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

e-Referral lifecycle

​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 yo'llanma qanday yaratilishi va bajarilishini ko'rsatadi. Yo'llanmalar bilan ishlashda dasturchilar ko'pincha qiyinchilikka duch keladi, chunki bu jarayonda ikkita resurs ishtirok etadi va ularning o'zaro bog'liqligi profil jadvallaridan aniq ko'rinmaydi. Asosiy qoida bir jumlada quyidagicha:

ServiceRequest - yo'llanmaning o'zi, ya'ni nima bajarilishi kerakligini ifodalaydi. Task - uni bajarish bo'yicha ishni, ya'ni ishni kim bajargani, qachon bajargani va qaysi bosqichda ekanini ifodalaydi.

Profillarning holati: ServiceRequest va Task profillari ishlab chiqilmoqda. Ushbu sahifada tizimlar integratsiyani hozirdanoq shu model asosida amalga oshirishi uchun rejalashtirilgan modellashtirish yondashuvi tavsiflangan. Profillar e'lon qilingunga qadar FHIR R5 bazaviy resurslari va quyidagi qoidalardan foydalaning. Yo'llanmani bajarishda qo'llaniladigan Procedure, Observation, Encounter va Condition resurslari profillangan.

Ishtirokchilar: yo'llanma beruvchi klinitsist; kelishish komissiyalari (davlat tomonidan moliyalashtiriladigan yo'llanmalar uchun); xizmat ko'rsatuvchi tibbiyot tashkiloti.

e-Referral lifecycleReferringclinicianReferringclinicianDHPDHPApprovalcommissionsApprovalcommissionsPerformingfacilityPerformingfacility1POST ServiceRequest(intent = order, PaymentType)alt[PaymentType = State-funded]2create approval Task chain(first Task status = requested)loop[approve-family-doctor ... approve-hospitalization]3advance Task(accepted -> in-progress -> completed)final approval Task completed[other financing]4referral proceeds directly(no Task created)5recordProcedure/Observation(basedOn -> ServiceRequest)6final Task completed7ServiceRequest -> completed


1. Yo'llanmani yaratish

Klinitsist yo'llanmaning tasniflash ma'lumotlarini o'z ichiga oluvchi ServiceRequest (intent = order) resursini yaratadi: so'ralgan xizmat code elementida, shoshilinchlik darajasi priority elementida (routine | urgent | stat), maqsadli xizmat HealthcareService orqali, klinik asos reason elementida va moliyalashtirish turi PaymentType kengaytmasida (Free | Paid | Insurance | State-funded) ko'rsatiladi.

POST [base]/ServiceRequest
{ "resourceType": "ServiceRequest", "status": "active", "intent": "order",
  "priority": "routine",
  "code": { "coding": [{ "system": "http://snomed.info/sct", "code": "..." }] },
  "subject": { "reference": "Patient/[id]" },
  "requester": { "reference": "PractitionerRole/[id]" },
  "reason": [{ "reference": { "reference": "Condition/[id]" } }] }

2. Kelishish bosqichlari zanjiri (faqat davlat tomonidan moliyalashtiriladigan uchun)

Bu asosiy qaror qabul qilish qoidasidir:

Agar ServiceRequest ning PaymentType qiymati State-funded bo'lsa, platforma kelishish uchun Task resurslari zanjirini yaratadi; aks holda Task yaratilmaydi va yo'llanma bevosita davom etadi.

Har bir kelishish bosqichi ServiceRequest resursiga reference saqlovchi alohida Task resursi bilan ifodalanadi (Task.focus/basedOn), Task.code elementida esa kelishish toifalari to'plamidagi kod ko'rsatiladi:

approve-family-doctor → approve-specialist → approve-regional-commission → approve-national-commission → approve-insurance-fund → approve-hospitalization

Task resursida ikkita mustaqil status yo'nalishi mavjud: FHIR-status Task.status (hayotiy sikl: requested, accepted, in-progress, completed, rejected, on-hold, failed, …) va Task.businessStatus (foydalanuvchilarga ko'rsatiladigan biznes holati: in-review, confirmed, overdue, …).

Task resurslari uchun alohida foydalanuvchi interfeysi nazarda tutilmagan. Menejerlar jarayon hodisalari asosida harakat qiladi va Task resursini bevosita yakunlamaydi. Bu asosiy ish bajarilmasdan turib bosqichni yakunlangan deb belgilashning oldini oladi.

3. Statuslarni sinxronlashtirish qoidalari

ServiceRequest va unga bog'liq Task resurslari quyidagi qoidalar asosida o'zaro muvofiq holatda saqlanadi:

Hodisa Natija
ServiceRequest active statusiga o'tadi (state-funded) birinchi kelishish Task resursi status=requested bilan yaratiladi
ServiceRequest revoked statusiga o'tkaziladi barcha ochiq Task resurslariga revoked statusi beriladi
ServiceRequest entered-in-error statusiga o'tkaziladi barcha Task resurslariga entered-in-error statusi beriladi
Yakuniy kelishish Task resursi completed statusiga o'tadi ServiceRequest completed statusiga o'tkaziladi
Komissiya Task resursi failed/rejected statusiga o'tadi ServiceRequest revoked statusiga o'tkaziladi
Qayta ishlash uchun qaytarish Task → on-hold / in-review; ServiceRequest → on-hold, so'ngra yangi kelishish Task resursi bilan yana active statusiga qaytariladi
SLA buzilishi faqat Task.businessStatus = overdue - ServiceRequest statusi o'zgarmaydi
Referral ServiceRequest status, driven by Task eventson-holdentered-in-erroractivecompletedrevokedAn SLA breach sets only Task.businessStatus = overdue;the ServiceRequest status does not change. created (status = active) returned for revision resubmitted with a new approval Task final approval / fulfilment Task completed cancelled, or a commission Task failed / rejected cancelled correction


Foydalanuvchiga ko'rsatiladigan yorliq Task holatidan kelib chiqib shakllantiriladi - masalan, businessStatus=overdue → «Muddati o'tgan», status=requested → «Qabul qilinishini kutmoqda», status=rejected → «Rad etilgan».

4. Yo'llanmani bajarish

Xizmat ko'rsatilganda, xizmat ko'rsatuvchi tibbiyot tashkiloti natijani yo'llanma bilan bog'langan holda qayd etadi: Procedure va/yoki Observation resursini (tashrif uchun esa Encounter resursini) yaratadi; ularning har biri basedOn orqali ServiceRequest resursiga reference saqlaydi. Tasviriy tekshiruv natijalari uchun ImagingStudy/DocumentReference, matnli xulosa uchun esa DiagnosticReport qo'llaniladi. Jarayon yakunlanganda yakuniy Task resursiga completed statusi, ServiceRequest resursiga ham completed statusi beriladi.

GET [base]/Task?based-on=ServiceRequest/[id]&_sort=-modified
GET [base]/ServiceRequest?patient=Patient/[id]&status=active
GET [base]/Procedure?based-on=ServiceRequest/[id]

Bekor qilingan yo'llanma bajarilishi mumkin emas; faol ServiceRequest mavjud bo'lmasa, Procedure boshlanishi mumkin emas; yakunlangan Procedure resursini o'zgartirish mumkin emas.

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