FHIR Chat · Modeling Hearing/Visual Function · implementers

Stream: implementers

Topic: Modeling Hearing/Visual Function

view this post on Zulip Alexander Henket (Apr 16 2019 at 12:56):

We have a functional model https://zibs.nl/wiki/HearingFunction-v3.1(2017EN) and https://zibs.nl/wiki/VisualFunction-v3.1(2017EN).

Both functional models have a nursing viewpoint where they want to know:

1. Does the person have normal ability to hear/see
2. Does the person have a hearing/visual aid and if so what type. Answer could be "no does not"
We are struggling a bit to find the right representations in FHIR for this:

  • (1) could be an Observation for hearing/vision and it could be a Condition. For as far we asked our functional modelers, this is not about problems/conditions, but about observations. The observation may or may not be on a problem list somewhere, but that is not in scope.

  • (2) looks like a DeviceUseStatement. We however have some trouble saying "does not have hearing/visual aid" using this resource

  • We struggle a little on interrelating the two. On a DeviceUseStatement.indication I could add the notion of hearing/vision impairment, but I cannot seem to connect the observation (or condition for that matter) to it.

Is this a topic worth discussing in Montreal, perhaps in Patient Care @Michelle (Moseman) Miller? CC: @Sebastiaan Raap @Pieter Edelman

view this post on Zulip Michelle (Moseman) Miller (Apr 17 2019 at 12:49):

@Alexander Henket I tend to agree with your assessment above, but I question whether this is better discussed in OO since they own both Observation and DeviceUseStatement.
Speaking as an implementer, I think our system treats most functional statuses as an Observation where some subset may also be represented as a Condition depending on whether any hearing or vision loss rises to a level of concern that warrants management and tracking (i.e. added to problem list).

view this post on Zulip Alexander Henket (Apr 17 2019 at 12:54):

Thanks Michelle, so maybe I/we need @Eric Haas, @Hans Buitendijk, @Lorraine Constable for an initial OO take?

view this post on Zulip Jose Costa Teixeira (Apr 17 2019 at 14:26):

Yes, those are the names. For what it is worth, I think that DeviceUseStatement should have a status "not used" like medicationRequest has "not taken" (and the event pattern has a "not done")

view this post on Zulip Alexander Henket (Apr 17 2019 at 19:32):

That would certainly solve that issue. If OO would be willing to entertain it, I'll happily make a ticket out of that one.

view this post on Zulip Alexander Henket (Apr 17 2019 at 19:37):

In the given context, I could also add a ticket for adding an "asserter" to Observation to support that e.g. a RelatedPerson told me that Observation.subject has a loss of hearing, even though the subject firmly denies this and was therefor never diagnosed properly. My neighbors would be fine examples of the use case :-)

view this post on Zulip Alexander Henket (Apr 18 2019 at 11:51):

Some thinking and chewing on how to relate HearingFunction and MedicalAid leads to this:

<Observation>
   code 47078008 (SNOMED CT)
   valueCodeableConcept HearingFunctionCodelist

extension HearingAid
       valueBoolean | valueReference reference(DeviceUseStatement)
</Observation>

Leaves the following things on the table for tickets:

  • Add a way within DeviceUseStatement to say "does not have this type of device" (perhaps via DeviceUseStatement.status) GF#20913

  • Add a second type to DeviceUseStatement.indication for reference(Observation | Condition) so you can formally reference why someone has glasses/hearing aids/pacemaker/... > I see this was already fixed in R4, alas we are on STU3

Last updated: Apr 12 2022 at 19:14 UTC


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