FHIR Chat · Consent.scope: diff in codes shown on FHIR vs Tx server

Stream: implementers

Topic: Consent.scope: diff in codes shown on FHIR vs Tx server

Ardon Toonstra (Oct 13 2021 at 18:56):

https://hl7.org/FHIR/codesystem-consent-scope.xml.html defines 4 codes in the codesystem while the 'official' URI http://terminology.hl7.org/CodeSystem/consentscope has only 3 codes. Resulting in validation errors for me... a bug somewhere?

Grahame Grieve (Oct 13 2021 at 19:36):

it should not exist in both places. You'll have to ask CBCC which is authoritative and to remove it from FHIR and make changes to the UTG version

David Pyke (Oct 13 2021 at 19:37):

We removed Advance Directives from the codelist for R5 so, UTG is correct but R4 still has ADR

David Pyke (Oct 13 2021 at 19:38):

That being said, we have people asking us to put it back...

Ardon Toonstra (Oct 13 2021 at 19:53):

CarePlan for R5 states:
"Self-maintained patient or care-giver authored plans identifying their goals and an integrated understanding of actions to be taken. This does not include the legal Advance Directives, which should be represented with either the Consent resource with Consent.category = Advance Directive ..."

David Pyke (Oct 13 2021 at 19:56):

That's going to be a problem. I'll have to talk to them

David Pyke (Oct 13 2021 at 19:57):

The PACIO project for ADR is asking for the scope code to be replaced but as we're merging scope and category together, it might not be an issue

Maria D Moen (Oct 13 2021 at 20:35):

Thank you David, indeed you do have people questioning the removal of ADR. What the perception was in 2019 for how successful an advance directive/advance care plan initiative that leverages the Consent Resource might be should be a vastly different perception today. We understand use of R4 today, but removal of an R5 concept based on what we knew then as opposed to what we know now should probably queue re-visiting the decision.

Maria D Moen (Oct 13 2021 at 20:43):

I would simply offer to Ardon that the business of standards-based data exchange should treat jurisdictional bias toward what is legal and what isn't separately from enablement of the information exchange. Person-authored information about what the goals, preferences, and priorities for treatment are during a time when the person can't communicate those values for himself/herself should be liberated from decades-old paper document processes. The evolution to digital information exchange will be iterative, as you'd expect, but barriers related to varied stances on what is legal and what isn't shouldn't be barriers to hindering the march forward - people have a tendency to slow the adoption of technology but changing behaviors isn't in scope of standards development (as a rule). My thoughts.

Ardon Toonstra (Oct 19 2021 at 08:48):

Thnx for your comments!
I am not completely sure if we are allowed to use the Advance Directive code for R4? I guess we are?
So @David Pyke , I see you are part of CBCC: are you able to change the UTG version for R4? Or what would be the plan?