Stream: implementers
Topic: Modeling Clinical Recommendation
Yunwei Wang (Dec 08 2020 at 21:14):
I am trying to model clinical recommendations using FHIR resource. The recommendation is like "recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years". Is that a PlanDefinition?
Lloyd McKenzie (Dec 08 2020 at 21:45):
Sounds like, y. It's sort of a protocol.
Lin Zhang (Dec 09 2020 at 00:47):
But a recommendation is generally different from a plan. So I'm little confused.
Lloyd McKenzie (Dec 09 2020 at 04:20):
PlanDefinition isn't a plan. It's used to represent protocols, order sets and similar concepts. (CarePlan represents an actual 'plan')
Yunwei Wang (Jan 11 2021 at 19:12):
I have more questions while exploring this approach:
1) How do I say "Not recommend screening for .... ". Is it still PlanDefinition?
2) What is the difference between useContext and subject? I want to say "recommends screening ... for women aged 21 to 29 years". Is the "women aged 21 to 29 years" a subject or useContext?
3) Why PlanDefinition does not support search by subject?
@Bryn Rhodes
Bryn Rhodes (Jan 11 2021 at 20:19):
@Yunwei Wang
1) Here's an example of a negative recommendation: http://build.fhir.org/ig/HL7/cqf-recommendations/examples/activities/activities.html#do-not-send-a-message. In particular, a recommendation not to perform a screening would be a ServiceRequest with doNotPerform true (CPG profile for this is here: http://build.fhir.org/ig/HL7/cqf-recommendations/StructureDefinition-cpg-servicerequest.html)
2) useContext is about establishing structurally represented criteria like gender, age-range, target setting, or related condition. Subject is specifically establishing the "scope" for the recommendation (i.e. does this recommendation apply to (and get evaluated in the context of) a patient, or a location, or an organization?). So women aged 21 to 29 years is a subject of Patient and useContext of gender and age range.
3) Almost all PlanDefinitions so far have been patient context. There are some measure use cases that have used other useContexts like Location and Organization. So no search path because no demand for it. Happy to add a search param if it's needed.
Last updated: Apr 12 2022 at 19:14 UTC
