL-CM:0.1.22 Arrowright.pngNumberType 1 NumberType indicates whether the number is a landline, temporary, work or mobile telephone number.
List2.png NumberTypeCodelist
Folder.png NL-CM:0.1.18 Arrowdown.pngEmailAddresses 0..* Container of the E-mailAddresses concept. This container contains all data elements of the E-mailAddresses concept.
ST.png NL-CM:0.1.20 Arrowright.pngEmailAddress 1 The patient’s e-mail address
CD.png NL-CM:0.1.19 Arrowright.pngEmailAddressType 1 E-mailAddressType indicates whether it is a private or business e-mail address.
List2.png EmailAddressTypeCodelist
Folder.png NL-CM:0.1.4 Arrowdown.pngAddressInformation 0..* Container of the AddressInformation concept. This container contains all data elements of the AddressInformation concept.
ST.png NL-CM:0.1.12 Arrowright.pngStreet 0..1 Street name of the address.
ST.png NL-CM:0.1.13 Arrowright.pngHouseNumber 0..1 House number of the address.
ST.png NL-CM:0.1.40 Arrowright.pngHouseNumberLetter 0..1 A letter following the house number as assigned by the municipal authorities.
ST.png NL-CM:0.1.41 Arrowright.pngHouseNumberAddition 0..1 The letters or signs needed to locate the mailbox, in addition to the house number and letter.
CD.png NL-CM:0.1.42 Arrowright.pngHouseNumberIndication 0..1 The indication used for addresses which do not consist of the usual street name and house number.
List2.png HouseNumberIndicationCodelist
ST.png NL-CM:0.1.15 Arrowright.pngPostcode 0..1 Postcode of the address.

In Dutch addresses, preferably use the postcode from the Postcode table (OID: 2.16.840.1.113883.2.4.4.15).

ST.png NL-CM:0.1.14 Arrowright.pngPlaceOfResidence 0..1 A geographically determined area which forms part of the municipal area.

For Dutch places of residence, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

ST.png NL-CM:0.1.16 Arrowright.pngMunicipality 0..1 Municipality of residence.

For Dutch municipalities, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

CD.png NL-CM:0.1.17 Arrowright.pngCountry 0..1 Country in which the address is located.
List2.png CountryGBACodelist
List2.png CountryISOCodelist
ST.png NL-CM:0.1.28 Arrowright.pngAdditionalInformation 0..1 Extra information such as the building name, building number, entrance, route number.
CD.png NL-CM:0.1.11 Arrowright.pngAddressType 1 The type of address in question, such as a home address or mailing address.
List2.png AddressTypeCodelist
Folder.png NL-CM:0.1.6 Arrowdown.pngNameInformation 1 Container of the NameInformation concept. This container contains all data elements of the NameInformation concept.
ST.png NL-CM:0.1.26 Arrowright.pngFirstNames 0..1 The person’s official first names.
ST.png NL-CM:0.1.35 Arrowright.pngInitials 0..1 The person’s initials.
ST.png NL-CM:0.1.27 Arrowright.pngGivenName 0..1 The name normally used to address the person.
CD.png NL-CM:0.1.34 Arrowright.pngNameUsage 0..1 This concept indicates the last name or order of last names with which the person is to be addressed.
List2.png NameUsageCodelist
Folder.png NL-CM:0.1.36 Arrowdown.pngLastName 0..1 Container of the LastName concept. This container contains all data elements of the LastName concept.
ST.png NL-CM:0.1.38 Arrowright.pngPrefix 0..1 Prefix to the person’s own last name.
ST.png NL-CM:0.1.24 Arrowright.pngLastName 1 Last name, given at birth.
Folder.png NL-CM:0.1.37 Arrowdown.pngLastNamePartner 0..1 Container of the LastNamePartner concept. This container contains all data elements of the LastNamePartner concept.
ST.png NL-CM:0.1.39 Arrowright.pngPartnerPrefix 0..1 Prefix to the partner’s last name.
ST.png NL-CM:0.1.25 Arrowright.pngPartnerLastName 1 Partner’s last name, given at birth.
II.png NL-CM:0.1.7 Arrowright.pngPatientIdentificationNumber 0..* The patient’s identification number. In transfer situations, use of the social security number (BSN) must comply with the Use of Social Security Numbers in Healthcare Act (Wbsn-z). In other situations, other number systems can be used, such as internal hospital patient numbers for example.
AA2.png Burgerservicenummer
TS.png NL-CM:0.1.10 Arrowright.pngDateOfBirth 1 Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted.
184099003 Date of birth
CD.png NL-CM:0.1.9 Arrowright.pngGender 1 Patient’s administrative gender.
263495000 Gender
List2.png GenderCodelist
BL.png NL-CM:0.1.31 Arrowright.pngMultipleBirthIndicator 0..1 An indication stating whether the patient is of a multiple birth.
BL.png NL-CM:0.1.32 Arrowright.pngDeathIndicator 0..1 An indication stating whether the patient has died.
TS.png NL-CM:0.1.33 Arrowright.pngDateOfDeath 0..1 The date on which the patient died. A ‘vague’ date, such as only the year, is permitted.

