Stream: implementers
Topic: Micro-BIology and FHIR resource versioning
Hans Buitendijk (Jun 04 2021 at 19:43):
The DiagnosticReport resource page includes a micro-biology and susceptibility report example with two examples on how those could be expressed. Work is in progress towards a core profile where a specific approach would be recommended to avoid variant representations where essentially many systems will be required to support multiple variants.
1) Rely on FHIR versioning (https://www.hl7.org/fhir/resource.html#Meta using versionId; https://www.hl7.org/fhir/http.html#history; https://www.hl7.org/fhir/http.html#vread). The resource.id remains the same, while versioning enables tracking updates to the resource
2) Use the "replaces" extension where a new DiagnosticReport (or Observation) instance is created and the new one references the old one. The resource.id changes, while the resource.identifier (if used) could remain the same.
The first requires full versioning support, which not all FHIR servers do, while the second requires a different approach on how to determine when/how to display/manage the multiple resource instances in the correct context.
As the update to the organism name does not really represent a different observation being performed, and references to that isolate identification observation should not have to be changes as other observations and tests are being performed in context of that isolate, the proposed direction is to utilize FHIR versioning as the profiled approach.
OO is seeking input on preferences with rationale as it aims to resolve https://jira.hl7.org/browse/FHIR-32860 in the next couple of weeks.
Grahame Grieve (Jun 07 2021 at 00:32):
this is confusing for me - the version tracking / updates / replacement question isn't and shouldn't be Micro specific. It's a very big and important question too, and I'd love for us to have a clear policy because this is one of the most unsafe things about diagnostic report distribution in Australia.
Last updated: Apr 12 2022 at 19:14 UTC
