FHIR Implementation Guide for Stroke
0.0.0 - ballot

FHIR Implementation Guide for Stroke - Local Development build (v0.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Questionnaires

These define forms used by systems conforming to this implementation guide to capture or expose data to end users.

Clinical Response Questionnaire 01 - Baseline

This questionnaire is meant to assess the clinical response in stroke patients at the initial point of assessment, which would be the first doctor’s visit.

Clinical Response Questionnaire 02 - Discharge or 7 days post admission

This questionnaire is meant to assess the clinical response in stroke patients at the patient discharge or 7 days post admission, whichever comes first.

Clinical Response Questionnaire 03 - 90 days post admission

This questionnaire is meant to assess the clinical response in stroke patients at 90 days post admission.

Clinical Response Questionnaire 04 - Annual Follow-up

This questionnaire is meant to assess the clinical response in stroke patients at annual follow-up, from 1 year to 5 years post admission.

Patient Reported Questionnaire 01 - Baseline

This questionnaire is designed to assess the patient-reported response in stroke patients at the initial point of assessment.

Patient Reported Questionnaire 02 - Discharge or 7 days post admission

This questionnaire is designed to assess the patient-reported response in stroke at the patient discharge or 7 days post admission, whichever comes first.

Patient Reported Questionnaire 03 - 90 days post admission

This questionnaire is designed to assess the patient-reported response in stroke at 90 days post admission.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Cardiovascular Comorbidities

Indicate which comorbidities the patient is living with.

Diagnosis Evidence Base

Indicate how the diagnosis was made.

Discharge Destination Following Acute Care Hospitalization

Indicate the patient’s discharge destination from acute care hospital.

Duration of Stroke Symptoms

Indicate the duration of the stroke symptoms measured on hospital arrival.

Estimated Stroke Severity: based on NIHSS Category

Indicate the estimated stroke severity category by the NIH Stroke Scale (NIHSS).

Healthcare Facility based on the Brazilian RNDS

The Organization Profile encompasses all healthcare institutions related to stroke care, based on the Brazilian National Data Network (RNDS).

Hemicraniectomy

Indicate if the patient underwent hemicraniectomy.

Inpatient Acute Care Rehabilitation

Indicate whether there is dedicated stroke rehabilitation during acute care.

Post Acute Care Rehabilitation

Indicate whether there is dedicated stroke rehabilitation during post-acute care, either hospital based or out patient/home based.

Prior Atrial Fibrillation and Flutter

Indicate whether the person has ever been diagnosed with atrial fibrillation and flutter.

Prior Diabetes Mellitus

Indicate if the patient has a documented history of diabetes mellitus (regardless of duration of disease or need for anti-diabetic agents).

Prior Hyperlipidemia

Indicate whether the patient has ever been diagnosed with hyperlipidemia.

Prior Hypertension

Indicate whether the patient has a documented history of hypertension, diagnosed and treated with medication and/or diet and/or exercise.

Prior Ischemic Heart Disease

Indicate whether the patient has ever been diagnosed with ischemic heart disease (including myocardial infarction).

Prior Myocardial Infarction

Indicate whether the patient has a documented history of myocardial infarction.

Prior Stroke excluding Transient Ischemic Attacks

Indicate whether the patient was ever diagnosed with a stroke (excluding transient ischemic attacks).

Prior Transient Ischemic Attacks

Indicate whether the patient was ever diagnosed with a Transient Ischemic Attacks.

Procoagulant Reversal Therapy

Indicate if the patient received procoagulant reversal therapy.

Stroke Patient based on the Brazilian RNDS

This profile stores demographics and other administrative information about a patient with stroke, based on the Brazilian National Data Network (RNDS).

Stroke Practitioner based on Brazilian RNDS

This profile encompasses all health professionals involved in the healthcare process and related health services as part of their formal responsibilities, conforming to the standards of the Brazilian National Data Network (RNDS).

Stroke Recurrence.

Indicate if the patient had a new stroke within 90 days of their first stroke occurrence.

Stroke Severity: Consciousness

Indicate the patient’s level of consciousness measured on hospital arrival.

Stroke Severity: NIHSS Score

Indicate the stroke severity as measured by the NIH Stroke Scale (NIHSS). Report the raw (uncategorized) NIHSS score.

Stroke Type

Indicate Stroke Type.

