Merge pull request #33 from fhir-fi/terminologies

Add non-FHIR terminologies

input/pagecontent/StructureDefinition-fi-base-patient-intro.md

@@ -1,12 +1,74 @@
 ### Scope and Usage
 
-The Finnish Core Patient profile is intended to encapsulate the most common and basic data model of patients in Finnish healthcare systems covering both primary sector, secondary sector (specialty doctors and hospitals) and municipality cases. The profile also presents data that is compulsory information in parts of Finnish legislation. As such the profile should be usable in most Finnish contexts.
+The Finnish Core Patient profile is intended to encapsulate the most common and basic data model of
+patients in Finnish social and healthcare systems. The profile also defines how to present data
+defined in Finnish legislation. As such the profile should be usable in most Finnish contexts.
 
-### Patient identifier
+### Identifying information
 
-Patient indentifier has two basic uses in Finnish healthcare: Official and Temporary. Official identifier, aka the personal identifier code (PIC), is granted and handled by [Digital And Population Data Services Agency](https://dvv.fi/en/personal-identity-code). Temporary identifier is defined by Kanta Services ([Temporary identifier](https://www.kanta.fi/en/system-developers/test-etiquette#:~:text=various%20Kanta%20Services.-,Temporary%20identifier,-Temporary%20identifiers%20are)). In addition Kanta also defines set of [test identity codes](https://www.kanta.fi/en/system-developers/test-etiquette#:~:text=events%20is%20forbidden.-,Test%20ID%20and%20other%20identification%20data,-Only%20900%2Dseries) which are being used in many healthcare systems regardless of Kanta integration.
+In the context of Finnish national social and healthcare, the
+[defined identifying information](https://yhteistyotilat.fi/wiki08/display/JULPOKY/7+Potilaan+perustiedot)
+for a person are
+* first (given) name
+* family name
+* name history
+* national person identifier
+* temporary identifier
+* time of birth
+* gender
+* time of death.
 
-Other identifiers could also be used to identify the patient. These indentifiers are usually system spesific and not necessarily used in other circumstances. Nevertheless it would be appropriate to distinguish these identifiers properly from each other.
+The unique identifier is the national person identifier.
+
+#### Patient identifier
+
+There are two versions of the national person identifier for people living in Finland.
+
+The [official Personal Identifier Code](https://dvv.fi/en/personal-identity-code) (PIC) is granted
+by the Digital And Population Data Services Agency. The `oid` for the official PIC is `1.2.246.21`.
+
+When an official PIC is not known or cannot be used for other reasons, a system may generate a
+[Temporary Identifier](https://www.kanta.fi/en/system-developers/test-etiquette#Temporary%20identifier).
+The `oid` for the temporary identifier is `1.2.246.10.<organization>.22.<year>`, where
+`<organization>` is the official identifier (y-tunnus) of the organization and `<year>` the year
+when the temporary identifier is generated.
+
+The identifiers are presented to human readers in the 11 character format, without any oid
+information.
+
+When a PIC is used for an Patient instance, the value of the `identifier.use` field SHOULD be
+[`official`](https://build.fhir.org/codesystem-identifier-use.html#identifier-use-official) and the
+value of the `identifier.type` SHOULD be `NNFIN` (see https://terminology.hl7.org/4.0.0/CodeSystem-v2-0203.html).
+
+When the `identifier.type` is `NNFIN`, the value of the identifier SHALL be a Finnish national PIC.
+
+In addition to person identifiers for people living in Finland, systems may use **test identifiers**
+that have a special range in the PIC format (the eighth character is `9`). For instance,
+`020516C903K`.
+
+#### Other identifiers
+
+Other identifiers can also be used to identify the patient. In many cases the national patient
+identifier is not required. In these cases systems should assign another unique identifier for
+patients. Note that these identifiers MAY be different for different apps, for instance. They
+SHOULD still be the same when the same app asks for the patient information multiple times. 
+
+### Additional Information
+
+#### Name
+
+Systems SHOULD populate the `.name.text` field and clients SHOULD use that version of the name,
+when available.
+
+Clients SHOULD be prepared for cases where the name is not available. Systems may allow individuals
+to limit the amount of information that is being shared with FHIR apps. Some privacy aware systems
+do not share names or any demographic information by default.
+
+
+#### Times
+
+Both time of birth and time of death SHOULD be recorded with the time component, if known. If the
+time of day is not known, the date SHALL be recorded as a date only, without the time component.
 
 ### Use of non-disclosure information
 
@@ -29,4 +91,7 @@ Finnish citizens that have requested name and address protection ([Non-disclosur
 
 ### Presenting guardian information
 
-In some cases a guardian could be appointed to the patient if the patients is for ex. incapable of managing one's matters due to an illness. In these situations guardian's informations shall be presented with [RelatedPerson](http://hl7.org/fhir/R4/relatedperson.html) resource with relationship type [GUARD](http://hl7.org/fhir/R4/v3/RoleCode/cs.html#:~:text=3-,GUARD,-guardian).
+In some cases, a guardian could be appointed to the patient if the patients is for ex. incapable of
+managing one's matters due to an illness. In these situations, the guardian's information shall be
+presented with [RelatedPerson](http://hl7.org/fhir/R4/relatedperson.html) resource with the
+relationship type [GUARD](http://hl7.org/fhir/R4/v3/RoleCode/cs.html#:~:text=3-,GUARD,-guardian).

input/pagecontent/extensions.md

@@ -4,6 +4,13 @@ through [extensions](http://hl7.org/fhir/R4/extensibility.html).
 This list includes the FI Base extensions as well as other known extesions used in Finland. We hope
 listing extensions here will promote their use and thereby increase interoperability.
 
