Stream: implementers
Topic: Cause Of Death
Mohamed Omar (Feb 22 2022 at 17:04):
Cause of death seems to be modeled as an observation or a condition. For an example the following http://hl7.org/fhir/us/vrdr/2019May/CauseOfDeathCondition.htm models it as a condition and it is based on STU3 - my question is how to model cause of death in R4 based on the US Core IG? any advice?
Lloyd McKenzie (Feb 22 2022 at 17:14):
The VRDR modeling is broken. Condition.code is "what condition does the patient have". It can't ascribe causality. Cause of death would have to be expressed as an Observation - specifically Observation.code would say something along the lines of "cause of death" and Observation.value would convey the determined cause.
US Core doesn't support capturing general observations as yet. You could ask on #argonaut where EHR implementers would currently typically expose this, if at all.
Jean Duteau (Feb 22 2022 at 17:56):
In my ICSR guide, we mapped the ICSR Cause of Death to an Observation. We didn't release that Observation because we didn't need to convey cause of death for our initial use cases. But I agree with Lloyd that it should be modelled as an Observation and not a condition.
Lloyd McKenzie (Feb 22 2022 at 18:00):
Or, if you're going to use Condition, you need an extension that labels it as being a "cause of death", because Condition out of the box has no way to say that.
Saul Kravitz (Feb 22 2022 at 22:38):
There are ready-made LOINC codes for observations of various types of causes of death including two that are flagged as CDC-related:
o Cause of Death: LOINC 69453-9
o Condition Contributing to Death (underlying ) LOINC 80358-5
We will be reconsidering the VRDR modeling. Thanks for pointing this out @Lloyd McKenzie
Lloyd McKenzie (Feb 22 2022 at 22:58):
I submitted FHIR#36077
Sarah Gaunt (Feb 24 2022 at 19:02):
I thought that US Core added the Condition.category code of 16100001|Death Diagnosis|”Death diagnosis, or cause of death is a contextual qualifier indicating the problem represented caused the patient's death.” (http://hl7.org/fhir/us/core/ValueSet-us-core-condition-category.html) to solve this issue?
Sarah Gaunt (Feb 24 2022 at 19:03):
@Lloyd McKenzie If this is wrong - do we need to comment on US Core Condition to remove this category code, otherwise it's going to cause confusion.
Lloyd McKenzie (Feb 24 2022 at 19:57):
Submitted FHIR#36104
Last updated: Apr 12 2022 at 19:14 UTC
