Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.5 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : Template for Remote Monitoring Heart Failure Care Plan - JSON Representation

Active as of 2023-07-25

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    {
      "resourceType" : "PlanDefinition",
      "id" : "RPMHeartFailureCarePlanTemplate",
      "language" : "en-NZ",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-NZ\" lang=\"en-NZ\">\n<div>\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">RPMHeartFailureCarePlanTemplate</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-RPMHeartFailureCarePlanTemplate.html\">Template for Remote Monitoring Heart Failure Care Plan</a></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.1.6</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\">\n                <b>\n                    \n                        Official\n                    \n                </b>\n            </th>\n            <td style=\"padding-left: 4px;\">\n                \n                <p style=\"margin-bottom: 5px;\">\n                    <span>RemoteMonitoringHeartFailureCarePlanTemplate</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Template for Remote Monitoring Heart Failure Care Plan</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Subtitle: </b></th>\n            <td style=\"padding-left: 4px;\">Care in the Community plans to handle heart failure patients remotely in an ongoing capacity</td>\n        </tr>\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">true</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>order-set</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Order Set</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Subject: </b></th>\n            \n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-resource-types.html\">http://hl7.org/fhir/resource-types</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>Patient</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Patient</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n            \n            \n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2023-07-25</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">Te Whatu Ora</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>This careplan designed to support ongoing monitoring of long term conditions (heart failure) in primary care.</p>\n</div></td>\n        </tr>\n        \n\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 4px;\">NZ</td>\n        </tr>\n        \n\n        \n            <tr>\n                <th scope=\"row\"><b>Topic: </b></th>\n                <td style=\"padding-left: 4px;\">treatment</td>\n            </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Purpose: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>This careplan designed to support ongoing monitoring of long term conditions (heart failure) in primary care</p>\n</div></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Usage: </b></th>\n            <td style=\"padding-left: 4px;\">Allows monitoring and tracking of progress of a self serve remote Heart failure patient.</td>\n        </tr>\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Effective Period: </b></th>\n            <td style=\"padding-left: 4px;\">2022-08-04..2023-08-04</td>\n        </tr>\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Actions: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    \n                    <tr>\n                        <td>\n                            \n                            Daily Survey to gather any symptoms experianced by a patient\n                            \n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>{{API_URL}}/Questionnaire?identifier=RemoteMonitoringHeartFailureSymptomSurveyQuestionnaire</code><br/>\n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            A weekly survey giving an opportunity for patients to provide feedback towards their experiance with the program\n                            \n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>{{API_URL}}/Questionnaire?identifier=RemoteMonitoringFeedbackSurveyQuestionnaire</code><br/>\n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b>3. Observation Activity:</b> Take an obervation\n                            \n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-RPMObservationRequest.html\">Vital Signs Observation Service Request</a><br/>\n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n    </table>\n</div>\n</div>"
      },
      "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/PlanDefinition/RemoteMonitoringHeartFailureCarePlanTemplate",
      "identifier" : [
        {
          "use" : "official",
          "value" : "RemoteMonitoringHeartFailureCarePlanTemplate"
        }
      ],
      "version" : "0.1.6",
      "name" : "RemoteMonitoringHeartFailureCarePlanTemplate",
      "title" : "Template for Remote Monitoring Heart Failure Care Plan",
      "subtitle" : "Care in the Community plans to handle heart failure patients remotely in an ongoing capacity",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
            "code" : "order-set",
            "display" : "Order Set"
          }
        ],
        "text" : "Order Set"
      },
      "status" : "active",
      "experimental" : true,
      "subjectCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/resource-types",
            "code" : "Patient",
            "display" : "Patient"
          }
        ],
        "text" : "Patient"
      },
      "date" : "2023-07-25",
      "publisher" : "Te Whatu Ora",
      "contact" : [
        {
          "name" : "Te Whatu Ora",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.tewhatuora.govt.nz/"
            }
          ]
        },
