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IPS problemObservation

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Different usage of the code and value in the problem and derived observations

(see also issue #6 https://art-decor.org/art-decor/decor-issues--hl7ips-?id=2.16.840.1.113883.3.1937.777.13.6.6)


Description

C-CDA, IHE PCC and epSOS/eHDSI use different pattern to represent coded information in the problem (and derived, as the allergy) observation.

The C-CDA uses a fixed value (“Assertion”) for the observation.code and the observation.value to covey the coded information

  • For example the kind of propensity (allergy, intolerance,..) for allergies
  • The reaction for the Reaction Observation
  • The problem for the problem observations
  • ….

Pros:

  • A simple pattern to be reused for all the different cases

Cons:

  • No way to distinguish between different kinds of conditions
  • less flexible for future extensions


Where to put the no data / known absent codes ? Observation value

In IHE PCC and epSOS/eHDSI the observation code is used for specifying the kind of observation

  • For example the kind of propensity (allergy, intolerance,..) for allergies
  • E.g. (Findings, diagnosis, condition, problem, functional limitation,..) for problem observation, reaction,…

And the observation.value for the coded information (when applies)

  • The problem for problems
  • The reaction for reactions
  • a description of the allergy or adverse reaction (optional can be omitted), used in epSOS only for the no known allergy case

Pros:

  • More flexible for future extensions

Cons:

  • Less simple

Where to put the no data / known absent codes ? Observation code

Note: that in eHDSI and IHE specifications the no known allergies coodes are in the observation value

Other comments

The main differences between the two pattern seems to be for the allergies and where to get the no data / known absent codes.

if "assertion" is one of the possible obs.code the C-CDA solution for problems would be still compliant..