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Difference between revisions of "Contraindication FHIR Resource Proposal"
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| − | This page documents a [[:category: | + | This page documents a [[:category:Approved FHIR Resource Proposal|Approved]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]] |
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<!-- Additional work groups that may have an interest in contributing to, or reviewing the content of the resource (optional) --> | <!-- Additional work groups that may have an interest in contributing to, or reviewing the content of the resource (optional) --> | ||
| − | * [[Pharmacy]] | + | * [[Pharmacy WG]] |
* [[Patient Care]] | * [[Patient Care]] | ||
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==Scope of coverage== | ==Scope of coverage== | ||
| + | The contraindication resource identifies a particular issue associated with a proposed or actual clinical action. For example, a drug-drug interaction, a procedure contraindicated based on weight or health condition, an out-of-range drug dose, etc. These may be identified by decision support systems or through human cognition. The scope includes both human and animal therapies and covers all disciplines and care environments. | ||
| + | |||
| + | QUESTION: should this be limited to clinical? Can administrative issues (lack of consent, permissions, etc.) fall here or is that always an OperationOutcome? ANSWER: No, should not be limited to clinical - use wherever a persistent resource is required. OperationOutcome is not intended to be persistent, rather is a transport acknowledgment similar to HL7 v2 ack/nack. | ||
| + | Should provide guidance as to when this resource should be used in preference to OperationOutcome. | ||
<!-- Define the full scope of coverage for the resource. The scope must be clearly delineated such that it does not overlap with any other existing or expected resource. The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%" | <!-- Define the full scope of coverage for the resource. The scope must be clearly delineated such that it does not overlap with any other existing or expected resource. The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%" | ||
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==Resource appropriateness== | ==Resource appropriateness== | ||
| + | Contraindications are a common concept in medicine, particularly in decision support. Contraindications tend to come into being as a result of some other resource, however they exist as separate structures and can be returned on their own. As well, they can have relationships to multiple resources. For example, in the case of a drug-drug interaction, the resource (prescription, dispense, etc.) for each of the two medications would be implicated and neither would have a stronger affiliation with the contraindication than the other. Therefore, the contraindication must be captured as a distinct resource. | ||
| + | |||
| + | Contraindications may be persisted and queried, though updates will be uncommon as they are typically point-in-time assessments. | ||
| + | |||
| + | Standardization of Contraindications is important for decision support purposes. | ||
<!-- Does the resource meet the following characteristics? | <!-- Does the resource meet the following characteristics? | ||
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==Expected implementations== | ==Expected implementations== | ||
| − | + | * QUICK decision support/quality metric logical model | |
| + | ** CQF pilots including Health eDecisions | ||
| + | ** OpenCDS (longer term) | ||
| + | ** SocraticGrid (longer term) | ||
| + | * Canadian pharmacy implementations (eventually) | ||
<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. --> | <!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. --> | ||
==Content sources== | ==Content sources== | ||
| − | + | * QUICK model | |
| + | * v3 CMET | ||
| + | * OpenEHR? | ||
| + | * CIMI DCM models? | ||
<!-- List all of the specifications (beyond those in the "standard" (FHIR_Design_Requirements_Sources) list of source specifications) that you’re planning to consult | <!-- List all of the specifications (beyond those in the "standard" (FHIR_Design_Requirements_Sources) list of source specifications) that you’re planning to consult | ||
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==Example Scenarios== | ==Example Scenarios== | ||
| − | + | * Drug-drug interaction detected between a prescription and an existing medication statement | |
| + | * Dose out of range by age | ||
| + | * Contraindicated medical procedure based on existing condition | ||
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource. They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) --> | <!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource. They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) --> | ||
==Resource Relationships== | ==Resource Relationships== | ||
| − | + | * OperationOutcome: A rejection or warning operation outcome may include an extension linking to a Contraindication providing the clinical basis for the rejection or warning | |
| + | * The various clinical resources (MedicationPrescription, AllergyIntolerance, Observation, Procedure, CarePlan, etc.) may all be triggers of a Contraindication | ||
<!-- What are the resources do you expect will reference this resource and in what context? | <!-- What are the resources do you expect will reference this resource and in what context? | ||
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==Timelines== | ==Timelines== | ||
| − | + | At least a draft prepared for the Jan 2015 DSTU ballot | |
<!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting --> | <!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting --> | ||
Latest revision as of 20:12, 5 December 2014
This page documents a Approved FHIR Resource Proposal
Contents
- 1 Contraindication
- 1.1 Owning committee name
- 1.2 Contributing or Reviewing Work Groups
- 1.3 FHIR Resource Development Project Insight ID
- 1.4 Scope of coverage
- 1.5 RIM scope
- 1.6 Resource appropriateness
- 1.7 Expected implementations
- 1.8 Content sources
- 1.9 Example Scenarios
- 1.10 Resource Relationships
- 1.11 Timelines
- 1.12 gForge Users
Contraindication
Owning committee name
Clinical Decision Support Workgroup
Contributing or Reviewing Work Groups
FHIR Resource Development Project Insight ID
Pending
Scope of coverage
The contraindication resource identifies a particular issue associated with a proposed or actual clinical action. For example, a drug-drug interaction, a procedure contraindicated based on weight or health condition, an out-of-range drug dose, etc. These may be identified by decision support systems or through human cognition. The scope includes both human and animal therapies and covers all disciplines and care environments.
QUESTION: should this be limited to clinical? Can administrative issues (lack of consent, permissions, etc.) fall here or is that always an OperationOutcome? ANSWER: No, should not be limited to clinical - use wherever a persistent resource is required. OperationOutcome is not intended to be persistent, rather is a transport acknowledgment similar to HL7 v2 ack/nack. Should provide guidance as to when this resource should be used in preference to OperationOutcome.
RIM scope
Obvseration [classCode=OBS, moodCode=EVN, code <= ISSUE]
Resource appropriateness
Contraindications are a common concept in medicine, particularly in decision support. Contraindications tend to come into being as a result of some other resource, however they exist as separate structures and can be returned on their own. As well, they can have relationships to multiple resources. For example, in the case of a drug-drug interaction, the resource (prescription, dispense, etc.) for each of the two medications would be implicated and neither would have a stronger affiliation with the contraindication than the other. Therefore, the contraindication must be captured as a distinct resource.
Contraindications may be persisted and queried, though updates will be uncommon as they are typically point-in-time assessments.
Standardization of Contraindications is important for decision support purposes.
Expected implementations
- QUICK decision support/quality metric logical model
- CQF pilots including Health eDecisions
- OpenCDS (longer term)
- SocraticGrid (longer term)
- Canadian pharmacy implementations (eventually)
Content sources
- QUICK model
- v3 CMET
- OpenEHR?
- CIMI DCM models?
Example Scenarios
- Drug-drug interaction detected between a prescription and an existing medication statement
- Dose out of range by age
- Contraindicated medical procedure based on existing condition
Resource Relationships
- OperationOutcome: A rejection or warning operation outcome may include an extension linking to a Contraindication providing the clinical basis for the rejection or warning
- The various clinical resources (MedicationPrescription, AllergyIntolerance, Observation, Procedure, CarePlan, etc.) may all be triggers of a Contraindication
Timelines
At least a draft prepared for the Jan 2015 DSTU ballot
