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LabReportDiscussion
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Discussion - Phoenix Jan 2013 WGM
Patrick reviewed the definitions for the FHIR Resource for LabReport. My comments are as follows:
- General
- Resource Naming: Suggest LabReport isn't the correct name. Not all regions 'bundle' their results in the form of a report (which, to OO, is a 'clinical document'). Need to discuss the architecture used: namely, report is made up of groups, made up of results
- GG: this is not a naming question, but scoping/analysis problem. We need to discuss use cases
- PL: Agree completely!
- GG: Actually, I think the scope is correct in this regard. This resource allows you to 'report'... but you can also use it just to send atomic results.
- Resource Naming: Suggest LabReport isn't the correct name. Not all regions 'bundle' their results in the form of a report (which, to OO, is a 'clinical document'). Need to discuss the architecture used: namely, report is made up of groups, made up of results
- Business
- LabReport.Issued: don't understand the definition
- GG: revision date time - need to fix the name/definition
- LabReport.Specimen: Why specimen at the report level,. esp considering at the report level, multiple specimens are supported
- GG: because it seems silly to repeat the same specimen for multiple groups - and this is a common situation
- ResultGroup: what's the requirement
- GG: this allows a single structure to handle all the reports we could find - sections/categories in common reports, immunology (a series of observations per antibody), micro (groups for organisms), Sections in synoptic reports (CAP definitions)
- Does Promise as a resource meet the 80/20 rule or is a promise simply a special kind of result?
- GG: open question - but why are you asking? this resource is not a promise, nor a fulfillment - that would be something else that might point to this.
- LabReport.Issued: don't understand the definition
- Technical
- RequestDetail.receiverOrderId: No requirement
- GG: I got lazy. I should add something
- ReferenceRange: missing another element. Can say Normal range and give the numbers. but can't say normal range for a male over 50 yo
- GG: that's what "meaning" is for
- Result.name: ResultGroup.name: Element names are wonky (don't like 'name') where used in this spec.
- GG: so we talk about renaming. I'd use "code" now.
- An individual result should be able to reference a specimen, in my opinion
- GG: what's the use case? Creatinine Clearance I suppose? but this does complicate matters - is it worth it? I thought it was outside the 80/20
- Result.codedDx (or some such). Need interpretation per result (esp. for micro)
- GG: agree - need to add interpretation - or we could change comments to interpretation and make it coded - but would you use both?
- LabReport.status: No use case for registered
- GG: yes there is - common to be required to let clinicians know that a report is coming.
- LabReport.status: interim, different than preliminary
- GG: well, how is it different, and what difference does it make in practice?
- LabReport.status: No use case for withdrawn
- GG: ? how can you not have a use case - what do you do when you want to withdraw a result? This is widely used in Australia. Note that withdrawn = changed/updated, but with formal notification that this change means, withdrawn. This allows the receiving system to actually remove (in whatever way is appropriate) the contents
- LabReport.status: Does this follow 80/20 too? Depending, we should consider adding the newer codes added for v2 for result status
- GG: well, some of the codes are outside the scope of a resource. Which codes did you have in mind?
- RequestDetail.receiverOrderId: No requirement