docs(datamodel): FCO-IM feitenronde instroom, besluitenlog + herstructurering
Voegt de discovery- en besluitvormingsronde van 18-19 juli toe (besluitenlog, begrippenlijst, feitenmodel-instroom met scenariotoetsen, terminologie- en leveranciersonderzoek) en synchroniseert feitenmodel-instroom.md met de screening=acceptatie-beslissing (§5). Herstructureert docs/datamodel/ naar submappen per documentsoort (besluiten/sessielogs/feitenmodellen/deelmodellen/ onderzoek/entiteitenkaarten) zodat toekomstige besluitenlogs en feitenrondes per deelgebied een vaste plek krijgen.
This commit is contained in:
colinislit
818
docs/datamodel/entiteitenkaarten/ehr-referral-terminology.html
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818
docs/datamodel/entiteitenkaarten/ehr-referral-terminology.html
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<!doctype html>
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<html lang="nl">
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<head>
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<meta charset="utf-8">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<meta name="color-scheme" content="light dark">
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<title>Engelstalige EHR-termen voor GGZ-instroom</title>
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<style>
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:root {
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--bg: #f5f7f6;
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||||
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--success-soft: #e7f6eb;
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--warning: #9a4d08;
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--warning-soft: #fceedc;
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--danger: #a12c2c;
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--danger-soft: #fce8e8;
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--code-bg: #e9efed;
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||||
}
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||||
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||||
@media (prefers-color-scheme: dark) {
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||||
:root {
|
||||
--bg: #0d1512;
|
||||
--surface: #12201c;
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||||
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||||
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||||
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|
||||
--line: #2a3b36;
|
||||
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||||
--accent-strong: #6ee7d9;
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|
||||
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||||
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||||
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|
||||
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|
||||
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||||
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||||
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|
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|
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|
||||
--line: #dce3e0;
|
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|
||||
--accent-strong: #0b5c56;
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||||
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|
||||
--success: #166534;
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||||
--success-soft: #e7f6eb;
|
||||
--warning: #9a4d08;
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||||
--warning-soft: #fceedc;
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||||
--danger: #a12c2c;
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||||
--danger-soft: #fce8e8;
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||||
--code-bg: #e9efed;
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||||
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||||
|
||||
:root[data-theme="dark"] {
|
||||
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|
||||
--surface: #12201c;
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|
||||
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||||
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|
||||
--line: #2a3b36;
|
||||
--accent: #35d6c4;
|
||||
--accent-strong: #6ee7d9;
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||||
--accent-soft: #163430;
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||||
--success: #72d58a;
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||||
--success-soft: #173322;
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||||
--warning: #f0a94e;
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||||
--warning-soft: #2a1f10;
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||||
--danger: #f18a8a;
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||||
--danger-soft: #341a1a;
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||||
--code-bg: #1c2d28;
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||||
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||||
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||||
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||||
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}
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html {
|
||||
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|
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|
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|
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|
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a {
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|
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a:hover {
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||||
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code {
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}
|
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||||
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||||
margin: 0 auto;
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||||
padding: 2rem 0 5rem;
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||||
}
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||||
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.toolbar {
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align-items: center;
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||||
gap: 1rem;
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||||
margin-bottom: 3rem;
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||||
color: var(--muted);
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||||
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||||
}
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||||
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||||
.toolbar-actions {
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||||
display: flex;
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align-items: center;
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gap: 0.75rem;
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}
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.button {
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border: 1px solid var(--line);
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||||
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||||
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||||
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||||
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.button:hover {
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}
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header {
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margin-bottom: 2rem;
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}
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||||
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||||
.eyebrow {
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margin: 0 0 0.65rem;
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color: var(--accent-strong);
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||||
font-family: ui-monospace, SFMono-Regular, Menlo, Consolas, monospace;
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font-size: 0.72rem;
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||||
font-weight: 700;
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||||
letter-spacing: 0.08em;
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text-transform: uppercase;
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||||
}
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||||
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||||
h1,
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h2,
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h3 {
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color: var(--text);
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||||
line-height: 1.2;
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||||
text-wrap: balance;
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}
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h1 {
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max-width: 22ch;
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||||
margin: 0 0 0.7rem;
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||||
font-family: "Iowan Old Style", "Palatino Linotype", "Book Antiqua", Georgia, serif;
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||||
font-size: clamp(2rem, 5vw, 3.7rem);
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||||
font-weight: 600;
