Stream: implementers
Topic: Encounter expected/planned discharge
Alexander Henket (Dec 19 2018 at 13:51):
Is there any guidance around expected/planned discharge date on an Encounter? In V2 this would be PV2-9.
It seems wrong to use Encounter.period for that
@Brian Postlethwaite ?
Martin Grundberg (Dec 21 2018 at 10:10):
I am also interested in this. This is a trickier area than people might expect at first glance as there are several concepts that are not exactly the same.
In our EHR I think this is (or was) handled by what would correspond to Encounter.period end date in combination of the Encounter.state not being Finished. But this is not a good design as you would want to differentiate between planned and actual discharge date, e.g. to investigate why patients are staying in the ward longer than the planned/estimated discharge date.
But there may also be some different concepts here that need to be distinguished:
Estimated discharge date - Sounds like something that you would "estimate" based on the type of patient, condition, procedure etc, likely before hand for planning and bed management
My conclusion/guess
I would actually see this belonging to Appointment.end as this is part of the planning phase of the encounter.
Planned discharge date - Sounds like something where you have planned the patient to be discharge on a certain date. This would be based on some type of decision, likely during the patient's admission.
My conclusion/guess
Sounds like this would have to be an extension, but if so, it sounds like this is such a common use case to be a standard extension. Or, potentially add this to the Encounter resource.
Ready for discharge - Patient is clinically fit to leave the ward, but there are tasks of administrative character preventing the patient from being discharged (waiting for transports, no bed at receiving ward/care home etc). Depending on system and use case, could be either date or boolean.
My conclusion/guess
Sounds like this would have to be an extension, but if so, it sounds like this is such a common use case to be a standard extension. Or, potentially add this to the Encounter resource.
Simone Heckmann (Jun 25 2019 at 07:55):
I have a proposal from a customer to add plannedStart/plannedEnd (boolean) to backbone element Encounter.period
to handle this.
Thoughts?
Lloyd McKenzie (Jun 25 2019 at 15:19):
@Brian Postlethwaite
Brian Postlethwaite (Jun 25 2019 at 21:33):
If there's a tracker for it we'll convert it on a PA call soon. Don't have strong feelings on this one.
As it sounds now I would just use the end date in the future. But that doesn't help if you're wanting to track the original planned date.
Appointment was updated to handle this already from memory
Simone Heckmann (Jun 26 2019 at 08:43):
dsh (May 13 2020 at 17:50):
We need to implement Discharge planning and this addition will be a huge help
Vassil Peytchev (May 13 2020 at 17:53):
In case you need to reference the decision it is at FHIR#22766
Last updated: Apr 12 2022 at 19:14 UTC
