Stream: implementers
Topic: Procedure & Observation reference
Vijay Thangavelu (Jan 05 2018 at 14:49):
Team,
We are documenting procedures like cannulation, vascular access placement etc.
we were able to map most of the elements to Procedure resource, But in the actual procedure record there are lot more attributes like
"what is the depth of Accesss"
"fill volume for Arterial/venous lumnen"
"has buttonhole track established during this procedure Y/N?"
which we couldn't map to the Procedure resource and we considered each one as individual observation and we modeled like below
Procedure ------report----> DiagnosticReport ----result---> Observation(s)
This is working fine, we just want to validate is this correct and is ths the only way?
We do have few challenges from of this model,
1. when we need to filter or retreive procedures based on the attribute which are part of observation
ex: get all procedures only with "has_buttonhole = Yes" (which is an observtion)
We were also trying if we can model like below,
Procedure Observation ---partOf---> Procedure
In this case, if we need to filter by Observation, we can retrieve observation with the necessary search param and include the Procedure.
Right not, Observation doesn't have partOf attribute to Procedure, but will this make sense?
Please Advice if we have any other better approach or Are we going to different path?
Thanks,
Vijay
Lloyd McKenzie (Jan 05 2018 at 15:34):
It seems to me that it should be possible to capture observations as components of a procedure without having to do a full report. @Michelle (Moseman) Miller @Eric Haas opinions?
Vijay Thangavelu (Jan 05 2018 at 21:24):
@Lloyd McKenzie - is there a component in Procedure to refer Observation other than "partOf".
Procedure.partOf -- the only reason we didn't consider is, the definition says like "this procedure is partOf a larger event" - conceptually this looks like opposite to our scenario where observation was partOf the procedure.
Looking forward for more opinions from @Eric Haas @Michelle (Moseman) Miller .
Lloyd McKenzie (Jan 05 2018 at 21:44):
Actually, you'd link the other way. Observation.partOf procedure.
Vijay Thangavelu (Jan 05 2018 at 21:56):
right, that should work. right now we don't have Observation.partOf, would this be an extension or is this something already considered adding to the resource.
Eric Haas (Jan 06 2018 at 02:02):
See the latest FHIR ballot. here: http://hl7.org/fhir/2018Jan/observation.html The event-partOf extension has been promoted to an inline element for R4
Eric Haas (Jan 06 2018 at 02:05):
It seems to me that it should be possible to capture observations as components of a procedure without having to do a full report. @Michelle (Moseman) Miller @Eric Haas opinions?
@Lloyd McKenzie I need to understand how we intend to "do a full report" and have carved out some time in New Orleans to discuss that.
Lloyd McKenzie (Jan 06 2018 at 03:50):
A procedure report would presumably be a FHIR document that would include the procedure, a whole bunch of sub-procedures and a whack of Observations and maybe some request resources as proposals and/or a few other things.
Last updated: Apr 12 2022 at 19:14 UTC
