Stream: implementers
Topic: Mapping To HL7 v2.3
Edwin Schaeffer (Sep 13 2021 at 05:49):
I'm working in Salesforce Health Cloud (Salesforce is a voting member of HL7). Currently, the data model they are conformed to is HL7 v2.3. I'm attempting to map a Questionnaire form to the data model which mirrors v2.3. The problem I'm having is I have a question such as this:
"Have you had any change or new problems with your head, neck, ears, nose, mouth, or throat? If so, explain."
According to the customer this maps to the following SNOMED codes:
Disorder of head: 118934005
Disorder of neck: 118939000
Ear, nose, and throat disorder: 232208008
Disorder of mouth: 118938008
Has explanation: 417151001
It seems to me we would label a positive response as a "Condition", but generally raw data in v3.0 is captured in QuestionnaireResponse. However, I don't have that object in Salesforce Health Cloud. In theory I could create my own object and mirror the fields of QuestionnaireResponse. The question I have is: how would this be handled in v2.3? The architect (who is now off the project) said to use Observation for all capture. However, according to spec, Observation captures specific "point-in-time" or lab data. So, it seems wrong to capture all values in "Observation". As some noted in other threads, Gravity auto-generates a "Condition" as "unconfirmed" based off of QuestionnaireResponse. I think that's the right approach. Am I correct?
Lloyd McKenzie (Sep 13 2021 at 16:50):
What you seem to be capturing is 'symptom' data, which is in fact appropriate to capture using Observation. Symptoms are point-in-time reported information, while Condition is more about diagnoses and health states that are tracked and evolve over time.
Edwin Schaeffer (Sep 14 2021 at 08:49):
Interesting. By the literature it seemed Observation was used for lab, vital data, or measurements taken by a device. The questions are asked via Electronic Health Forms. You think it's Observations across the board? I have other questions ranging in changes in prescribed medications or psychological diagnosis.
Lloyd McKenzie (Sep 15 2021 at 04:18):
In some contexts, one can argue that "everything is an Observation". When data is managed in a question & answer format, it may be that Observation is the best way to represent it - even something like "patient birth data". However, for much healthcare data there are better places for it once you have a certain level of detail. So "is the patient on an ACE inhibitor?" might be an Observation. On the other hand, a record that the patient is on a particular ACE inhibitor and it was started 2.5 years ago would ideally be captured as a MedicationStatement.
In short - it can get messy :)
Last updated: Apr 12 2022 at 19:14 UTC
