Stream: implementers
Topic: Encounter 'first seen' information
Luud Slagter (Feb 11 2022 at 09:02):
Hi! In our source system an encounter also contains some 'first seen' information (i.e. information w.r.t. the first time a practitioner has seen the patient in the same context as the encounter in question), which is mostly used for analytics (to answer questions such as 'How much time passes in general between the first visit and the actual treatment of a patient?'). In order to map this information to FHIR, there seem to be two obvious possibilities, namely an Encounter or an Observation:
- In the former case the first visit is regarded as an Encounter of itself, and the first visit and the Encounter that contains the 'first seen' information in the source system could be regarded as part of the same 'parent' Encounter (via
Encounter.partOf). Basically both are then part as separate steps in the treatment process. - In the latter case the 'first seen' information is considered to be an Observation, that is linked to the current Encounter via
Observation.encounter.
Does someone already have some experience with such a usecase, and if so, could you point out some pros and cons of both approaches?
Lloyd McKenzie (Feb 11 2022 at 17:39):
I wouldn't mark the "first seen" as "part of" a common parent. Instead, I'd link from the current encounter to 'first seen' with an extension. Alternative would be to put both encounters in a common EpisodeOfCare and the 'fist seen' would just be the earliest encounter in the episode.
If all you need is a date, then Observation is probably simpler and more likely to be supported.
Ardon Toonstra (Feb 14 2022 at 14:39):
Regarding the use of an extension in Encounter, would the associated encounter extension fit that purpose?
Lloyd McKenzie (Feb 14 2022 at 15:36):
That's a pretty generic extension. It wouldn't be specific to 'first seen'.
Luud Slagter (Feb 23 2022 at 14:47):
In the end we've chosen for an Observation, since next to the date not many other data elements were present (and moreover an implementation based on Observation was already used).
Last updated: Apr 12 2022 at 19:14 UTC