+Please note that there is no guarantee that the extensions from other sources are kept in sync with
+the source implementation guides. For up-to-date information, please refer to the original
+definitions (which can be read from the `Official URL` part of the page describing the extension,
+or from the `url` field of the relevant StructureDefinition resouce). For Kanta PHR extensions 
+(with URLs starting http://phr.kanta.fi) see the 
+[Finnish PHR implementation guide](https://simplifier.net/FinnishPHRR4).
+
 <ul>
 {% include list-extensions.xhtml %}
 </ul>

input/pagecontent/index.md

@@ -120,21 +120,26 @@ resources and the REST interface.
 Our main intent is still to limit profiling specific to Finland. During the process, we actively
 monitor other national base profiles. We attempt to harmonize our base profiles with already
 published base profiles from other Nordic countries, specifically the Danish
-[DK Core](https://hl7.dk/fhir/core) and the Norwegian
-[no-basis-Profiles](https://simplifier.net/HL7Norwayno-basis/~introduction).
+[DK Core](https://hl7.dk/fhir/core), the Norwegian
+[no-basis-Profiles](https://simplifier.net/HL7Norwayno-basis/~introduction),
+and the [Swedish Base Profiles](https://hl7.se/fhir/ig/base/).
 
 The Finnish FHIR base profiles derive from the
 [International Patient Access (IPA) specification](https://build.fhir.org/ig/HL7/fhir-ipa/)
-and we will keep the specifications conformant. Should we find any constraints in IPA that we
-can't adhere to, the main resolution should be to affect the IPA specification and search for
-wider consensus and shared understanding.
+where applicable, and we will keep the specifications conformant. Should we find any constraints in
+IPA that we can't adhere to, the main resolution should be to affect the IPA specification and
+search for wider consensus and shared understanding.
 
 Other notable national base profiles under our radar are the
 [US Core](https://hl7.org/fhir/us/core/), the
 [Canadian baseline](https://build.fhir.org/ig/HL7-Canada/ca-baseline/), the Swiss
 [CH Core](http://fhir.ch/ig/ch-core/index.html), and the Australian
 [AU Base](http://hl7.org.au/fhir/4.0.0/).
 
+See also the
+[National IG Implementations](https://confluence.hl7.org/display/IC/National+IG+Implementations)
+page in HL7 International's Confluence.
+
 #### Profiles and Examples
 
 We publish profile resources that help implementers validate their implementations.

input/pagecontent/profiles.md

@@ -13,4 +13,8 @@ This is the list of profiles from the Kanta PHR, where a lot of early profiling
 It is worth noting that these profiles are more restrictive than the national base profiles. They
 are still listed here, to increase awareness of work already done and to act as inspiration.
 
+Note that there is no guarantee that these profiles are kept in sync with the Kanta profiles. For
+up-to-date information, please refer to the
+[Finnish PHR implementation guide](https://simplifier.net/FinnishPHRR4).
+
 {% include fragment-other-profiles.html %}

input/pagecontent/terminology.md

@@ -53,3 +53,33 @@ FHIR specification.
 
 ### Terminologies not available in FHIR format
 
+#### National Code Server
+
+The Finnish Institute for Health and Welfare maintains a
+[National code server of social welfare and health care](https://koodistopalvelu.kanta.fi/codeserver/pages/classification-list-page.xhtml),
+only in Finnish language. The standardised data structures required by the electronic client data
+systems in social welfare and health care as well as the central code sets of the statistical and
+register data collection are all published on the code server.
+
+The code sets are available on the Code server free of charge.
+
+The responsibility for the contents of the code sets on the code server belongs to THL as laid down
+by law,
+[Act on the Electronic Processing of Client Data in Social and Health Care, 9 Feb, 159/2007 (in Finnish)](http://www.finlex.fi/fi/laki/ajantasa/2007/20070159).
+The technical maintenance of the code server is the responsibility of the Social Insurance
+Institution of Finland (Kela).
+
+The Code Service forms a part of Kanta, the national patient data system. The Code Service
+maintains nationally integrated data structures and code sets for electronic patient case
+histories. The Code server also develops registration practices for the client data in social
+welfare.
+
+#### Laboratory
+
+Most systems and services in Finland use the laboratory test codes and names specified in the
+[laboratory test name set](https://koodistopalvelu.kanta.fi/codeserver/pages/classification-view-page.xhtml?classificationKey=88&versionKey=120)
+by Kuntaliitto.
+
+Upcoming European legislation, like that for the European Health Data Space introduces some
+pressure to adopt LOINC codes too. Therefore systems SHOULD include LOINC codes in adddition to the
+national Kuntaliitto codes, where a LOINC code is known.