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letter-spacing: -0.025em;
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}
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h2 {
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margin: 0 0 1rem;
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font-family: "Iowan Old Style", "Palatino Linotype", "Book Antiqua", Georgia, serif;
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font-size: clamp(1.4rem, 2.4vw, 2rem);
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font-weight: 600;
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}
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h3 {
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margin: 0;
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font-size: 1rem;
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}
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.subtitle {
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max-width: 68ch;
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margin: 0;
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font-size: 1.05rem;
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}
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||||
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||||
section {
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||||
margin-top: 3.5rem;
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||||
}
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||||
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||||
.callout {
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||||
margin-top: 2rem;
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padding: 1.15rem 1.25rem;
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||||
border: 1px solid color-mix(in srgb, var(--success) 36%, var(--line));
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||||
border-radius: 10px;
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||||
background: var(--success-soft);
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||||
}
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||||
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||||
.callout.warning {
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||||
border-color: color-mix(in srgb, var(--warning) 36%, var(--line));
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||||
background: var(--warning-soft);
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||||
}
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||||
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||||
.callout h2,
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.callout h3 {
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margin-bottom: 0.45rem;
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color: inherit;
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}
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||||
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.callout p {
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||||
max-width: 80ch;
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||||
margin: 0;
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||||
}
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||||
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||||
.concept-grid {
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||||
display: grid;
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||||
grid-template-columns: repeat(3, minmax(0, 1fr));
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gap: 1rem;
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}
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.concept-card {
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display: flex;
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flex-direction: column;
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min-height: 230px;
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border: 1px solid var(--line);
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border-radius: 10px;
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background: var(--surface);
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||||
overflow: hidden;
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||||
}
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.concept-header {
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display: flex;
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justify-content: space-between;
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align-items: center;
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gap: 0.75rem;
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padding: 0.75rem 1rem;
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||||
border-bottom: 1px solid var(--line);
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||||
}
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||||
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||||
.concept-body {
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||||
display: flex;
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flex: 1;
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flex-direction: column;
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gap: 0.9rem;
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padding: 1rem;
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}
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||||
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.concept-body p {
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margin: 0;
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}
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.concept-body .note {
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margin-top: auto;
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color: var(--muted);
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font-size: 0.86rem;
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}
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.pill {
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display: inline-flex;
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align-items: center;
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border-radius: 999px;
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background: var(--surface-subtle);
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color: var(--muted);
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padding: 0.18rem 0.55rem;
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||||
font-size: 0.72rem;
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||||
white-space: nowrap;
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||||
}
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||||
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.model-flow {
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||||
display: grid;
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grid-template-columns: repeat(5, minmax(0, 1fr));
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gap: 0.55rem;
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||||
margin-top: 1.2rem;
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}
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||||
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||||
.flow-step {
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||||
position: relative;
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padding: 0.75rem 0.8rem;
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||||
border-radius: 8px;
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||||
background: var(--accent-soft);
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||||
color: var(--accent-strong);
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||||
font-family: ui-monospace, SFMono-Regular, Menlo, Consolas, monospace;
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||||
font-size: 0.78rem;
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text-align: center;
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||||
}
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||||
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.flow-step:not(:last-child)::after {
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position: absolute;
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top: 50%;
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right: -0.48rem;
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z-index: 1;
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content: "›";
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transform: translateY(-52%);
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color: var(--muted);
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font-family: sans-serif;
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||||
font-size: 1.2rem;
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||||
}
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||||
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.caption {
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margin: 0.75rem 0 0;
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color: var(--muted);
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||||
font-size: 0.82rem;
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||||
}
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||||
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||||
.table-shell {
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||||
overflow-x: auto;
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||||
border: 1px solid var(--line);
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||||