Symptomatic Intracranial Hemorrhage

Indicate if the patient developed symptomatic intracerebral hemorrhage after treatment of ischemic stroke with intravenous thrombolysis and/or thrombectomy.

Thrombectomy

Indicate if the patient underwent thrombectomy.

Thrombolytic Therapy

Indicate if the patient received intravenous thrombolytic therapy.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Ethnicity

Extension to capture the patient’s ethnicity which represents their cultural background or heritage.

Gender Identity

Extension of the patient’s gender.

Race

Extension that represents the race of a patient.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Cardiovascular Comorbidities

Valueset that indicate which comorbidities the patient is living with. Select all conditions that apply.

Diagnostic Evidence Base

ValueSet that indicates which diagnostic evidence base was used for its realization

Discharge Location

ValueSet about discharge destination following acute care hospitalization. What type of place was the patient discharged to?

Duration of Stroke Symptoms

ValueSet that categorizes the duration of stroke symptoms, considering the time from symptom onset to admission at the reference hospital.

Estimated stroke severity using the NIHSS.

ValueSet that intended to categorize the severity of the stroke based on the National Institutes of Health Stroke Scale (NIHSS).

Gender Identity

ValueSet for Gender Identity based on LOINC.

Live Alone Pre-Stroke

ValueSet indicating whether a patient lived alone prior to a stroke event based on ICHOM terminology.

PROMIS-10 Response Questionnaire

ValueSet that defines the response values for the PROMIS-10 (Patient-Reported Outcomes Measurement Information System 10-item short form) Questionnaire.

Patient's Residence Post to a Stroke

ValueSet that represents the patient’s most recent place of residence after the occurrence of a stroke based on ICHOM code.

Patient's Residence Prior to a Stroke

ValueSet that represents the patient’s most recent place of residence before the occurrence of a stroke based on ICHOM code.

Prestroke and Poststroke Functional Status: Ambulation

ValueSet that defines the response values for the Prestroke and Poststroke Functional Status: Ambulation.

Prestroke and Poststroke Functional Status: Dressing

ValueSet that defines the response values for the Prestroke and Poststroke Functional Status: Dressing.

Prestroke and Poststroke Functional Status: Toileting

ValueSet that defines the response values for the Prestroke and Poststroke Functional Status: Toileting.

Simplified modified Ranking Scale questionnaire (SMRSq)

ValueSet that defines the response values for the simplified modified Ranking Scale questionnaire.

Smoking Status

ValueSet for Smoking Status. A person’s current and past smoking behavior.

State of Consciousness.

ValueSet based on the ICHOM standard that indicates the patient’s state of consciousness as measured upon arrival at the reference hospital.

Stroke type based on ICHOM

ValueSet that aims to categorize the stroke type according to the ICHOM standard.

Yes, No and Unknown

ValueSet with responses Yes, No, and Unknown

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Cardiovascular Comorbidities

CodeSystem that indicate which comorbidities the patient is living with. Select all conditions that apply.

Diagnostic Evidence Base

CodeSystem that indicates which diagnostic evidence base was used for its realization

Discharge Location

CodeSystem about Discharge destination following acute care hospitalization. What type of place was the patient discharged to?

Duration of Stroke Symptoms

CodeSystem that categorizes the duration of stroke symptoms, considering the time from symptom onset to admission at the reference hospital.

Estimated stroke severity using the NIHSS.

CodeSystem that intends to categorize the severity of the stroke based on the National Institutes of Health Stroke Scale (NIHSS).

Live Alone Pre-Stroke

CodeSystem indicating whether a patient lived alone prior to a stroke event based on ICHOM terminology.

PROMIS-10 Response Questionnaire

CodeSystem that defines the response values for the PROMIS-10 (Patient-Reported Outcomes Measurement Information System 10-item short form) Questionnaire.

Patient's Residence Post to a Stroke

CodeSystem that represents the patient’s most recent place of residence after the occurrence of a stroke based on ICHOM code.

Patient's Residence Prior to a Stroke

CodeSystem that represents the patient’s most recent place of residence before the occurrence of a stroke based on ICHOM code.

Prestroke and Poststroke Functional Status

CodeSystem that defines the response values for the Prestroke and Poststroke Functional Status.

Simplified Modified Ranking Scale questionnaire (sMRSq)

CodeSystem that defines the response values for the simplified modified Ranking Scale questionnaire (sMRSq).

Smoking Status

CodeSystem for Smoking Status. A person’s current and past smoking behavior.

