Stream: implementers
Topic: Orthostatic BP and HR -- one resource or separate resources?
Daniel Tam (Oct 30 2021 at 00:27):
Hi, another orthostatic question. As mentioned we are going to start documenting on orthostatic Blood Pressure and orthostatic Heart Rate at my organization. I had originally planned to have separate Observation resources for these. However, one clinician noted that she would generally do orthostatic BP and heart rate at same time. Even in LOINC, these are combined into one Orthostatic panel (https://loinc.org/34553-8/)
Would you separate these into two resources? Say one BP resource with six slices, for supine systolic, sitting systolic, standing systolic,.... etc) and then a second HR resource with 3 slices, for supine HR, sitting HR, standing HR?
Or do you think these should be packaged into a single resource, with 9 slices, for all of the BP's and HRs?
I'm waffling -- hearing that these are generally done together makes me consider combining these into one packaged resource.
Yet at the same time, I could see value in keeping these separate -- might be easier to analyze with other BP or HR trends, and I think I could easily combine the two resources for analysis if I wanted to later, either with a flag or based on timestamp.
Thoughts please, especially from clinicians and those who have had to utilize orthostatic data.
Lloyd McKenzie (Oct 30 2021 at 02:12):
BP is already borderline as to whether it should be one resource or two. The key questions are "are they useful independently" and "are they always captured and shared together?". It's certainly not the case that heart rate isn't useful independently from blood pressure, nor that it's always captured along with blood pressure, so a separate Observation instance is appropriate. You can certainly group them into a panel using a 'parent' Observation with hasMember relationships to the individual components. (A similar approach is used with things like blood panels.)
Last updated: Apr 12 2022 at 19:14 UTC