border-radius: 10px;
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||||
background: var(--surface);
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||||
}
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||||
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||||
table {
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||||
width: 100%;
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||||
min-width: 780px;
|
||||
border-collapse: collapse;
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||||
font-size: 0.9rem;
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||||
}
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||||
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th,
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td {
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padding: 0.8rem 0.9rem;
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border-bottom: 1px solid var(--line);
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||||
text-align: left;
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||||
vertical-align: top;
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||||
}
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||||
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||||
th {
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||||
background: var(--surface-subtle);
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||||
color: var(--muted);
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||||
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||||
font-weight: 700;
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||||
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||||
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||||
}
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||||
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tbody tr:last-child td {
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tbody tr:nth-child(even) {
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||||
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||||
}
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||||
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||||
.rating {
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display: inline-block;
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min-width: 4.5rem;
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border-radius: 999px;
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||||
padding: 0.15rem 0.5rem;
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font-size: 0.75rem;
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font-weight: 700;
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||||
text-align: center;
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||||
}
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||||
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.rating.strong {
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||||
background: var(--success-soft);
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color: var(--success);
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||||
}
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.rating.moderate {
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background: var(--accent-soft);
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color: var(--accent-strong);
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}
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.rating.weak {
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background: var(--warning-soft);
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color: var(--warning);
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}
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.rating.reject {
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background: var(--danger-soft);
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color: var(--danger);
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}
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.two-column {
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display: grid;
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grid-template-columns: 1fr 1fr;
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gap: 2rem;
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align-items: start;
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||||
}
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.avoid-list {
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display: grid;
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gap: 0.65rem;
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||||
margin: 0;
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padding: 0;
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list-style: none;
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}
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||||
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.avoid-list li {
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||||
padding-bottom: 0.65rem;
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||||
border-bottom: 1px solid var(--line);
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||||
}
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||||
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||||
.panel {
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||||
padding: 1.25rem;
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||||
border: 1px solid var(--line);
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||||
border-radius: 10px;
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||||
background: var(--surface);
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||||
}
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||||
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||||
.panel h3 {
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||||
margin-bottom: 0.65rem;
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||||
}
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||||
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||||
.panel p {
|
||||
margin: 0 0 0.8rem;
|
||||
}
|
||||
|
||||
.panel p:last-child {
|
||||
margin-bottom: 0;
|
||||
}
|
||||
|
||||
.source-grid {
|
||||
display: grid;
|
||||
grid-template-columns: repeat(2, minmax(0, 1fr));
|
||||
gap: 0.65rem 1.5rem;
|
||||
padding: 0;
|
||||
list-style: none;
|
||||
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|
||||
|
||||
.source-grid a {
|
||||
display: block;
|
||||
padding: 0.5rem 0;
|
||||
border-bottom: 1px solid var(--line);
|
||||
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|
||||
|
||||
footer {
|
||||
margin-top: 4rem;
|
||||
padding-top: 1.25rem;
|
||||
border-top: 1px solid var(--line);
|
||||
color: var(--muted);
|
||||
font-size: 0.8rem;
|
||||
}
|
||||
|
||||
@media (max-width: 840px) {
|
||||
.concept-grid,
|
||||
.two-column {
|
||||
grid-template-columns: 1fr;
|
||||
}
|
||||
|
||||
.model-flow {
|
||||
grid-template-columns: 1fr;
|
||||
}
|
||||
|
||||
.flow-step:not(:last-child)::after {
|
||||
top: auto;
|
||||
right: 50%;
|
||||
bottom: -0.72rem;
|
||||
transform: translateX(50%) rotate(90deg);
|
||||
}
|
||||
}
|
||||
|
||||
@media (max-width: 620px) {
|
||||
.page {
|
||||
width: min(100% - 1.25rem, 1180px);
|
||||
padding-top: 1rem;
|
||||
}
|
||||
|
||||
.toolbar {
|
||||
align-items: flex-start;
|
||||
flex-direction: column;
|
||||
margin-bottom: 2rem;
|
||||
}
|
||||
|
||||
.source-grid {
|
||||
grid-template-columns: 1fr;
|
||||
}
|
||||
}
|
||||
|
||||
@media print {
|
||||
:root {
|
||||
--bg: #ffffff;
|
||||
--surface: #ffffff;
|
||||
--surface-subtle: #f3f5f4;
|
||||
--text: #111111;
|
||||
--muted: #444444;
|
||||
--line: #cccccc;
|
||||
--accent: #0f766e;
|
||||
--accent-strong: #0b5c56;
|
||||
--accent-soft: #edf7f5;
|
||||
--success: #166534;
|
||||
--success-soft: #eef8f0;
|
||||
--warning: #814005;
|
||||
--warning-soft: #fff6e8;
|
||||
--danger: #8a2424;
|
||||
--danger-soft: #fff0f0;
|
||||
--code-bg: #eeeeee;
|
||||
}
|
||||
|
||||
.toolbar-actions {
|
||||
display: none;
|
||||
}
|
||||
|
||||
.page {
|
||||
width: 100%;
|
||||
padding: 0;
|
||||
}
|
||||
|
||||
section,
|
||||
.concept-card,
|
||||
.panel,
|
||||
.callout {
|
||||
break-inside: avoid;
|
||||
}
|
||||
}
|
||||
</style>
|
||||
</head>
|
||||
<body>
|
||||
<main class="page">
|
||||
<nav class="toolbar" aria-label="Documentacties">
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<span>Lokaal onderzoeksartefact · 18 juli 2026</span>
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<div class="toolbar-actions">
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<a href="onderzoek-engelstalige-epd-terminologie.md">Onderzoeksrapport</a>
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<button class="button" id="theme-toggle" type="button" aria-label="Wissel licht en donker thema">
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Licht/donker
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</nav>
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<header>
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<p class="eyebrow">EHR terminology review</p>
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<h1>Engelstalige EHR-termen voor GGZ-instroom</h1>
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<p class="subtitle">
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Vergelijking van Epic, Oracle Health, athenahealth, Netsmart, NextGen,
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HL7 FHIR, ONC/360X en NHS, aangescherpt voor een primair ambulante GGZ-context.
