Data dictionary

A submitted Bundle maps into BirthTracks’ canonical spine — a small set of entities shared by every input path (FHIR push, CSV import, structured web form). This is the common shape that downstream filing and benchmarking read from.

A course of care is one Submission with one Mother, one Encounter, one or more Children, and zero or more Transfers of care.

Note

The FHIR ingestion endpoint lands the core demographics and newborn measures listed below as mapped from FHIR. The remaining clinical fields are part of the same canonical model and are captured via the CSV importer or the structured web form (the long-tail path). USCDI/FHIR covers only a fraction of birth-record fields by design.

Submission (course of care)

Field	Type	Notes
uuid	string (uuid)	Stable id for the course of care.
status	string	Lifecycle: draft, enrolled, … A FHIR push enrolls the record.
source	string	Input path — fhir_push, csv, or manual.
external_record_id	string	Your record id, from the Bundle identifier.value. Unique per practice.
intended_place / actual_place	string	Planned vs. actual place of birth.
intention_to_treat_flag	boolean	Intention-to-treat marker for benchmarking.
attendant_type	string	Type of attendant for the course.
bfdr_ig_version	string	BFDR IG version declared on the mother’s meta.profile.
enrolled_at / completed_at	datetime	Set as the record progresses.

Mother

Field	Type	Source	Notes
maternal_age	integer	mapped from FHIR	Derived from the mother’s birthDate and the newborn date.
residence_zip3	string(3)	mapped from FHIR	First 3 digits of the mother’s address.postalCode (Safe Harbor).
race	json	long-tail
ethnicity	string	long-tail
education	string	long-tail
marital_status	string	long-tail
primary_payer	string	long-tail
parity / gravidity	integer	long-tail
prepregnancy_bmi	decimal	long-tail
prior_cesarean / prior_cesarean_count	boolean / integer	long-tail
chronic_hypertension	boolean	long-tail
pre_existing_diabetes	boolean	long-tail
tolac_attempted	boolean	long-tail	Trial of labor after cesarean.
perineal_status	string	long-tail
postpartum_hemorrhage	boolean	long-tail
estimated_blood_loss_band	string	long-tail
maternal_icu_admission	boolean	long-tail
maternal_mortality	boolean	long-tail
breastfeeding_at_discharge / breastfeeding_at_six_weeks	string	long-tail

Encounter (labor & delivery)

Field	Type	Notes
labor_onset	string	Spontaneous, induced, etc.
induction / augmentation	boolean
rom_method / rom_at	string / datetime	Rupture of membranes method and time.
fetal_monitoring	string
pain_management	string
mode_of_birth	string
cesarean_type	string
shoulder_dystocia	boolean

Child

Field	Type	Source	Notes
sequence	integer	mapped from FHIR	Birth order; from multipleBirthInteger when present.
sex	string	mapped from FHIR	From the child Patient.gender.
birth_datetime	datetime	mapped from FHIR	From the child Patient.birthDate/time.
birth_weight_g	integer	mapped from FHIR	LOINC 8339-4 Observation (grams).
gestational_age_weeks	integer	mapped from FHIR	LOINC 11884-4 Observation.
apgar_one_minute	integer	mapped from FHIR	LOINC 9272-6 Observation.
apgar_five_minute	integer	mapped from FHIR	LOINC 9274-2 Observation.
gestational_age_days	integer	long-tail
resuscitation / assisted_ventilation	boolean	long-tail
congenital_anomaly	string	long-tail
nicu_admission	boolean	long-tail
neonatal_death / neonatal_death_timing / neonatal_death_cause	boolean / string	long-tail

Transfer of care

Zero or more per course of care — the community-birth differentiator. Captured via the structured web form (0..n), the CSV importer (one per row, gated on transfer_type), and the FHIR push (see below). In the CSV template the columns are prefixed transfer_.

Field	Type	Provenance	Notes
transfer_type	string	long-tail	One of antepartum, intrapartum, postpartum_maternal, neonatal. Marks a transfer present.
reason_code	string	long-tail	Coded reason (SNOMED). CSV column transfer_reason_code.
reason_text	string	long-tail	Free-text reason. CSV column transfer_reason_text.
destination	string	long-tail	Where care transferred to. CSV column transfer_destination.
emergency	boolean	long-tail	Whether the transfer was an emergency. CSV column transfer_emergency.
occurred_at	datetime	long-tail	When the transfer occurred. CSV column transfer_occurred_at.

FHIR representation

A transfer of care has no dedicated BFDR profile, so the push lane reads it from a FHIR R4 Encounter in the course-of-care Bundle. The transfer type is the gate — an Encounter that names no recognized transfer type (e.g. the birth Encounter) records no transfer, mirroring the CSV/web “transfer_type marks a transfer present” rule. Map each transfer Encounter as:

Canonical field	FHIR source
transfer_type	Encounter.type[].coding[].code ∈ {antepartum, intrapartum, postpartum_maternal, neonatal} (recommended system https://laravel-sandbox.twosportday.com/fhir/CodeSystem/transfer-type; matched on code, case-insensitive, regardless of system)
reason_code	Encounter.reasonCode[0].coding[0].code (SNOMED)
reason_text	Encounter.reasonCode[0].text, falling back to the coding display
destination	Encounter.hospitalization.destination.display
emergency	true iff Encounter.priority.coding[].code ∈ {EMER, STAT, ASAP} (HL7 ActPriority); otherwise false
occurred_at	Encounter.period.start

Provider attribution

Providers named in a course of care are stored as their own canonical entity, so attendant-level benchmarking works. Provider attribution is not patient PHI, so unlike the mother and child, a provider’s name and credentials are retained.

Canonical field	FHIR source
external_provider_id	The first non-NPI Practitioner.identifier.value, falling back to Practitioner.id. The stable identity key — a Practitioner without one is skipped.
npi	The identifier whose system names US-NPI. A discovery signal only; deliberately never the key, because doulas and CPMs frequently have none.
role	Keyword-matched from the practitioner’s qualification text/display: midwife (also CNM/CPM/LM), doula, nurse (also RN), assistant, else other.
display_name	Practitioner.name[0].text, falling back to the assembled human name.
credentials	The practitioner’s qualification text/display.

The attending provider is the participant an Encounter marks with the HL7 v3 ParticipationType ATND; nothing else promotes a practitioner to attendant.

Partner lane

On the partner lane (an EHR vendor pushing for its practices) the mother and child are reduced to a coarse, de-identified spine before anything is persisted, while provider attribution is retained as above. See Partner onboarding.

LOINC codes used on newborn Observations

LOINC	Meaning
8339-4	Birth weight (grams)
11884-4	Gestational age (weeks)
9272-6	Apgar score at 1 minute
9274-2	Apgar score at 5 minutes