O‘zbekiston Raqamli sog‘liqni saqlash platformasi
0.7.0 - ci-build Uzbekistan bayroqcha

Uzbekistan Digital Health Platform - Local Development build (v0.7.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Patient journey (Episode of Care)

Ushbu sahifa qo‘llanma yozilgan asl manba tilidan tarjimalarni o‘z ichigaoladi. Ushbu tarjimalar haqidagi ma’lumot va ularga fikr bildirish bo‘yichako‘rsatmalarni bu yerda topishingiz mumkin.

Ushbu jarayon bitta muammo bo'yicha bemorga ko'rsatiladigan tibbiy yordam ma'lumotlari vaqt davomida qanday guruhlanishini ko'rsatadi. Alohida tashrif Encounter resursi bilan ifodalanadi; bir nechta tashrifni qamrab oladigan tibbiy yordam jarayoni - masalan, homiladorlikni kuzatish, onkologik kasallikni davolash yoki surunkali infeksiyani boshqarish - EpisodeOfCare resursi bilan ifodalanadi. EpisodeOfCare bitta klinik holatga tegishli tashriflar, tashxislar va natijalarni bog'laydi, natijada klinitsist tarqoq yozuvlar o'rniga holatning to'liq tarixini ko'radi.

Profillarning holati: EpisodeOfCare, Encounter, Condition va Observation UZ Core doirasida profillangan. Davolash vaqtida ishlatiladigan MedicationRequest profili ishlab chiqilmoqda. U e'lon qilingunga qadar FHIR R5 bazaviy resursidan foydalaning.

Ishtirokchilar: umumiy amaliyot shifokori (klinik holatni ochadi va kuzatib boradi); mutaxassislar (klinik holat doirasida davolaydi); DHP (Digital Health Platform - Raqamli sog'liqni saqlash platformasi).

A case grouped under one EpisodeOfCareClinician(GP)Clinician(GP)DHPFHIR serverDHPFHIR serverClinician(specialist)Clinician(specialist)1POSTEpisodeOfCare(status = active)period.start = diagnosis date2POSTEncounter(episodeOfCare -> EpisodeOfCare)+Condition(diagnosis)+Observation(confirming result)every visit, result and prescriptionin the case references the episodeloop[each visit during the case]3POST Encounter / Observation / MedicationRequest(-> EpisodeOfCare)alt[acute / curable case]4PUT EpisodeOfCare (status = finished)period.end = recovery[chronic / lifelong case]5append to statusHistory (onhold <-> active);episode stays open


1. EpisodeOfCare resursini ochish

Muammo yuritilishi kerak bo'lgan klinik holatga aylanganda - odatda tasdiqlovchi natija olingach - klinitsist status = active bo'lgan EpisodeOfCare resursini yaratadi, patient elementida bemorni, mas'ul klinitsist yoki jamoani ko'rsatadi va period.start elementiga tashxis qo'yilgan sanani kiritadi. Diagnostik Encounter va Condition ushbu EpisodeOfCare bilan bog'lanadi.

POST [base]/EpisodeOfCare
{ "resourceType": "EpisodeOfCare",
  "meta": { "profile": ["https://dhp.uz/fhir/core/StructureDefinition/uz-core-episodeofcare"] },
  "status": "active",
  "patient": { "reference": "Patient/[id]" },
  "period": { "start": "2026-05-30" } }

2. Klinik holatga tegishli barcha ma'lumotlar EpisodeOfCare bilan bog'lanadi

Klinik holat davomida har bir tashrif va har bir natija EpisodeOfCare resursiga reference saqlaydi, shu sababli yozuvlar birgalikda guruhlangan holda qoladi. Encounter resursida episodeOfCare elementi orqali EpisodeOfCare ko'rsatiladi; Observation resursida unga tegishli Encounter encounter elementida qayd etiladi; davolash esa shu Encounter resurslari doirasida MedicationRequest (yoki MedicationAdministration) yordamida qayd etiladi.

POST [base]/Encounter
{ "resourceType": "Encounter",
  "meta": { "profile": ["https://dhp.uz/fhir/core/StructureDefinition/uz-core-encounter"] },
  "status": "completed",
  "subject": { "reference": "Patient/[id]" },
  "episodeOfCare": [{ "reference": "EpisodeOfCare/[id]" }] }

3. Tibbiy yordam jarayonining ikki ko'rinishi

EpisodeOfCare resursining hayotiy sikli klinik holat turiga qarab farq qiladi:

O'tkir / davolash mumkin bo'lgan holat (masalan, HCV - C gepatiti virusini davolash kursi). EpisodeOfCare tashxis qo'yilganda ochiladi, davolash tashriflari va nazorat laboratoriya tekshiruvlarini qamrab oladi hamda sog'ayish tasdiqlanganda yopiladi: status = finished qiymatini belgilang va period.end elementida sog'ayish sanasini ko'rsating.

Surunkali / umrbod kuzatuvni talab qiladigan holat (masalan, HBV - B gepatiti virusi bilan bog'liq holatni yuritish). EpisodeOfCare ko'p yillar davomida active statusida qoladi. Tibbiy yordamning to'xtatilishi va qayta boshlanishi EpisodeOfCare resursini yopish orqali emas, EpisodeOfCare.statusHistory elementida qayd etiladi. Bemor boshqa tibbiy xizmat ko'rsatuvchi tashkilotga o'tganda, EpisodeOfCare resursini boshqa tashkilotga qayta biriktirmang: dastlabki EpisodeOfCare resursini yoping (status = finished) va qabul qiluvchi tashkilotda yangi EpisodeOfCare yarating. Shunda har bir tashkilot o'zi ko'rsatgan tibbiy yordam qismi uchun javob beradi.

Hodisa Natija
Klinik holat boshlanadi (tasdiqlovchi natija) EpisodeOfCare.status = active, period.start ko'rsatiladi
Tibbiy yordam to'xtatiladi / qayta boshlanadi statusHistory elementiga yozuv qo'shiladi (onholdactive); EpisodeOfCare ochiq holatda qoladi
Sog'ayish tasdiqlandi (o'tkir holat) status = finished, period.end ko'rsatiladi
Tibbiy yordamni boshqa tashkilotga o'tkazish dastlabki status = finished; yangi tashkilotda yangi EpisodeOfCare ochiladi

4. Tibbiy yordam jarayonini ko'rish

Klinitsist EpisodeOfCare va unga reference saqlaydigan resurslarni o'qish orqali klinik holatni ochadi:

GET [base]/EpisodeOfCare?patient=Patient/[id]&status=active
GET [base]/Encounter?episode-of-care=EpisodeOfCare/[id]&_sort=-date
GET [base]/Observation?patient=Patient/[id]&_sort=-date

Har bir tashrif, natija va dori vositasini tayinlash EpisodeOfCare resursiga reference saqlaganligi sababli, ushbu so'rovlar butun klinik holatni yagona bog'langan ketma-ketlik sifatida qaytaradi. Yozuvlarni alohida Encounter resurslari bo'yicha tarqoq qoldirmasdan EpisodeOfCare yordamida guruhlashning maqsadi ham shundan iborat.

Bog'liq materiallar