FHIR Chat · COVID-19 Laboratory Result Observation Profile Question

Stream: implementers

Topic: COVID-19 Laboratory Result Observation Profile Question

Hristijan Curukoski (May 20 2021 at 14:18):

Hello, what is the proper way to add the physician who read the results from the lab test in regards to the COVID-19 Laboratory Result Observation Profile (http://build.fhir.org/ig/dvci/vaccine-credential-ig/branches/main/StructureDefinition-covid19-laboratory-result-observation.html). It seems like the "performer" only accept Reference(Organization)

Lloyd McKenzie (May 20 2021 at 14:25):

This would be someone at the lab reviewing the results before their release, or a clinician the results are delivered to once released by the lab?

Hristijan Curukoski (May 20 2021 at 16:47):

@Lloyd McKenzie Thank you for your reply! This will be someone at the lab reviewing the results before their release

Lloyd McKenzie (May 20 2021 at 17:36):

It looks like the dvci project has over-constrained. What they should have done is define a mustSupport slice for the Organization, but not constrained out the other resource types (Practitioner, PractitionerRole, etc.). I suggest that you provide feedback to the authors of the IG.

Dragan Sahpaski (May 22 2021 at 17:23):

I suggest that you provide feedback to the authors of the IG.

What is the easiest way to see who the authors are?

Josh Mandel (May 22 2021 at 19:14):

This constraint was intentional. These profiles are specifically not designed to be used with a practitioner or practitioner role in this slot.

Josh Mandel (May 22 2021 at 19:14):

FYSA @Max Masnick

Lloyd McKenzie (May 22 2021 at 19:15):

And the intention is that if you have that information you must strip it out here as a 'custom interface' for bandwidth reasons?

Lloyd McKenzie (May 22 2021 at 19:15):

Providing contacts for the IG in the IG would be a good idea :)

Josh Mandel (May 22 2021 at 19:16):

Agreed, re: contacts! (And yes, you would strip these names out for data minimization reasons. This includes aspects of privacy and payload size.)

Max Masnick (May 24 2021 at 11:08):

The IG actually does have contact info: http://build.fhir.org/ig/dvci/vaccine-credential-ig/branches/main/#contact-information

If there's a recommendation for making the contact info more prominent please let me know!

Josh Mandel (May 24 2021 at 12:15):

I took this as a suggestion about http://build.fhir.org/implementationguide-definitions.html#ImplementationGuide.contact, but I didn't know if/where the template surfaces this

Max Masnick (May 24 2021 at 16:44):

I guess this goes to the PSS on IG authoring guidance...I had no idea that was a thing until now!

Sai Valluripalli (Nov 01 2021 at 17:18):

Is there any opensource implementation for COVID-19 test results?

Lloyd McKenzie (Nov 01 2021 at 21:39):

Implementation of what sort of solution?

Sai Valluripalli (Nov 01 2021 at 21:41):

Any Java based implementation, I am looking for basic Diagnostic report to be generated, no need for Vaccination report

Lloyd McKenzie (Nov 01 2021 at 21:42):

@Eric Haas @Hans Buitendijk

Sai Valluripalli (Nov 01 2021 at 21:43):

@Lloyd McKenzie Thank you so much for the quick response.

Sai Valluripalli (Nov 01 2021 at 21:43):

I worked with @Eric Haas on eICR project before. @Eric Haas any references?

Eric Haas (Nov 01 2021 at 22:12):

I am not aware of any

Sai Valluripalli (Nov 02 2021 at 02:28):

Sai Valluripalli (Nov 02 2021 at 02:37):

Thank you @Eric Haas I am looking for a basic JSON output example for COVID-19 Diagnostic report. Any pointers are helpful.

Eric Haas (Nov 02 2021 at 05:24):

@Gay Dolin ?

Hans Buitendijk (Nov 02 2021 at 17:36):

I'm not familiar with open source being used by a Lab to generate their official diagnostic reports from the results they are producing. Also, not aware of much activity using FHIR to report lab results back to consumers or ordering providers. eCR uses FHIR from the source EHR to gather relevant data that would include a COVID result if the eCR is for a COVID case, but the report is a CDA eICR report for public health in the US.

To get an idea what commercial Labs in the US may have done, check with @David Burgess with LabCorp and @F. Hall with Quest Diagnostics who are active laboratory representatives in HL7 O&O workgroup. Most output is still HL7 v2 as HL7 ELR is the standard to communicate results to public health.

I can understand Josh' response that for reporting to the consumer various personnel references are removed. But contact information could have been included with the organization referenced as the performer.

Sai Valluripalli (Nov 03 2021 at 14:55):

@Hans Buitendijk Appreciate your detailed response. I am still working on eCR, I will first check with Dragon and then reach out of other teams as well.

Sai Valluripalli (Nov 03 2021 at 14:55):

I am also planning to do small quick PoC to build this today / tomorrow.

Sai Valluripalli (Nov 03 2021 at 14:55):

All I need is a simple output JSON with required valuesets

Derek Ritz (Nov 04 2021 at 09:28):

@Sai Valluripalli It may be worthwhile to check the OpenELIS group's work (https://openelis-global.org/). They are using FHIR to convey lab orders and results in an HIV care use case in Haiti. It shouldn't be a huge leap to leverage this work to convey COVID lab test orders / results (but of course... this may turn out to be one of the most naïve things I've ever said). @Jan Flowers @Piotr Mankowski

Jan Flowers (Nov 04 2021 at 13:03):

Thanks @Derek Ritz . Yes, we are generating lab results in OpenELIS (open source enterprise lab information system) and exchanging using FHIR. OpenELIS Global is being used in multiple countries, and OpenELIS (US version) is being used by the public health labs here in several states. The US version does not yet use FHIR though, only the Global version. http://openelisglobal.org/