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Collecting Measurement Data from Devices
Determining
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Which Device(s) to Use
When a ServiceRequest referenced from a citizen’s CarePlan has a status set to active, it is expected that any required measurement device has been provided to the individual expected to perform the measuring. Typically but not necessarily this individual is the citizen. Once provided, the following FHIR resources are created or, for the first two, reused:
FHIR Device representing the particular device instance
FHIR DeviceMetric representing represents the state and details about of the particular device instance
FHIR DeviceUseStatement which establishes relationships between the Device, Patient, and CarePlan.
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The https://docs.ehealth.sundhed.dk/latest-released/ig/ValueSet-ehealth-activitydefinition-code.html current currently does not contain the concept SDG but this will be fixed with the next IG release. For now, please refer to the continuous build of the eHealth Implementation Guide (IG): https://docs.ehealth.sundhed.dk/latest/ig/ValueSet-ehealth-activitydefinition-code.html. |
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The citizen’s CarePlan refers a number of to several ServiceRequest for activities to perform. Each ServiceRequest refers to an ActivityDefinition containing definitional details. Such details can be text and/or pictures to display to the individual performing the measurement just prior to or during measuring. These possible texts/pictures reside in ActivityDefinition.relatedArtifact with:
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It is expected that a Telemedicine Solution detects whether measuring is performed automatically or by manual entry and examines whether the corresponding |
Presenting Offsets between Activities and Duration of Activity
Offset The offset between activities has different meaning meanings depending on where used. The citizen’s CarePlan refers to a PlanDefinition in which offset can be defined between its comprised activities through PlanDefinition.action.relatedAction.offset. In the following, it is assumed that the Patient-specific adjustments of measurement regimes (in ServiceRequest.timing) have not veered off significantly from the intention for offset and/or measurement regimes described in sub-elements of PlanDefinition.action, at least for the same-group activities.
When defined between activities within the same activity group, the
PlanDefinition.action.relatedAction.offset(typically in the variant offsetDuration) defines a pause between the activities often specified in minutes or seconds.When defined between activities no in the same activity group, the same offset defines different measurement regimes, for instance, that a one activity starts a month after another activity ends. The offset is often specified in months or days.
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It is expected that a Telemedicine Solution treats offset between activities in the same activity group as a pause for which a countdown or count-up should be presented to the user (typically the individual following the plan). In case it is not specified whether to perform a countdown or count up (this is currently not modelled), the Telemedicine Solution shall perform a countdown. |
An activity may be described with a duration for actually performing the activity, beside a measurement regime. When this is the case, the:
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It is expected that a Telemedicine Solution treats activity duration as a situation where a countdown or count-up should be presented to the user (typically the individual following the plan). In case it is not specified whether to perform a countdown or count up (this is currently not modelled), the Telemedicine Solution shall perform a countdown. |
Ensuring the Use of Proper Units
A measurement submitted as an Observation shall conform to the measurement unit expected by the eHealth infrastructure. See https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/2235432961/Interactions+with+the+Terminology+Service#Determining-the-proper-code%2C-system-and-unit-for-Quantity.
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When submitting measurements, it is mandatory to specify the resolved timing (see https://ehealth-dk.atlassian.net/wiki/spaces/EDTW/pages/1661665301/Adhering+to+Care+Plans+and+Measurement+Regimes#When-an-Activity-is-Supposed-to-Happen---The-Notion-of-Resolved-Timing ) information in the ehealth-resolved-timing element of Observation, QuestionnaireResponse and Media. The structure of ehealth-resolved-timing contains:
serviceRequestVersionIdwhich must specify the current FHIR technical version of the ServiceRequestreferenced inbasedOnelement of Observation, QuestionnaireResponse and Media.start- start datetime of resolved timing period. This is mandatory when thetypeisResolved.end- end datetime of resolved timing period. This is mandatory when thetypeisResolved.typeResolvedif the ServiceRequest has a measurement regime supported by the infrastructureUnresolvedif the ServiceRequest has a measurement regime not supported by the infrastructureAdhoc, if the ServiceRequest has a measurement regime, is specified as ad-hoc or the measurement was collected as per request from a practitioner.
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statusisin-progressbasedOnreferences the ServiceRequest stating that answering of questionnaire should be performed as an activityresolvedTimingreflects the resolved timing with which the QuestionnaireResponse is intended to be submitted (as final).
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One such use is a PlanDefinition with an activity for answering a COPD Assessment Test (CAT) Questionnaire followed by an activity for a CAT score “measurement”.
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Measurements are submitted using $submit-measurement. Technically, it is possible to submit multiple measurements in different ways, ranging from:
Each measurement is submitted with individual invocation of in an individual call to
$submit-measurementAll measurements from a wider measurement period submitted in a single invocation
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It is expected that a Telemedicine Solution (typically a Citizen Solution) places multiple measurements into partitions each with measurements sharing the same or similar resolve timing, and, furthermore, submits each partition as an individual invocation of |