State of Consciousness according to the ICHOM standard

CodeSystem based on the ICHOM standard that indicates the patient’s state of consciousness as measured upon arrival at the reference hospital.

Stroke Type

CodeSystem that aims to categorize the stroke type according to the ICHOM standard.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Cardiovascular Comorbidities

Example of Cardiovascular Comorbidities. Indicate which comorbidities the patient is living with.

Diagnosis Evidence Base

Example of Diagnosis Evidence Base. Indicate how the diagnosis was made.

Discharge Destination Following Acute Care Hospitalization

Example of Discharge Destination Following Acute Care Hospitalization. Indicate the patient’s discharge destination from acute care hospital.

Duration of Stroke Symptoms

Example of Duration of Stroke Symptoms. Indicate the duration of the stroke symptoms measured on hospital arrival.

Estimated Stroke Severity: based on NIHSS Category

Example of Estimated Stroke Severity: based on NIHSS Category. Indicate the estimated stroke severity category by the NIH Stroke Scale (NIHSS).

Healthcare Facility

Example of Healthcare Facility related to stroke care, based on the Brazilian National Data Network (RNDS).

Hemicraniectomy

Example of Hemicraniectomy. Indicate if the patient underwent hemicraniectomy.

Inpatient Acute Care Rehabilitation

Example of Inpatient Acute Care Rehabilitation. Indicate whether there is dedicated stroke rehabilitation during acute care.

Post Acute Care Rehabilitation

Example of Post Acute Care Rehabilitation. Indicate whether there is dedicated stroke rehabilitation during post-acute care, either hospital based or out patient/home based.

Prior Atrial Fibrillation and Flutter

Example of Prior Atrial Fibrillation and Flutter. Indicate whether the person has ever been diagnosed with atrial fibrillation and flutter.

Prior Diabetes Mellitus

Example of Prior Diabetes Mellitus. Indicate if the patient has a documented history of diabetes mellitus (regardless of duration of disease or need for anti-diabetic agents).

Prior Hyperlipidemia

Example of Prior Hyperlipidemia. Indicate whether the patient has ever been diagnosed with hyperlipidemia.

Prior Hypertension

Example of Prior Hypertension. Indicate whether the patient has a documented history of hypertension, diagnosed and treated with medication and/or diet and/or exercise.

Prior Ischemic Heart Disease

Example of Prior Ischemic Heart Disease. Indicate whether the patient has ever been diagnosed with ischemic heart disease (including myocardial infarction).

Prior Myocardial Infarction

Example of Prior Myocardial Infarction. Indicate whether the patient has a documented history of myocardial infarction.

Prior Stroke excluding Transient Ischemic Attacks

Example of Prior Stroke excluding Transient Ischemic Attacks. Indicate whether the patient was ever diagnosed with a stroke (excluding transient ischemic attacks).

Prior Transient Ischemic Attacks

Example of Prior Transient Ischemic Attacks. Indicate whether the patient was ever diagnosed with a Transient Ischemic Attacks.

Procoagulant Reversal Therapy

Example of Procoagulant Reversal Therapy. Indicate if the patient received procoagulant reversal therapy.

Stroke Patient

Example of Stroke Patient. This example presents a profile for stroke patient based on Brazilian RNDS.

Stroke Practitioner

This example presents a practitioner profile for stroke attendance based on Brazilian National Data Network.

Stroke Recurrence.

Example of Stroke Recurrence. Indicate if the patient had a new stroke within 90 days of their first stroke occurrence.

Stroke Severity: Consciousness

Example of Stroke Severity: Consciousness. Indicate the patient’s level of consciousness measured on hospital arrival.

Stroke Severity: NIHSS Score

Example of Stroke Severity: NIHSS Score. Indicate the stroke severity as measured by the NIH Stroke Scale (NIHSS). Report the raw (uncategorized) NIHSS score.

Stroke Type

Example of Stroke Type. Indicate Stroke Type.

Symptomatic Intracranial Hemorrhage

Example of Symptomatic Intracranial Hemorrhage. Indicate if the patient developed symptomatic intracerebral hemorrhage after treatment of ischemic stroke with intravenous thrombolysis and/or thrombectomy.

Thrombectomy

Example of Thrombectomy. Indicate if the patient underwent thrombectomy.

Thrombolytic Therapy

Example of Thrombolytic Therapy. Indicate if the patient received intravenous thrombolytic therapy.