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</p>
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</header>
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<aside class="callout">
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<h2>Aanbevolen richting</h2>
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<p>
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Gebruik <code>referral</code> als eersteklas lifecycle-object voor het beheerde
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aanmeldingstraject en <code>referral_submission</code> voor iedere afzonderlijke
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ontvangst of aanvulling. Een mogelijk <code>referral_request</code> blijft een
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apart te valideren concept voor het inhoudelijke verzoek of de formele verwijzing.
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</p>
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</aside>
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<section aria-labelledby="core-model-title">
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<h2 id="core-model-title">Voorgesteld kernmodel</h2>
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<div class="concept-grid">
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<article class="concept-card">
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<div class="concept-header">
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<h3>Referral Request</h3>
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<span class="pill">verzoek · open</span>
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</div>
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<div class="concept-body">
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<p><code>referral_request</code></p>
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<p>
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Het inhoudelijke verzoek om zorg of beoordeling, geïnitieerd door een
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professional, organisatie, cliënt of vertegenwoordiger.
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</p>
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<p class="note">
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Mogelijke Engelse tegenhanger van de formele VERWIJZING. Eerst bepalen
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of dit een eigen identiteit nodig heeft.
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</p>
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</div>
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</article>
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<article class="concept-card">
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<div class="concept-header">
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<h3>Referral Submission</h3>
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<span class="pill">ontvangst</span>
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</div>
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<div class="concept-body">
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<p><code>referral_submission</code></p>
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<p>
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Eén ontvangen indiening of aanvulling, met eigen kanaal, bron, tijdstip,
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documenten en oorspronkelijke inhoud.
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</p>
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<p class="note">
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Voorkeursnaam voor AANMELDSIGNAAL. Een lokale technische term, geen
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universele EHR-standaard.
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</p>
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</div>
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</article>
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<article class="concept-card">
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<div class="concept-header">
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<h3>Referral</h3>
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<span class="pill">workflow</span>
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</div>
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<div class="concept-body">
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<p><code>referral</code></p>
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<p>
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Het beheerde instroomobject dat submissions en eventuele requests
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beoordeelt, aanvult, trieert en afsluit.
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</p>
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<p class="note">
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Voorkeursnaam voor AANMELDINGSTRAJECT. Sluit aan op Epic, Oracle en
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behavioral-healthleverancier Netsmart.
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</p>
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</div>
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</article>
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</div>
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<div class="model-flow" aria-label="Voorgestelde instroomketen">
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<div class="flow-step">referral_submission</div>
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<div class="flow-step">referral</div>
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<div class="flow-step">acceptance_decision</div>
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<div class="flow-step">clinical_care_episode</div>
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<div class="flow-step">clinical_intake</div>
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</div>
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<p class="caption">
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De zorgsetting is een afzonderlijk tijdgebonden kenmerk. De keten heet dus
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niet admission of pre-admission; de meeste GGZ-behandeling is ambulant.
