Stream: implementers
Topic: Procedure resulting from ServiceRequest - missing quantity
Halina Labikova (Jan 31 2020 at 19:33):
The Procedure resource is lacking the quantity element. I don't see any alternatives for capturing the quantity which was specified in the ServiceRequest that resulted in that procedure - any suggestions (other than creating own extensions)?
Michele Mottini (Jan 31 2020 at 19:39):
What would be the quantity of a procedure?
Halina Labikova (Jan 31 2020 at 19:47):
Fractions in Radiation Therapy, for example. I was poking around mCODE RT Profile, and it doesn't make too much sense to me to just capture the RT modality w/o total grays delivered or gy per fraction. (http://build.fhir.org/ig/HL7/fhir-mCODE-ig/StructureDefinition-CancerRelatedRadiationProcedure.html)
Edit: @May Terry or maybe I'm missing something and there's reasoning behind omitting this information?
Michele Mottini (Jan 31 2020 at 20:02):
Got it, thanks
Lloyd McKenzie (Jan 31 2020 at 22:37):
The whole question of how to deal with radiation (or any procedure with a 'dose' that isn't a drug administration) is still open. For now, you'll need to use extensions.
Halina Labikova (Feb 01 2020 at 00:26):
@Lloyd McKenzie I see, thank you. Is this an issue that is being actively considered in the Patient Care wg for the future fhir releases? If so, could you point me to the place where this discussion happens? (I'm not able to find anything relevant on JIRA/Confluence)
Lloyd McKenzie (Feb 01 2020 at 00:48):
@Michelle (Moseman) Miller
Michelle (Moseman) Miller (Feb 01 2020 at 08:00):
It's probably better described as a topic that is somewhat stuck in our backlog -- meaning it isn't actively being discussed, but is still in our backlog. To watch the related JIRAs, check out:
- J#8458 -- requested quantity as part of procedure for blood transfusion use cases
- J#13047 -- requested dosage instructions be added to procedure for blood transfusion use cases
- J#12993 -- requested a new resource for non-med admins
These have been long-standing questions of whether to create a new resource or enhance procedure. It typically involves both OO and PC work groups since OO owns ServiceRequest and PC owns Procedure. There was some work done on a new draft resource named BiologicallyDerivedProduct (owned by OO) that probably needs to be revisited to assess next steps.
Russell Leftwich (Feb 01 2020 at 10:46):
It should really be blood products, not blood. And "quantity" is uniquely defined for each. A "blood transfusion" is usually packed red blood cells (PRBC). Other common blood products are fresh frozen plasma and platelets. A unit of blood is defined by volume (525 ml). A unit of platelets is defined by a number of platelets. Other biologics are not usually "transfused", such as snake antivenom and immune globulin for hepatitis prophylaxis. They are more like administration of other meds. And does the scope of BiologicallyDerivedProducts include monoclonal antibodies?
Michelle (Moseman) Miller (Feb 04 2020 at 03:35):
It sounds like there are some recurring OO discussions taking place.
https://confluence.hl7.org/display/OO/Healthcare+Product
May Terry (Feb 05 2020 at 16:47):
Hi @Halina Labikova -
Re: "*(http://build.fhir.org/ig/HL7/fhir-mCODE-ig/StructureDefinition-CancerRelatedRadiationProcedure.html)
...maybe I'm missing something and there's reasoning behind omitting this information?*"
yeh, there was input from another commenter that we should be removing radiation dose and adding it as a CodeX use case because it wasn't included in the data dictionary. We have removed it in Pre-Release#2 but could reconsider. Let's revisit and possibly discuss in a follow-up meeting once @Mark Kramer returns from the Sydney WGM. In the meantime, I have captured the issue in https://github.com/standardhealth/fsh-mcode/issues/75. Thanks! :-)
Last updated: Apr 12 2022 at 19:14 UTC
