Stream: social
Topic: Other forums
Grahame Grieve (Mar 01 2022 at 06:17):
Someone has asked me where is the best question to ask something like this:
For instance, heart rate recorded and visualised by a nurse vs heart rate recorded via a remote wearable device. Which do we trust more, can both be used to measure a trend, are they interchangeable?
My response is that you ask here on #Clinicians on FHIR but it's not quite our usual fare. Is there other places like this that they could ask questions like this?
John Moehrke (Mar 01 2022 at 11:23):
there are mechanisms in the spec to support multiple choices (Provenance, .meta.security, author). So is the question asking for the methods available, or is the question asking for an opinion on medical practice ?
Grahame Grieve (Mar 01 2022 at 12:08):
opinion on medical practice. It's not a FHIR question per se
Ward Weistra (Mar 01 2022 at 13:24):
Perhaps @John Manning knows a place where medical informaticians discuss these topics?
Ward Weistra (Mar 01 2022 at 13:24):
(DevDays Doctor track lead)
Mikael Rinnetmäki (Mar 01 2022 at 17:11):
I guess if you ask clinicians, you get more answers leaning towards "trust the nurse." If you ask in #patient empowerment, you may get answers favoring the wearable device, but reminding you to ask the patient confirm whether they agree with the data.
Mikael Rinnetmäki (Mar 01 2022 at 17:11):
In my view (a lot of experience in many wearable devices) they are not interchangeable. Even data from different wearable devices are not interchangeable, if you want to really "trust" the data. Any wearable data should give you more confidence, though, compared to not having it.
Mikael Rinnetmäki (Mar 01 2022 at 17:12):
Finally, I agree it is not a FHIR question, and therefore #social should be the right stream to discuss it if you want to discuss it in chat.fir.org. :)
John Manning (Mar 01 2022 at 22:34):
There are a few options for this. Within Zulip, I agree that #social is the proper channel for this.
There are other external tools and means by which people talk about informatics in its various respects, though this seems to be more clinically focused.
Regarding the question of trust, I think there's something to be said about the waveform seen that is tied to the number. I can give many examples of clinical data that can look like an abnormal rhythm / heart rate... But really is just because the patient is moving / shivering / etc
John Manning (Mar 01 2022 at 22:37):
Hard to give a blanket statement about remote wearable devices in general... But that concept is similar. The data are only as good as the waveform.
John Silva (Mar 01 2022 at 23:46):
Also, the folks in the "Devices on FHIR" group might have insight into this
https://www.iheusa.org/devices-fhir
Michael Lawley (Mar 01 2022 at 23:52):
The other question is trust for what? Depending on the decision being made, the risks of inaccurate / out-of-date data may be different.
Also, the path of data into the record can be significant: when our local hospital switched from manual transcribing of measurements into the record to device directly populating the record, the effect of trigger thresholds was immediately seen; during the manual process, results would be rounded down/up to avoid triggering alerts (with justifications like "I'll check again in x min to see if this is 'real'").
Jayant Singh (Mar 02 2022 at 05:46):
Hi all. This is my first time here, hope you'll are doing great.
As I am about to start a web app, on medical health, I came to know about FHIR
Can any one guide me, how can implement it with my existing project, in php (Laravel)
Richard Townley-O'Neill (Mar 02 2022 at 23:30):
Welcome @Jayant Singh ! What reading/exploring have you done so far?
Jayant Singh (Mar 03 2022 at 04:19):
Richard Townley-O'Neill said:
Welcome Jayant Singh ! What reading/exploring have you done so far?
What I have done is how to format the data while sending it, in JSON format.
But what I want to know is how can I use PHP to do the same?
Richard Townley-O'Neill (Mar 03 2022 at 05:53):
You might find something useful in the Implementers stream searching for PHP.
I found https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Most.20Active.20Language.20for.20FHIR
and https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Implement.20Patient.20Resource
Jayant Singh (Mar 03 2022 at 06:03):
Richard Townley-O'Neill said:
You might find something useful in the Implementers stream searching for PHP.
I found https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Most.20Active.20Language.20for.20FHIR
and https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Implement.20Patient.20Resource
Thanks a lot. I'll look forward to it.
Last updated: Apr 12 2022 at 19:14 UTC