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page List2.png

Example Instances

Only available in Dutch

Patiënt  
Naamgegevens  
PatiëntIdentificatienummer 111222333
Achternaam Putten
Voorvoegsels van
AchternaamPartner Giessen
VoorvoegselsPartner van der
Voornamen Johanna Petronella Maria
Initialen J.P.M.
Roepnaam Jo
Geslacht Vrouw
Geboortedatum 28-04-1934
MeerlingIndicator Ja
OverlijdensIndicator Nee
DatumOverlijden
Adresgegevens*  
Straat 1e Jacob van Campenstr
Huisnummer 15
Woonplaats Hoogmade
Gemeente Kaag en Braassem
Postcode 1012 NX
AdresSoort Woon-/verblijfadres
Land Nederland
Adresgegevens*  
Straat Stationsstraat
Huisnummer 11
Woonplaats Alphen aan den Rijn
Gemeente
Postcode 2406 AB
AdresSoort Officieel adres
Land
Telefoonnummers*  
Telefoonnummer +31611234567
NummerSoort Mobiel telefoonnummer
EmailAdressen*  
EmailAdres giesput@myweb.nl
EmailSoort Privé e-mailadres

Instructions

If both a name and an identification number are given, the name must match the name registered under that identification number, for verification purposes.

References

1. DCM Patientgegevens V0.91. [Online] Beschikbaar op: http://www.nictiz.nl/uploaded/FILES/htmlcontent/dcm/Nictiz/DCMPatientgegevens_V_0.91loNL.pdf [Geraadpleegd: 23 februari 2015].

2. Implementatiehandleiding HL7v3 Basiscomponenten, Stichting HL7 Nederland [Online] Beschikbaar op:http://www.hl7.nl/images/downloads/Implementatiehandleiding%20HL7v3%20Basiscomponenten%20%202.3NL_secure.pdf [Geraadpleegd: 23 februari 2015].

Assigning authorities

The identifying numbers are issued by the following authorities

Burgerservicenummer

Identifying number ID system OID
Burgerservicenummer OID: 2.16.840.1.113883.2.4.6.3

Valuesets

AddressTypeCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.2 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Postal Addres PST AddressUse 2.16.840.1.113883.5.1119 Postadres
Primary Home HP AddressUse 2.16.840.1.113883.5.1119 Officieel adres
Visit Address PHYS AddressUse 2.16.840.1.113883.5.1119 Woon-/verblijfadres
Tempory Address TMP AddressUse 2.16.840.1.113883.5.1119 Tijdelijk adres
Work Place WP AddressUse 2.16.840.1.113883.5.1119 Werkadres
Vacation Home HV AddressUse 2.16.840.1.113883.5.1119 Vakantie adres

CountryGBACodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.9 Binding:
Conceptname Codesystem name Codesystem OID
Alle waarden GBA Tabel 34 (Landentabel) 2.16.840.1.113883.2.4.4.16.34

CountryISOCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.8 Binding:
Conceptname Codesystem name Codesystem OID
Alle waarden ISO 3166-1 (alpha-2) 1.0.3166.1.2.2

EmailAddressTypeCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.4 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Primary Home HP AddressUse 2.16.840.1.113883.5.1119 Privé e-mailadres
Work Place WP AddressUse 2.16.840.1.113883.5.1119 Zakelijk e-mailadres

GenderCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Undifferentiated UN AdministrativeGender 2.16.840.1.113883.5.1 Ongedifferentieerd
Male M AdministrativeGender 2.16.840.1.113883.5.1 Man
Female F AdministrativeGender 2.16.840.1.113883.5.1 Vrouw
Unknown UNK NullFlavors 2.16.840.1.113883.5.1008 Onbekend

HouseNumberIndicationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.7 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Tegenover to AanduidingBijHuisnummer 2.16.840.1.113883.2.4.3.11.60.101.5.3 Tegenover
Bij by AanduidingBijHuisnummer 2.16.840.1.113883.2.4.3.11.60.101.5.3 Bij

NameUsageCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.6 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Eigen geslachtsnaam NL1 NaamGebruik 2.16.840.1.113883.2.4.3.11.60.101.5.4 Eigen geslachtsnaam
Geslachtsnaam partner NL2 NaamGebruik 2.16.840.1.113883.2.4.3.11.60.101.5.4 Geslachtsnaam partner
Geslachtsnaam partner gevolgd door eigen geslachtsnaam NL3 NaamGebruik 2.16.840.1.113883.2.4.3.11.60.101.5.4 Geslachtsnaam partner gevolgd door eigen geslachtsnaam
Eigen geslachtsnaam gevolgd door geslachtsnaam partner NL4 NaamGebruik 2.16.840.1.113883.2.4.3.11.60.101.5.4 Eigen geslachtsnaam gevolgd door geslachtsnaam partner
Unknown UNK NullFlavors 2.16.840.1.113883.5.1008 Onbekend

NumberTypeCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.0.1.3 Binding:
Conceptname Conceptcode Codesystem name Codesystem OID Description
Primary Home HP AddressUse 2.16.840.1.113883.5.1119 Telefoonnummer thuis
Tempory Address TMP AddressUse 2.16.840.1.113883.5.1119 Tijdelijk telefoonnummer
Work Place WP AddressUse 2.16.840.1.113883.5.1119 Zakelijk telefoonnummer
Mobile Contact MC AddressUse 2.16.840.1.113883.5.1119 Mobiel telefoonnummer
Pager PG AddressUse 2.16.840.1.113883.5.1119 Pieper

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Information model references

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Technical specifications in HL7v3 CDA and HL7 FHIR

To exchange information based on health and care information models, additional, more technical specifications are required.
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:

  • HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment Artdecor.jpg
  • HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR Fhir.png

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This information model is also available as pdf file PDF.png or as spreadsheet Xlsx.png

About this information

The information in this wikipage is based on Registratie aan de bron publication 2015 including errata dd. 16-07-2015
Conditions for use are located on the mainpage List2.png
This page is generated on 24/12/2018 12:31:38 with ZibExtraction v. 3.0.6932.1989


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