Stream: implementers
Topic: Fluit intake and Output Profile
Pranitha Sruthi (Aug 16 2017 at 13:05):
Hi all, I need to create a profile for fluid intake(intravascular, oral etc) using the resource Observation and need to capture the duration (for example "fluid intake intravascular 1 hour") along with the type (lipid or medication). Do I need to create an extension for duration or use the element "effectivePeriod"? Thank you
Lloyd McKenzie (Aug 16 2017 at 13:37):
If you know the start and end times, then by all means use effectivePeriod. If you can't get the duration pre-coordinated into the Observation.code, then you'll need an extension. You might also submit a change proposal suggesting either a standard extension or new core element.
Robert McClure (Aug 16 2017 at 14:12):
@Pranitha Sruthi If this is like the other observation you asked about (I.E; drain ouput) and the DURATION period is not a specific known start/end, then LOINC would expect you to pre-coordinate the observation into a new LOINC code because the expectation is someone would request such an observation. I'm not completely on board with this assumption, but it's how I understand LOINC and UCUM work. I say DURATION versus RATE because there are exsisting LOINC codes focused on rate, such as 8976-3 Fluid intake intravascular 1 hour which has a unit that assumes a per hour rate and not so much a duration that communicates a specific single hour duration. I wonder how we communicate a specific duration when a specific start and end is not known. @Lloyd McKenzie - can you help me understand how this is to be done?
Lloyd McKenzie (Aug 16 2017 at 14:51):
We'd need a new data element - thus the recommendation to use an extension and to propose a change to the resource. I agree LOINC typically expects the duration to be pre-coordinated. However, sometimes "non-standard" durations get used and sometimes people use code systems other than LOINC. So a new data element is probably reasonable.
Lloyd McKenzie (Aug 16 2017 at 14:52):
It would be similar to Observation.methodCode - where that's also typically pre-coordinated into LOINC
Eric Haas (Aug 16 2017 at 16:35):
will be considering adding Timing
as a choice which should handle duration?
Lloyd McKenzie (Aug 16 2017 at 19:39):
That would mean you couldn't capture any details about start or end if you do duration. Is that reasonable?
Eric Haas (Aug 16 2017 at 20:52):
For "Gave IV bolus 500ml for one hour on Thursday"
Timing.event = dateTime(Thursday)
Timing.repeat.count = 1
Timing.repeat.duration = 1
Timing.repeat.durationUnit= hr
Eric Haas (Aug 16 2017 at 20:55):
(I noticed the Timing elements descriptions are still future tense .... )
Eric Haas (Aug 16 2017 at 20:56):
if you know the start and end you would not need to use timing. timing is for fuzzy times and for repeating patterns
Eric Haas (Aug 16 2017 at 20:57):
If using for Observations
Lloyd McKenzie (Aug 17 2017 at 03:28):
I think there's some value in making duration explicit even if you have start and end, though agree it's less critical. I hadn't considered using Timing.event with Timing.repeat, though apparently that's allowed, so I guess that would be a legal representation.
Pranitha Sruthi (Aug 17 2017 at 06:45):
@Lloyd McKenzie thank you
@Robert McClure I also have to capture a modifier called "type" which specifies the type of fluid (lipid or medication) in the profile.
Jose Costa Teixeira (Aug 17 2017 at 09:58):
I noticed the "using observation".. If the fluid intake is medication, is that an observation? I don't know the context, but making an observation for fluid intake and then using "type" to say that it is a medication administration seems not interoperable.
Jose Costa Teixeira (Aug 17 2017 at 10:00):
@Eric Haas if the fluid is nutrition, this falls under the nutrition discussion, right? this was discussed a few days ago.
and I think we should look for a pattern for "administration/intake", of which these things are clearly guided specifications.
No implementer should have any doubt whether to use an administration or an observation.
Lloyd McKenzie (Aug 17 2017 at 14:51):
@Jose Costa Teixeira If your focus is measuring the amount of fluid in and out (and not the administration of any particular medication), then Observation is correct.
@Pranitha Sruthi Again, most typically this would be pre-coordinated into the code. If not, you could capture it as an Observation.component
Eric Haas (Aug 17 2017 at 15:04):
@Eric Haas if the fluid is nutrition, this falls under the nutrition discussion, right? this was discussed a few days ago.
and I think we should look for a pattern for "administration/intake", of which these things are clearly guided specifications.
No implementer should have any doubt whether to use an administration or an observation.
@Jose Costa Teixeira you are right. I didn't see the forest for the trees - to focused on the Timing datatype. IV fluid is a MedAdmin or MedStatement. An oral intake ( I drank a glass of water yesterday ) would have to be observation right now but we are looking at a NutritionIntake resource that is modeled after MedAdmin for this.
Pranitha Sruthi (Aug 18 2017 at 05:16):
@Lloyd McKenzie ok thank you
Last updated: Apr 12 2022 at 19:14 UTC