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FHIR for Orders

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Introduction

This is the project page for the development of FHIR resources in the OO domain. Project #952

Scope

Resources under development by OO:

  • Device
  • Substance
  • Supply
  • Observation
  • DiagnosticReport
  • Specimen

Resources under development by Core Team:

  • Order
  • OrderResponse

Documents

Resources

Resource Resource Page Status Next Ballot
Device Composite Order Development Sep 13
Substance Laboratory Orders Ballot Reconciliation MAY 13
Supply Blood, Tissue, Organ v3 HOLD ON HOLD
Specimen Blood Donation v2 Published N/A
Observation Common Product Model DSTU R2  
DiagnosticReport DiagnosticReport Updates from Ballot Reconciliation SEP13


Discussion - Phoenix Jan 2013 WGM

Patrick reviewed the definitions for the FHIR Resource for LabReport. Comments are as follows:

  1. General
    1. 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
      1. GG: this is not a naming question, but scoping/analysis problem. We need to discuss use cases
      2. PL: Agree completely!
      3. 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.
  2. Business
    1. LabReport.Issued: don't understand the definition
      1. GG: revision date time - need to fix the name/definition
    2. LabReport.Specimen: Why specimen at the report level,. esp considering at the report level, multiple specimens are supported
      1. GG: because it seems silly to repeat the same specimen for multiple groups - and this is a common situation
    3. ResultGroup: what's the requirement
      1. 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)
    4. Does Promise as a resource meet the 80/20 rule or is a promise simply a special kind of result?
      1. 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.
  3. Technical
    1. RequestDetail.receiverOrderId: No requirement
      1. GG: I got lazy. I should add something
    2. ReferenceRange: missing another element. Can say Normal range and give the numbers. but can't say normal range for a male over 50 yo
      1. GG: that's what "meaning" is for
    3. Result.name: ResultGroup.name: Element names are wonky (don't like 'name') where used in this spec.
      1. GG: so we talk about renaming. I'd use "code" now.
    4. An individual result should be able to reference a specimen, in my opinion
      1. 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
    5. Result.codedDx (or some such). Need interpretation per result (esp. for micro)
      1. GG: agree - need to add interpretation - or we could change comments to interpretation and make it coded - but would you use both?
    6. LabReport.status: No use case for registered
      1. GG: yes there is - common to be required to let clinicians know that a report is coming.
    7. LabReport.status: interim, different than preliminary
      1. GG: well, how is it different, and what difference does it make in practice?
    8. LabReport.status: No use case for withdrawn
      1. 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
    9. LabReport.status: Does this follow 80/20 too? Depending, we should consider adding the newer codes added for v2 for result status
      1. GG: well, some of the codes are outside the scope of a resource. Which codes did you have in mind?