Stream: implementers
Topic: Encounter Resource
Anjali Vartak (Jun 08 2017 at 16:57):
Hi,
I am implementing encounter FHIR resource from CCD.
In my CCD, i have an Emergency Department Visit encounter. That Encounter also contains discharge instructions but I am not sure where to map discharge instructions in Encounter FHIR resource.
Hospitalization in Encounter resource doesn't have any text or instructions field.
Thank you for the help !
-Anjali
Lloyd McKenzie (Jun 08 2017 at 17:53):
@Brian Postlethwaite (new) ?
Michelle (Moseman) Miller (Jun 08 2017 at 18:55):
FYI - This question has come up before within Patient Care since we own the Communication and Procedure resources. I don't recall any decisions, but here were some of the discussion points:
- Education is within the scope of Procedure.
-
Is instruction the same as education? If not, how should the boundaries be determined? The closest we got was:
** Instruction is intended to have the patient or family take some action, like self management or make a follow up appointment.
** Education is to inform the patient, like the risk of disease or the risk of side effects or adverse outcome of a medication or procedure, then it is education. -
A lot of things are labeled as instructions, but have no similarities except that they are a communication with a patient or family member.
- Communication.catrgory has an example "instruction" code, per http://build.fhir.org/valueset-communication-category.html, but we never landed if the Communication.payload.content would be a string or another resource.
Oh, and Hospital Discharge Instructions is also an example Composition.section.code per http://build.fhir.org/valueset-doc-section-codes.html
Anjali Vartak (Jun 08 2017 at 22:45):
@Michelle (Moseman) Miller Thank you for your response.
So to include the hospital discharge instructions, I have to expose my encounter in CCD as a Composition resource?
Brian Postlethwaite (Jul 05 2017 at 06:22):
THanks @Michelle (Moseman) Miller
Floyd Eisenberg (Aug 07 2017 at 14:25):
This string seems to help with the issue I'm trying to solve. Medication at discharge includes medications the patient is to take at home, after discharge. While there may be orders for some medications, other medications on the list are over-the-counter and thus don’t merit an order, still others are already present in the home based on prior ambulatory prescriptions. The LOINC code specified in the value set 10183-2 is appropriate, but how is this concept managed in Medication Statement or Hospital Discharge Instructions. It seems that Hospital Discharge Instructions is a more appropriate - would that be handled as 8653-8 Hospital Discharge instructions (with specialized content as 10183-2), a Resource DocumentContent Type for an Encounter?
Bryn Rhodes (Aug 22 2017 at 18:59):
While you could model the content as a document in that way, I think I would expect to see the resources represented more discretely with Medication-specific resources for each item as appropriate. Are there any implementers that are representing this case currently and willing to comment on how they handle it? Medications at discharge?
Robert P (Nov 01 2021 at 16:25):
I hope I’m in the appropriate chat. We’d like to be able to determine when a patient arrives in the OR. We would be able to do a check to make sure the OR location/room and patient ID matches a known OR assignment . Should we start by looking at the Encounter resource? Thank you
Lloyd McKenzie (Nov 01 2021 at 16:53):
@Brian Postlethwaite
René Spronk (Nov 02 2021 at 08:55):
Encounter can also be used to do location tracking (not real time, but in the sense of arrival/departure), so yes, it'd be a good candidate to look at.
Last updated: Apr 12 2022 at 19:14 UTC
