Stream: implementers
Topic: FMM5 Patient Change - GeneralPracitioner
Brian Postlethwaite (Dec 10 2017 at 06:49):
Currently the Patient.generalPracitioner is a reference to Practitioner, however sometimes there is a need to know which practice the practitioner is at (where has multiple), this would require a reference to point to a PractitionerRole.
Making the property
generalPractitioner 0..* Reference(Organization|Practitioner|PractitionerRole)
The Patient Administration workgroup is requesting opinion from the community if they would be against this change before it is applied.
Brett Esler (Dec 10 2017 at 19:32):
+1 for change; think related Practitioner/PractitionerRoles need review over the whole spec - i am thinking Encounter.participant....
Brett Esler (Dec 10 2017 at 19:35):
and why can't we type Practitioner? Pracitioner here - I usually go for Practitoner
René Spronk (Dec 15 2017 at 15:56):
Not a terribly relevant use case where I live. Note that the GP Organization can already be identified (inclusive of location). So in case of doubt as to where a practitioner works one could supply both Practitioner as well as Organization.
Stefan Lang (Dec 21 2017 at 08:01):
Many real life systems seem to join practitioners and their organizations into a single record, which is reflected by PractitionerRole. They also refer to these records from the patient. So especially for FHIR facades of such backends, this would make things much easier.
It would also simplify some issues we had when doing a combined FHIR/CDA implementation guide.
Grahame Grieve (Dec 21 2017 at 08:19):
I believe this is a vote in favour
Michelle (Moseman) Miller (Jan 05 2018 at 14:44):
We have a similar tracker (GF#14334) logged for CareTeam.participant.member, which generated a lot of discussion in Patient Care yesterday. Currently, CareTeam.participant.member can reference a Practitioner and CareTeam.participant.onBehalfOf can reference an Organization, but the tracker asked for CareTeam.participant.member to also support referencing a PractitionerRole (to get telecom, available times etc.). The debate within Patient Care is what impact the addition of PractitionerRole should (or shouldn't) have on the onBehalfOf element. The tracker outlines the specific pros and cons voiced. Patient Care is looking for implementer feedback on this topic. For example, is it confusing to reference the PractitionerRole resource when the actual role (PractitionerRole.code) is unknown?
Lloyd McKenzie (Jan 05 2018 at 15:31):
The updated workflow patterns call for the elimination of "onBehalfOf" and to just use PractitionerRole in those situations.
Michelle (Moseman) Miller (Jan 08 2018 at 19:53):
@Lloyd McKenzie yep, that was noted and discussed, but it wasn't convincing enough for PC to proceed with the removal of onBehalfOf. I might have suggested they raise the topic with workflow :)
Dave Carlson (Jan 08 2018 at 20:47):
I intend to request a breakout session during the New Orleans connectathon focused on CareTeam participants and PractionerRole, emphasizing implementer feedback and requirements. Positioned as a breakout for the Care Plan track. I thought about also including PratitionerRole as it relates to provider directories. Thoughts?
Last updated: Apr 12 2022 at 19:14 UTC
