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Device (QDM)
Revision as of 12:31, 29 March 2018 by FEisenberg (talk | contribs)
QDM defines Device as an instrument, apparatus, implement, machine, contrivance, implant, in-vitro reagent, or other similar or related article, including a component part or accessory, intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and not dependent on being metabolized to achieve any of its primary intended purposes. QDM provides three contexts for expressing devices: Device, Applied; Device, Order; and Device, Recommended.
Device, Applied
| QDM Attribute | QI Core Metadata Element | Comment |
| Device Applied | Procedure (the .status metadata allows conformance to the specific QDM datatype context) | Device.status allows active | inactive | entered-in-error | unknown as a required value set; Procedure.status seems more appropriate - constrain the event code to "Completed" |
| Anatomical Approach Site | Procedure.extension (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurerequest-approachBodySite) | QDM matched to QI Core / FHIR |
| Anatomical Location Site | Procedure.bodySite | Device.location (QI Core only) can indicate where the resource is found, but Procedure seems a better fit for Device, Applied |
| Negation Rationale | Procedure.notDoneReason | QDM matched to QI Core / FHIR |
| Reason | Procedure.reasonCode | QDM matched to QI Core / FHIR |
| Relevant Period | Procedure.performed[x] | QDM matched to QI Core / FHIR [Note that Procedure.performed generally refers to a point in time which implementers should map the the start of the relevant period. In most cases the start and end of the Relevant Period will be the same. |
| Author dateTime | part of FHIR Provenance Resource | FHIR references authorDatetime as part of the provenance resource for all resources. Is authorDatetime still appropriate for this QDM datatype? |
| Code | Procedure.focalDevice | QDM matched to QI Core / FHIR |
| id | Procedure.id | QDM matched to QI Core / FHIR |
| Source | Procedure.performer | QDM matched to QI Core / FHIR |
Device, Order
| QDM Attribute | QI Core Metadata Element | Comment |
| Device Order | ProcedureRequest.intent | Procedure Request intent uses the concepts proposal, plan, order, original-order, reflex-order, filler-order, instance-order, option. Constrain to "order" from the intent value set for QDM datatypes with the order context. |
| Negation Rationale | ProcedureRequest.extension (http://hl7.org/fhir/StructureDefinition/procedurerequest-reasonRefused) | QDM matched to QI Core / FHIR |
| Reason | ProcedureRequest.reasonCode | QDM matched to QI Core / FHIR |
| Author dateTime | ProcedureRequest.AuthoredOn | Note - ProcedureRequest.occurrence(x) defines a dateTime when the event should occur - not addressed in QDM |
| Code | ProcedureRequest.code | See also, Observation.category |
| id | ProcedureRequest.id | QDM matched to QI Core / FHIR |
| Source | ProcedureRequest.requester | Author, orderer - note also, ProcedureRequest.requester.agent for device, practitioner or organization who initiated the request; or ProcedureRequest.requester.onBehalfOf - the organization the device or practitioner was acting on behalf of |
Device, Recommended
| QDM Attribute | QI Core Metadata Element | Comment |
| Device Recommended | ProcedureRequest.intent | Procedure Request intent uses the concepts proposal, plan, order, original-order, reflex-order, filler-order, instance-order, option. "Proposal" is most consistent with the ProcedureRequest when applied to clinical decision support (CDS) in which the CDS proposes an action to a provider or to a patient. The QDM concept Recommended addresses expectations a provider gives to a patient. Such recommendations are most consistent with the ProcedureRequest.intent value of "plan" (an intension to ensure something occurs without providing an authorization to act). |
| Negation Rationale | ProcedureRequest.extension (http://hl7.org/fhir/StructureDefinition/procedurerequest-reasonRefused) | QDM matched to QI Core / FHIR |
| Reason | ProcedureRequest.reasonCode | QDM matched to QI Core / FHIR |
| Author dateTime | ProcedureRequest.AuthoredOn | Note - ProcedureRequest.occurrence(x) defines a dateTime when the event should occur - not addressed in QDM |
| Code | ProcedureRequest.code | See also, Observation.category |
| id | ProcedureRequest.id | QDM matched to QI Core / FHIR |
| Source | ProcedureRequest.requester | Author, orderer - note also, ProcedureRequest.requester.agent for device, practitioner or organization who initiated the request; or ProcedureRequest.requester.onBehalfOf - the organization the device or practitioner was acting on behalf of |
