Stream: implementers
Topic: ImmunizationRecommendation forecast status
Jose Costa Teixeira (Nov 23 2020 at 09:48):
What would be the status for a recommendation for yellow fever immunization, before the patient travels?
Jose Costa Teixeira (Nov 23 2020 at 09:49):
I don't think any of the values in http://build.fhir.org/valueset-immunization-recommendation-status.html are a good match.
We can define a local value set but this seems a common eough need, no?
Jose Costa Teixeira (Nov 23 2020 at 09:49):
@Craig Newman
Lin Zhang (Nov 23 2020 at 11:45):
Use "due" for the first immunization?
Craig Newman (Nov 23 2020 at 13:20):
I would agree that "due" is appropriate. While most immunization recommendations are based on a person's age, there are a number of recommendations that are based on other factors (risk factors, behaviors, occupation, etc). In my mind, an immunization is still "due" even if the vaccine is to be given because of one of these other factors.
Craig Newman (Nov 23 2020 at 13:21):
@Nathan Bunker may have thoughts too
Nathan Bunker (Nov 23 2020 at 13:34):
If a person is known to be traveling to a place that would require a yellow fever immunization then this would be something the CDS engine could be told and then it could recommend the vaccination by saying it is "due".
However, in practice most of the CDS engines I work with do not support travel recommendations because the primary utility of CDS engines is to remind people of standard vaccinations in routine care. People who get Yellow Fever present themselves at a travel clinic where the staff specialize in giving travel vaccinations, this is all outside of routine care and workflows. The vaccination schedule itself is not complex but the rules for identifying if the vaccination are needed are. In the US I've never seen this implemented, but did see travel vaccinations implemented very nicely in the Mes Vaccins system in France. In that one they had an extensive intake form that would allow the person to specify their travel in a very detailed way that could then support a specific travel vaccination recommendation.
Perhaps the question is what should a CDS engine do if it can recommend Yellow Fever but doesn't have any reason to do so for a patient? In what case should the status be? Is that the question?
Jose Costa Teixeira (Nov 23 2020 at 16:33):
Ok, so one step back: AFAIK,
- vaccines like HPV or yellow fever etc are recommended in certain circumstances That recommendation may or not be formally captured
- for some of these vaccines, the patient still needs to have a valid request from a GP to go pick up the vaccine
The immunization should be pointing at the GP's request as a justification.
Jose Costa Teixeira (Nov 23 2020 at 16:35):
1 is captured with an immunizationRecommendation.
2 could be either an immunizationRecommendation or a MedicationRequest. What I read above is that 2 is not a ImmunizationRecommendation but a MedicationRequest. Is that what I should interpret?
Craig Newman (Nov 24 2020 at 13:24):
I agree with you. ImmunizationRecommendation says that some CDS system thinks that the vaccine is appropriate and then the MedicationRequest is the provider's official request that the vaccine be given (and this request may be based on the CDS recommendation)
Last updated: Apr 12 2022 at 19:14 UTC
