Stream: implementers
Topic: Attachments for a HealthcareService
Tim Berezny (Aug 18 2020 at 00:19):
I want to publish an attachment with a HealthcareService (e.g., a menu for a meals on wheels service).
However, the DocumentReference resource does not allow the subject to be a HealthcareService (it can only be Practitioner | PractitionerRole | Organization | Device | Patient).
What would be the best way to attach documents to a HealthcareService?
Jean Duteau (Aug 18 2020 at 00:36):
you could use the HealthcareService.photo field which is an Attachment
Tim Berezny (Aug 18 2020 at 01:00):
Yes, but that's 0..1 and I need a many attachments.
Jean Duteau (Aug 18 2020 at 01:04):
then extension-time it is!
Tim Berezny (Aug 18 2020 at 01:19):
Would the correct approach be to extend DocumentReference to be able to point to a HealthcareService? Or extend the HealthcareService to reference many DocumentReference resources?
Grahame Grieve (Aug 18 2020 at 01:31):
typically, you would expect the reference to go from HealthcareService to DocumentReference
Jean Duteau (Aug 18 2020 at 03:08):
Although I wouldn't use a DocumentReference. Just have HealthcareService.extension().valueAttachment be 0..*. Unless you want the ability to reference a menu URL instead of embedding it directly.
Lloyd McKenzie (Aug 23 2020 at 23:04):
DocumentReference.subject seems over-constrained to me. Compositions can have a subject of any resource and DocumentReference is even broader in scope. @Tim Berezny care to submit a change request to loosen the type restriction?
Tim Berezny (Aug 24 2020 at 11:16):
Yes, I can submit that.
In the meantime... is there a method to extend what resources an element can reference while I use R4?
John Moehrke (Aug 24 2020 at 13:43):
Just leave the DocumentRefernce.subject empty. The DocumentReference other elements will describe the content. You could have DocumentReference.context.related point at your HealthService
Lloyd McKenzie (Aug 24 2020 at 14:34):
That's a work-around. But it's appropriate to have DocumentReference.subject point to the resource the document is about.
John Moehrke (Aug 24 2020 at 14:35):
@Lloyd McKenzie I never said the CR was not good and proper. I welcome it. I was just responding to the request for "In the meantime..."
Tim Berezny (Aug 27 2020 at 13:07):
If I implement with documentReference.subject point to HealthcareService (which is not in the constrained list of referenced resources) in R4 ... do I need to do anything special (like an extension) to implement that, or am I breaking any fundamental principles of using FHIR?
John Moehrke (Aug 27 2020 at 13:24):
that would not be allowed by R4 rules. Hence the request for you to create a Change Request so that in R5 subject can point at anything. This is why I recommended the short term solution is to use .context.related
Lloyd McKenzie (Aug 27 2020 at 14:41):
You would need an extension. However, an extension would be appropriate - especially if you submit a change request and get the change adopted in R5. (In that case there'd automatically be a 'standard' extension.)
Tim Berezny (Aug 27 2020 at 15:53):
Posted: https://jira.hl7.org/projects/FHIR/issues/FHIR-28366?filter=allissues
Tim Berezny (Aug 27 2020 at 15:57):
To extend HealthCareservice, is the best approach to add an extra element (called something like "additionalSubject") or is there a way to extend the constraint of HealthcareService.subject?
Lloyd McKenzie (Aug 27 2020 at 18:48):
You can put an extension on DocumentReference.subject
Tim Berezny (Sep 15 2020 at 20:05):
What if we refer to the HealthcareService with DocumentReference.context.related? Would that be aligned with the purpose of that field, or a hack?
Geoff Ramsay (Sep 15 2020 at 20:05):
https://www.hl7.org/fhir/documentreference-definitions.html#DocumentReference.context.related
Last updated: Apr 12 2022 at 19:14 UTC