        {
          "name" : "Te Whatu Ora Integration Team",
          "telecom" : [
            {
              "system" : "email",
              "value" : "integration@tewhatuora.govt.nz",
              "use" : "work"
            }
          ]
        }
      ],
      "description" : "This careplan designed to support ongoing monitoring of long term conditions (heart failure) in primary care.",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "NZ",
              "display" : "New Zealand"
            }
          ]
        }
      ],
      "purpose" : "This careplan designed to support ongoing monitoring of long term conditions (heart failure) in primary care",
      "usage" : "Allows monitoring and tracking of progress of a self serve remote Heart failure patient.",
      "lastReviewDate" : "2022-08-04",
      "effectivePeriod" : {
        "start" : "2022-08-04",
        "end" : "2023-08-04"
      },
      "topic" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/definition-topic",
              "code" : "treatment",
              "display" : "Treatment"
            }
          ],
          "text" : "Treatment"
        }
      ],
      "author" : [
        {
          "name" : "HNZ RPM Project"
        }
      ],
      "editor" : [
        {
          "name" : "HNZ RPM Project"
        }
      ],
      "reviewer" : [
        {
          "name" : "HNZ RPM Project"
        }
      ],
      "endorser" : [
        {
          "name" : "Alastair Kenworthy",
          "telecom" : [
            {
              "system" : "other",
              "value" : "CinC Fit for Future Project"
            }
          ]
        }
      ],
      "goal" : [
        {
          "id" : "heart-failure-monitoring",
          "category" : {
            "text" : "Heart Failure Monitoring"
          },
          "description" : {
            "text" : "Activities in the Remote Monitoring Careplan for Cardiac Heart Failure are intended to support the person and whanau managing their heart failure through capturing and sharing information relating to their needs and experience, symptoms and observations. These activities are in alignment with the NZ Health pathways base heart failure pathway."
          },
          "priority" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
                "code" : "medium-priority",
                "display" : "Medium Priority"
              }
            ],
            "text" : "Medium Priority"
          },
          "start" : {
            "text" : "Assessed as suitable"
          }
        }
      ],
      "action" : [
        {
          "id" : "1",
          "prefix" : "1.",
          "title" : "Daily Symptom Survey",
          "description" : "Daily Symptom Survey",
          "textEquivalent" : "Daily Survey to gather any symptoms experianced by a patient",
          "priority" : "routine",
          "goalId" : [
            "heart-failure-monitoring"
          ],
          "subjectCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/resource-types",
                "code" : "Patient",
                "display" : "Patient"
              }
            ],
            "text" : "Patient"
          },
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/action-type",
                "code" : "create",
                "display" : "Create"
              }
            ],
            "text" : "Create"
          },
          "requiredBehavior" : "must",
          "precheckBehavior" : "yes",
          "cardinalityBehavior" : "multiple",
          "definitionCanonical" : "{{API_URL}}/Questionnaire?identifier=RemoteMonitoringHeartFailureSymptomSurveyQuestionnaire"
        },
        {
          "id" : "2",
          "prefix" : "2.",
          "title" : "Weekly Feedback Survey",
          "description" : "Weekly Feedback Survey",
          "textEquivalent" : "A weekly survey giving an opportunity for patients to provide feedback towards their experiance with the program",
          "priority" : "routine",
          "goalId" : [
            "heart-failure-monitoring"
          ],
          "subjectCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/resource-types",
                "code" : "Patient",
                "display" : "Patient"
              }
            ],
            "text" : "Patient"
          },
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/action-type",
                "code" : "create",
                "display" : "Create"
              }
            ],
            "text" : "Create"
          },
          "requiredBehavior" : "must",
          "precheckBehavior" : "yes",
          "cardinalityBehavior" : "multiple",
          "definitionCanonical" : "{{API_URL}}/Questionnaire?identifier=RemoteMonitoringFeedbackSurveyQuestionnaire"
        },
        {
          "id" : "3",
          "prefix" : "3.",
          "title" : "Observation Activity",
          "description" : "Take an obervation",
          "priority" : "routine",
          "goalId" : [
            "heart-failure-monitoring"
          ],
          "subjectCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/resource-types",
                "code" : "Patient",
                "display" : "Patient"
              }
            ],
            "text" : "Patient"
          },
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/action-type",
                "code" : "create",
                "display" : "Create"
              }
            ],
            "text" : "Create"
          },
          "requiredBehavior" : "must",
          "precheckBehavior" : "yes",
          "cardinalityBehavior" : "multiple",
          "definitionCanonical" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/ActivityDefinition/RemoteMonitoringObservationRequest"
        }
      ]
    }