Stream: implementers
Topic: Condition Vs. Observation
Amrit (May 13 2020 at 06:18):
I am looking for guidance on the appropriate resource to use for the patient reported signs and symptoms (including chief complaint) - which would constitute the "Subjective" section of a SOAP note. The resourceguide page of the specification (https://www.hl7.org/fhir/resourceguide.html) states Condition as the resource for these but the "Boundaries and Relationships" section of the Condition resource page (http://hl7.org/fhir/R4/condition.html) appears to contradict this. How has the community been implementing these?
René Spronk (May 13 2020 at 06:22):
IMHO Observations are mostly O, but could be S. Conditions are kind of a A summary/conclusion based on O and S. That's why Condtion has a 'evidence' reference to Observation.
Jose Costa Teixeira (May 13 2020 at 06:24):
We had this recently: patient is addicted to alcohol = condition. Patient is drinking or has alcohol in blood = observation
https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Addiction
Lloyd McKenzie (May 13 2020 at 17:13):
@Michelle (Moseman) Miller
Amrit (May 14 2020 at 08:30):
Thanks for the responses. I will go ahead and build Observation for complaints and symptoms. I strongly feel that the FHIR documentation should be updated to uniformly reflect one choice or the other, otherwise different parties may end up implementing this in different ways. (And newer people would most likely look at the resourceguide page first because it is part of the certification reading list.)
Lloyd McKenzie (May 14 2020 at 13:34):
The reality is that systems will actually capture this in multiple places. Sometimes something is considered a complaint/symptom, sometimes it's considered a diagnosis. So it's best to search for it in both Observation and Condition.
Last updated: Apr 12 2022 at 19:14 UTC
