Stream: implementers
Topic: Encounter narrative
Richard Kavanagh (Oct 12 2017 at 21:02):
Looking at the encounter there does not seem to anywhere to hold any additional narrative that relates to the encounter. If we need to hold some narrative (which is more than just a human rendering of the resource elements ie. not Encounter.Text) what is the best way forward? All I can think of is to add an extension or use a Composition instead.
The Composition is problematic as FHIR says COMPOSITIONS are documents which is not really the case for us,
Eric Haas (Oct 12 2017 at 22:09):
can set text.status to "additional" and add it there. There is not a note element on Encounter.
Richard Kavanagh (Oct 12 2017 at 22:17):
Thanks @Eric Haas I'd completely overlooked that as we dont tend to use Resource.text at all...
Grahame Grieve (Oct 14 2017 at 20:38):
"The Composition is problematic as FHIR says COMPOSITIONS are documents which is not really the case for us," - umm, no? we say that documents are compositions, but we don't say that all compositions are documents.
Kevin Mayfield (Oct 15 2017 at 05:50):
On a slight tangent but could you use DocumentReferenc to link in the narrative? (with the note being rtf). When I worked in primary care, we recorded encounter notes in a Composition like strucutre but more recently in acute it's been RTF (/html) but more oftenPDF/MS-Word.
Brian Postlethwaite (Oct 16 2017 at 02:31):
Is this referring to the clinical/progress notes that the practitioner is taking during the encounter? Or something else?
Kevin Mayfield (Oct 16 2017 at 05:10):
I was reading this as clinical/progress note (but wondered if I was reading this wrongly)
Richard Townley-O'Neill (Oct 17 2017 at 05:27):
@Richard Kavanagh
As Narrative.text is 0..1, you will not be able to distinguish your "additional" narrative from the "normal" narrative. That might not be a problem.
Last updated: Apr 12 2022 at 19:14 UTC
