Stream: implementers
Topic: Patient transition
Emad Elagouz (Nov 27 2018 at 06:08):
Hi all,
How can I capture a "transition of care" event in FHIR? what resource can I use? "communication" ?
Lloyd McKenzie (Nov 27 2018 at 06:20):
A transition of care generally means that there's a new encounter, or a referral that's been actioned or something like that. So it would typically be an Encounter or a ServiceRequest or a Task that deals with one of those two things. Communication is about recording "Person A was given this information".
Emad Elagouz (Nov 27 2018 at 07:41):
Thanks Lloyd for your reply.
ProcessRequest has limited set of actions (cancel | poll | reprocess | status) which I dont think fits the transition of care (toc).
Encounter: It does represent the whole encounter, where the toc can be considered as part of an encounter (i think)
Task: looks promising but still too generic.
The main information that we want to capture is the patient, source ward and target ward. may be some other metadata like date.
Michele Mottini (Nov 27 2018 at 15:16):
Use Encounter : either add a new location to the same encounter or close the existing encounter and create a new one for the new location
Lloyd McKenzie (Nov 27 2018 at 16:29):
@Emad Elagouz I don't understand "looks promising but still too generic". Task is intended to be generic. The specific event is conveyed by the Task.code.
Emad Elagouz (Nov 27 2018 at 21:57):
@Lloyd McKenzie I prefer to use a resource that fits the business description of ToC. Being too generic means that we will have to workaround or use fields in a way that is not intended for them and might cause confusion later on. For example, how can I represent the target ward? I can use "requester" to represent the source ward. May be I am missing something?
I appreciate you reply, thanks Lloyd :)
Emad Elagouz (Nov 27 2018 at 22:00):
@Michele Mottini I am building an API, and one of the endpoints should retrieve the list of awaiting ToC. I am afraid that encounter might cause confusion to the users of the API. Get Encounters has a different meaning than Get pending ToCs...What do you think?
Thanks for you time :)
Michele Mottini (Nov 27 2018 at 22:18):
Encounter is where this kind of data is usually found - you can surely use something different in your implementation, but it won't be very interoperable
Emad Elagouz (Nov 27 2018 at 22:58):
OK cool.
Thanks Michele :)
Lloyd McKenzie (Nov 27 2018 at 23:22):
The intended performer of the Task is the "owner" - so that would be your target ward.
Grahame Grieve (Nov 29 2018 at 02:31):
How can I capture a "transition of care" event
I followed the rest of the discussion with interest, but I'm not sure it got to the heart of the matter. what does it mean to capture a transition of care? To record that the patient was transferred, or to propose it?
Emad Elagouz (Nov 29 2018 at 03:19):
Hey Grahame, long time no chat :)
Well, normally it happens after the patient leaves the ward and before he/she reaches the destination. Either way i don't think it should make a big difference, as the information captured in the resource i am looking for should be the same: Patient, Source Ward, Destination Ward, Status (transferred, pending, etc), Dates (date of the transfer if it already happened, date of the request if it not)..
For time being I've used a custom resource to hold my information, which breaks the FHIR specs. So I was looking for an appropriate resource to use. It would be great if I could find a "Transfer" resource that capture that information or something closer. Encounter looks the closest thing, but I am afraid that it can be confusing as it has other clinical meaning.
Grahame Grieve (Nov 29 2018 at 09:07):
this is about moving the patient around?
Brian Postlethwaite (Dec 03 2018 at 11:20):
I would expect this to be a ServiceRequest, @Tim Berezny how have you profiled this?
Emad Elagouz (Dec 10 2018 at 06:48):
@Grahame Grieve yes
Last updated: Apr 12 2022 at 19:14 UTC