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</p>
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</section>
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<section aria-labelledby="options-title">
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<h2 id="options-title">Beoordeling van naamparen</h2>
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<div class="table-shell">
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<table>
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<thead>
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<tr>
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<th>Naamparen</th>
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<th>Oordeel</th>
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<th>Sterk punt</th>
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<th>Belangrijk risico</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td>Referral Submission / Referral</td>
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<td><span class="rating strong">Voorkeur</span></td>
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<td>Idiomatic in referral management en behavioral health</td>
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<td>Referral moet expliciet als ontvangende lifecycle worden gedefinieerd</td>
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</tr>
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<tr>
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<td>Referral Submission / Referral Case</td>
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<td><span class="rating moderate">Sterk</span></td>
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<td>Scheidt ontvangst en workflow zeer expliciet</td>
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<td>Case kan elders juridisch, financieel of klinisch iets anders betekenen</td>
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</tr>
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<tr>
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<td>Care Access Submission / Care Access Case</td>
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<td><span class="rating moderate">Redelijk</span></td>
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<td>Inclusief voor zelfaanmelding en niet-formele bronnen</td>
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<td>Access kan als dossier-, systeem- of autorisatietoegang worden gelezen</td>
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</tr>
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<tr>
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<td>Referral Submission / Referral Intake Case</td>
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<td><span class="rating weak">Zwak</span></td>
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<td>Sluit aan op behavioral-healthtaal als referral intake</td>
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<td>Botst met Triqura's afzonderlijke klinische intake</td>
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</tr>
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<tr>
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<td>Inbound Care Submission / Access Assessment Case</td>
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<td><span class="rating reject">Afwijzen</span></td>
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<td>Domeinneutraal</td>
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<td>Abstract en niet herkenbaar in onderzochte EHR-documentatie</td>
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</tr>
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</tbody>
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</table>
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</div>
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</section>
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<section aria-labelledby="evidence-title">
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<h2 id="evidence-title">Wat markt en standaarden feitelijk gebruiken</h2>
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<div class="table-shell">
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<table>
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<thead>
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<tr>
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<th>Bron</th>
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<th>Gepubliceerde term</th>
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<th>Betekenis</th>
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<th>Gevolg voor Triqura</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<td>Epic</td>
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<td>Referral</td>
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<td>Lifecycle-object met incoming/outgoing class, status, triage en historie</td>
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<td>Ondersteunt <code>referral</code> als beheerd instroomobject</td>
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</tr>
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<tr>
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<td>Oracle Health</td>
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<td>Referral / Referral Order</td>
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<td>Order is verzoek; Referral Management beheert status, bijlagen en tijdlijn</td>
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<td>Scheidt request en beheerde referral</td>
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</tr>
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<tr>
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<td>Netsmart</td>
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<td>Incoming Referral / Referral Manager / Referral Packet</td>
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<td>Behavioral-healthinstroom uit meerdere kanalen; acceptatie naar pre-admit</td>
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<td>Referraltaal past bij de GGZ, maar pre-admit niet als generieke kernterm</td>
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</tr>
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<tr>
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<td>HL7 FHIR</td>
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<td>ServiceRequest / Task / EpisodeOfCare / Encounter</td>
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<td>Verzoek, workflowtaak, verantwoordelijkheid en contact zijn aparte concepten</td>
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<td>Lokale objecten niet naar één FHIR-resource forceren</td>
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</tr>
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<tr>
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<td>ONC/360X</td>
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<td>Referral Request / Referral Order / Referral Identifier</td>
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<td>Closed-loop workflow met persistente identifier tot afsluiting</td>
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<td>Request en workflow moeten herkenbaar maar niet samengevouwen zijn</td>
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</tr>
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<tr>
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<td>NHS</td>
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<td>Referral Request / Patient Pathway</td>
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<td>Referral Request omvat self-referral; Patient Pathway is veel breder</td>
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<td>Ondersteunt een apart request, maar niet Patient Pathway voor deze fase</td>
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</tr>
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</tbody>
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</table>
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</div>
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</section>
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<section class="two-column" aria-label="Terminologierisico's en modelcorrectie">
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<div>
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<h2>Termen om te vermijden</h2>
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<ul class="avoid-list">
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<li><code>signal</code> — klinkt als alert of klinisch vroegsignaal.</li>
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<li><code>admission</code> — suggereert opname of reeds verleende toegang.</li>
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<li><code>pre_admission</code> — is opnamegericht en niet passend als ambulante standaard.</li>
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<li><code>encounter</code> — is een feitelijk contact, geen instroomworkflow.</li>
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<li><code>episode_of_care</code> — impliceert organisatorische verantwoordelijkheid.</li>
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<li><code>patient_pathway</code> — is breder en langduriger dan beoordeling vóór acceptatie.</li>
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<li><code>referral_intake_case</code> — botst met de afzonderlijke klinische intake.</li>
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</ul>
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</div>
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<article class="panel">
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<h3>Belangrijkste modelcorrectie</h3>
|
||||
<p>
|
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Het huidige AANMELDSIGNAAL bevat zowel een transportfeit als inhoud van
|
||||
een zorgverzoek. Engelstalige EHR-terminologie maakt zichtbaar dat dit
|
||||
twee betekenissen kunnen zijn.
