Stream: implementers
Topic: Map ORC.9 or OBR.7 to DiagnosticReport.effectiveDateTime ?
Eli-Jean Leyssens (Oct 18 2021 at 15:45):
I'm transforming an ORU_R01 message to a Bundle with a MessageHeader and a DiagnosticReport in it. The following two pages list mappings for the ORC and OBR segments:
https://build.fhir.org/ig/HL7/v2-to-fhir/ConceptMap-segment-orc-to-diagnosticreport.html
http://hl7.org/fhir/uv/v2mappings/2020Sep/ConceptMap-segment-obr-to-diagnosticreport.html
The first one tells to map ORC.9 to DiagnosticReport.effectiveDateTime and the second one says to map OBR.7 to DiagnosticReport.effectiveDateTime. Unfortunately I have a message where both fields are set, with different values (ORC.9 contains a slightly later time than OBR.7). Is there any concensus on which of these two one should prioritize over the other?
Craig Newman (Oct 19 2021 at 20:05):
OBR-7 seems more appropriate as the clinically relevant date/time. I'll bring this up with the v2-to-FHIR group on the Thursday call.
Craig Newman (Oct 28 2021 at 16:38):
The project team agrees that ORC-9 isn't really appropriate for .effectiveDateTime, so we've updated the current version of the mappings.
Craig Newman (Oct 28 2021 at 16:43):
If the message doesn't have OBR-7 populated, I don't think it we even be appropriate to value .effectiveDateTime with the OCR-9 value as that is the time of the event (presumably the result release date/time) and not the physiologically relevant date/time.
Other possible fields would be SPM-17 (Specimen Collection date/time) if the message uses SPMs. A specimen collection data/time is usually considered the relevant timepoint for a lab test. OBX-14 is the other place worth looking. This might get complicated if there are multiple OBXs and they have different OBX-14 values (it's either a multiple specimen test or some of the OBXs are echoed Ask at Order Entry questions or something else).
In general, it seems like if a results message doesn't have OBR-7 valued, you should be asking the sender why that is. It's usually pretty important to the result.
@Hans Buitendijk - anything to add?
Last updated: Apr 12 2022 at 19:14 UTC
