2017-12-05 PA Call Minutes
- 1 Patient Administration Call
- 2 14024 - Patient.contact and RelatedPerson need a better connection
- 3 14154 - Searching a Patient by Identifier Type
- 4 14118 - Why does FHIR use codes that have been deprecated in V2.3?
- 5 14112 - Patient.communication should have way to designate if the preferred language is written versus verbal
- 6 Navigation
Patient Administration Call
|PA Work Group Conference Call
14024 - Patient.contact and RelatedPerson need a better connection
14154 - Searching a Patient by Identifier Type
14118 - Why does FHIR use codes that have been deprecated in V2.3?
Version notes say that some codes were removed after v2.3 ex. Some codesets can have them, but maybe as an extension shouldn't?
Brian: Should this be something we chat with Grahame about?
14112 - Patient.communication should have way to designate if the preferred language is written versus verbal
Alexander: Like V3.
Drew: We [Cerner] don't record if the preferred language is written or spoken.
Cooper: Our use case might be: if they only speak a language, but can't read or write it, we don’t want to print them materials with instructions to take home in a language they can't read.
Alexander: Illiteracy isn't really handled either. It's not language dependent, but a state of being.
Drew: Would this be an observation?
Alexander: Still feels like part of communication in FHIR. We would probably extend patient in FHIR if the need comes up again.
Drew: Administrative task wouldn't document illiteracy, would be more of a clinical thing.
Alexander: If someone is illiterate, you'd want that to be part of where ever the patient goes (part of the Patient resource). Have not dealt with this need in FHIR yet.
Cooper: Makes sense, but we [Epic] also don't document this.
Alexander: If you care about proficiency for written in English, isn't that the same as caring about illiteracy in any language?
Cooper: In theory, yes.
Brian: Could have extension--
Drew: Or text
Brian: --that says they are illiterate, and then have no language.
Louis? Illiteracy the ability to read or write--and there are some languages that are only spoken. You can be "illiterate".
Alexander: This is not distinguishing because in that case, everyone in the language would be considered illiterate. Maybe we should ignore this concept and go back to what's in the tracker item. Proficiency codes / proficiency modes? Like V3
Drew: This isn't proficiency though.
Brian: It's not a first class property, so it's in extension territory. Should this be a standard extension?
Drew: Sounds like there's a use case for it, but primarily is Epic.
Alexander: Anyone who doesn't read the extension would see repetition of languages with no distinguishing features-- is this okay?
Drew: doesn't have to be separate from the communication
Alexander: Make it a modifying extension would signal that you can't understand the information well without understanding the extension.
Brian: If you don't understand the extension you shouldn't look at the resource or the property. If you put the extension on the preferred flag, it wouldn’t matter.
Cooper: Preferred is still a little separate from what we are discussing.
Drew: Right, this should be an extension on the communication.
Brian: That's not what's in the tracker.
Cooper: Would prefer it not to be on the "preferred", but some kind of sibling.
Alexander: It's an extension of language--written English versus spoken English.
Brian: preferred written or preferred spoken.
Cooper: We [Epic] have one overall preferred language, and then we have language for care, which is verbal.
Brian: Not an extension on language, extension on communication or preferred
Cooper: Communication, it's like a use, what way is this communication is used.
Alexander: That sounds right to me too.
Brian: With multiple uses, which one is the preferred use for written?
Can have multiple preferred communications. But if a system doesn't understand the extension, it won't differentiate.
Drew: Should be on backbone of communication as it's an attribute of the communication.
Alexander: If a language is both written a verbal, you can repeat an extension.
Brian: Is it preferred, or is it just able to? If we take preferred out of the picture is it still relevant?
Dan: With the Healthcare directory use of communication element, we added a proficiency and have found three valuesets that are used to describe proficiency. So they kind of go hand in hand because you might be proficient in a few, you might prefer a couple. There's a two pronged item. For them, it's Practitioner.communication.
Brian: This should also consider if proficiency is this concept.
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