Stream: implementers
Topic: Journal/Diary
David Boerner (Jul 27 2016 at 13:35):
Which resource would map best to the concept of a patient diary or journal? Just something where patients could write down anything they want... free text, not things like symptoms
David Boerner (Jul 27 2016 at 13:36):
http://hl7.org/fhir/composition.html ? that doesn't quite seem right
Lloyd McKenzie (Jul 27 2016 at 16:16):
Typically Observation, I think
David Boerner (Jul 27 2016 at 16:17):
Hmm I was vacillating between the two...
Abbie Watson (Aug 02 2016 at 15:02):
ClinicalImpression is also a possible choice for a diary or journal. We built a basic healthlog prototype, and ClinicalImpression sufficed to get the job done.
What's interesting are the interpretive differences that Observation vs ClinicalImpression create... using Observation sort of assumes that the observer (i.e. patient) is fundamentally a rational observer; or rather, has the capability to be rational. Is this always a valid assumption? That's not entire clear.
Whereas using ClinicalImpression assumes the author (i.e patient) has limited knowledge and is impressionable. It also assumes a certain responsibility by the patient for their own health. Again, are these valid assumptions? Maybe; maybe not.
We're working on adding the Observation resource to our healthlog, and are considering the possibility of using both resources rather than replacing one with the other... so that a journal would alternate between Observations and Impressions. Sort of like Tumblr.
However, despite those work-arounds and attempts to work within the spec, I've got a nagging feeling that a Post or Status resource is missing from the FHIR spec.
Grahame Grieve (Aug 02 2016 at 21:13):
I think the difference is intent rather than ability
Justin McReynolds (Aug 28 2018 at 23:43):
Wondering if anyone has an updated suggestion here? We are considering a use case where the patient records diary-like notes, which are viewable by providers. Both Observation and Communication seem close, but not quite on mark.
Lloyd McKenzie (Aug 29 2018 at 01:07):
Why is Observation not on the mark?
Grahame Grieve (Aug 29 2018 at 03:58):
there's no appropriate LOINC code?
Justin McReynolds (Aug 29 2018 at 18:51):
I see this https://details.loinc.org/LOINC/51855-5.html "Patient Note". So, we'll use Observation with that as the code. Thanks to you both!
Last updated: Apr 12 2022 at 19:14 UTC