|
||||
</p>
|
||||
<p>
|
||||
Een huisartsbrief, later ontvangen diagnostiek en een telefoontje kunnen
|
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drie submissions binnen één referral zijn, zonder dat drie nieuwe
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zorgverzoeken of trajecten ontstaan.
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||||
</p>
|
||||
<p>
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||||
Of het inhoudelijke verzoek daarom een eigen <code>referral_request</code>
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||||
nodig heeft, wordt in de FCO-IM-feitenronde bepaald.
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</p>
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</article>
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</section>
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<section aria-labelledby="sources-title">
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<h2 id="sources-title">Primaire bronnen</h2>
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<ul class="source-grid">
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||||
<li><a href="https://open.epic.com/EHITables/GetTable/REFERRAL.htm">Epic REFERRAL</a></li>
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||||
<li><a href="https://open.epic.com/EHITables/GetTable/REFERRAL_2.htm">Epic referral triage</a></li>
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||||
<li><a href="https://docs.oracle.com/en/industries/health/oracle-health-ehr/ehrfg/referrals.html">Oracle Health Referrals</a></li>
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||||
<li><a href="https://www.ntst.com/carefabric/population-health-management/referral-management">Netsmart Referral Manager</a></li>
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||||
<li><a href="https://hl7.org/fhir/R5/servicerequest.html">HL7 FHIR ServiceRequest</a></li>
|
||||
<li><a href="https://hl7.org/fhir/R5/episodeofcare.html">HL7 FHIR EpisodeOfCare</a></li>
|
||||
<li><a href="https://oncprojectracking.healthit.gov/wiki/spaces/TechLab360X/pages/18776120/360X+Home">ONC 360X</a></li>
|
||||
<li><a href="https://www.datadictionary.nhs.uk/classes/patient_pathway.html">NHS Patient Pathway</a></li>
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</ul>
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||||
</section>
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||||
|
||||
<aside class="callout warning">
|
||||
<h2>Nog één open begrippenvraag</h2>
|
||||
<p>
|
||||
<code>referral_submission</code> en <code>referral</code> zijn de huidige
|
||||
voorkeursrichting. De bestaande begrippenlijst is nog niet aangepast omdat
|
||||
eerst moet worden vastgesteld of de Nederlandse VERWIJZING volledig
|
||||
samenvalt met een zelfstandig <code>referral_request</code>.
|
||||
</p>
|
||||
</aside>
|
||||
|
||||
<footer>
|
||||
Zelfstandig HTML-artefact. Geen externe scripts, fonts of stylesheets.
|
||||
Bronlinks vereisen internet; alle onderzoeksinhoud is lokaal beschikbaar.
|
||||
</footer>
|
||||
</main>
|
||||
|
||||
<script>
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(() => {
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const root = document.documentElement;
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const toggle = document.getElementById("theme-toggle");
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const storedTheme = localStorage.getItem("ehr-referral-theme");
|
||||
|
||||
if (storedTheme === "light" || storedTheme === "dark") {
|
||||
root.dataset.theme = storedTheme;
|
||||
}
|
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|
||||
toggle.addEventListener("click", () => {
|
||||
const systemDark = window.matchMedia("(prefers-color-scheme: dark)").matches;
|
||||
const current = root.dataset.theme || (systemDark ? "dark" : "light");
|
||||
const next = current === "dark" ? "light" : "dark";
|
||||
root.dataset.theme = next;
|
||||
localStorage.setItem("ehr-referral-theme", next);
|
||||
});
|
||||
})();
|
||||
</script>
|
||||
</body>
|
||||
</html>
|
||||
Reference in New Issue
Block a user