Stream: implementers
Topic: Capturing COVID-19 PCR test results
Bill Claxton (wmclaxton) (Oct 15 2020 at 05:22):
New here and I posted this previously under SMART but was told I should search out some implementers (thanks @Lloyd McKenzie ). I have some questions about how to implement a health certificate for COVID-19 PCR test results as a Verifiable Credential. See also: https://chat.fhir.org/#narrow/stream/179170-smart/topic/Health.20Cards
By way of background, my company NextID is working on the Safe Travel project in Singapore (https://safetravel.ica.gov.sg/pdt-digital-certification). We are adding a feature to our NextCert issuance application to support HealthCerts which use FHIR syntax, much like the Health Cards example (https://healthwallet.cards/credential-modeling). These certs will record the result of a COVID-19 PCR test based on a nasalpharyngeal swab. The presentation layer will display the result as 'positive/negative/inconclusive/invalid'.
The sample certificate given in the specification (not to be confused with a JSON schema) has capability for recording the clinical lab result as a text string such as 'negative'. But we feel that the certificate should be more informative and include also the Ct (cycle time), igG and igM (2 types of antibody) in the certificate data, whether or not is shown in the presentation layer. Here is a snippet from the observation block of the sample cert as shown in the specification document:
{
"resourceType": "Observation",
"identifier": [{
"value": "123456789",
"type": "ACSN"
}],
"code": {
"coding": [{
"system": "http://loinc.org",
"code": "94531-1",
"display": "Reverse transcription polymerase chain reaction (rRT-PCR) test"
}]
},
"valueCodeableConcept": {
"coding": [{
"system": "http://snomed.info/sct",
"code": "260385009",
"display": "Negative"
}]
}
I'm not sure if the only value we need to make dynamic is the valueCodeableConcept display. It seems from what I've read that the code number also changes if the result is other than negative. Aside from this point, my primary question is, how would we add the fields to capture Ct, igG and igM and what is the data type to be captured (eg- are they text, integer values or scientific notation)?
Lin Zhang (Oct 15 2020 at 06:16):
Helpful Links:
https://loinc.org/sars-cov-2-and-covid-19/
https://loinc.org/sars-coronavirus-2/
Maybe you need LOINC Panel(s) to construct the report sections of the results as the section "What are LOINC panel codes used for?" on the second page above shows.
Lin Zhang (Oct 15 2020 at 06:21):
In other words, Observations could be nested as a tree structure to represent Lab test/Imaging results.
Lin Zhang (Oct 15 2020 at 06:29):
Something like:
Comprehensive report (organizer)
-
Lab report
-- ELISA Abs
-- rRT-PCR
--- IgM
--- IgG -
Imaging study (CT)
Last updated: Apr 12 2022 at 19:14 UTC
