Stream: implementers
Topic: Patient Lists in FHIR
Ian Bacher (Feb 14 2020 at 14:55):
Is there any standard or any guidance on implementing patient lists in FHIR? This would be for managing something like a list of patients a practitioner is actively responsible for the care of, e.g., patients expected that day, patients on inpatient wards, etc.
Ian Bacher (Feb 14 2020 at 14:57):
To be a little clearer, the List resource is seems the obvious choice, but the only way of associating a practitioner with the List without a custom extension seems to be by using the List.source field, which may not always be semantically accurate (i.e., the list might have been created by a person for the benefit of that practitioner)
HadoopHelp (Feb 14 2020 at 14:57):
Hi there .
i have below use case and facing the problem please suggest any one.
below is the link-
https://github.com/microsoft/fhir-server/issues/869
Ian Bacher (Feb 14 2020 at 14:58):
HadoopHelp said:
Hi there .
i have below use case and facing the problem please suggest any one.
below is the link-
https://github.com/microsoft/fhir-server/issues/869
I think you probably wanted to start a new thread. Unfortunately, I don't really have any advice on that.
HadoopHelp (Feb 14 2020 at 15:08):
Thanks
@Ian Bacher
sure i will
John Moehrke (Feb 14 2020 at 15:40):
There are two choices depending on if you need to have the list as passive (List resource), or where the group of patients can do some action together (Group resource)... I would suspect in your case List is the best fit.
Lloyd McKenzie (Feb 14 2020 at 15:41):
Your feedback on List is valid @Ian Bacher. You could propose adding List.for. (In fact, that may be more relevant than List.source.)
@John Moehrke Groups can't act, they can only be acted upon.
John Moehrke (Feb 14 2020 at 15:47):
right. I knew that... I am sure my brain said that to my fingers
Brian Postlethwaite (Feb 14 2020 at 20:34):
This doesn't feel like a list to me, but a specific search query.
Jenni Syed (Feb 14 2020 at 20:42):
These are some of the most common patient lists in our system as well. Practitioners do build them (or, as mentioned, someone else builds them on their behalf) but we've also always thought these were likely "List" in fhir (or _list search param)
Jenni Syed (Feb 14 2020 at 20:43):
@Brian Postlethwaite what aspect makes it feel like they're not a List?
Brian Postlethwaite (Feb 14 2020 at 20:44):
Not appointments?
Brian Postlethwaite (Feb 14 2020 at 20:45):
Or careteams
Brian Postlethwaite (Feb 14 2020 at 20:45):
Or careplans
Brian Postlethwaite (Feb 14 2020 at 20:45):
Depends on what level of responsibility or purpose.
Brian Postlethwaite (Feb 14 2020 at 20:45):
Or encounters/admissions
Brian Postlethwaite (Feb 14 2020 at 20:46):
Or episodeofcares
Gino Canessa (Feb 14 2020 at 20:58):
If you want to know the boundaries around when a patient was on the list, it appears you should use Group instead of List. Group allows for a period of membership, while list has an added dateTime and deletion flag.
As for linking, Group also has Group.managingEntity which can be associated withe a Practitioner or PractitionerRole (among others), but it is limited to 1 per Group.
I'll note that I'm actively working on sorting out the differences between Group and List in my head, so anyone else can jump in with more on it.
Lloyd McKenzie (Feb 14 2020 at 21:11):
Group is an entity that can be acted upon. Lists can't be acted upon - they simply organize data.
Gino Canessa (Feb 14 2020 at 21:19):
Lloyd McKenzie said:
Group is an entity that can be acted upon. Lists can't be acted upon - they simply organize data.
What would an example of that be?
For tracking a set of patients under a care team, if either a List or a Group has the membership, I would check that resource for the members and perform my actions.
Lloyd McKenzie (Feb 14 2020 at 21:27):
A Group can be the subject of a procedure, observation, encounter, research study, outbreak, etc. Any of those resources can point to Group as a subject. Resources aren't permitted to point to List as a subject. The group might be a family, a cage of rats, a herd of cows, females between 40 and 65 living in Arkansas, anyone who passed through a particular mall in a specified time range, etc. The use of Group as a collector of patients outside the research or public health setting is a slight stretch of its original purpose, but it's still reasonable to have a Group as a subject of a CareTeam or something like that and use Group to manage the capitation process.
Ian Bacher (Feb 17 2020 at 15:34):
Brian Postlethwaite said:
Not appointments?
While I think that these resources might serve as sources for a patient list, none of them seems to clearly map to the concept of a patient list itself.
Last updated: Apr 12 2022 at 19:14 UTC
