Stream: implementers
Topic: Psychiatric Hold
Michael Wang (Feb 17 2020 at 18:33):
HI all, We're trying to figure out how to represent psychiatric legal holds in fhir. As an example, https://igniteteentreatment.com/defining-5150-and-5585-legal-holds/ . It seems like consent is the correct resource to use but wanted to confirm with the community. However, its explicitly a lack of consent more so than actual consent. Its primarily an encounter level association.
Lloyd McKenzie (Feb 17 2020 at 19:04):
@David Pyke
David Pyke (Feb 17 2020 at 19:11):
I understand the concept you wish to represent, however, I don't understand what aspect. A judicial hold can be either Contract (based on the terms) or Consent (for enforced treatment). As Consent, you would put the policy appropriately to the codelist under scope treatment and put the treatment enforced.
John Moehrke (Feb 17 2020 at 19:31):
Or a good example of the newly proposed Permission (that has not yet been added to the core build).
John Moehrke (Feb 17 2020 at 19:32):
but; typically this is just implemented as a business rule not part of a normal flow that would show up as a resource.
Jose Costa Teixeira (Feb 18 2020 at 05:31):
How is this a "lack of consent"? from what I read, psychiatric legal hold is to deprive someone from their legal / civic liberties for medical reasons,
Jose Costa Teixeira (Feb 18 2020 at 05:32):
@Michael Wang what are you trying to convey?. The order to hold a person? Or the awareness that a person is being held? ...
Michael Wang (Feb 18 2020 at 07:29):
a psych hold allows clinicans to administer medical treatment to a patient despite them not explicitly consenting. In effect, the legal system is temporarily consenting for a patient since they do not have a capacity to make their own decisions so I think it can be probably be implemented in the same way a legal power of attorney is implemented. The main difference here is that while the power of attorney/proxy acts at patient level, psychiatric holds are typically limited to a single encounter. Practically, I mostly want to represent that for a given encounter, the patient has one of several psych code statuses. Its very similar in use to a code status.
Jose Costa Teixeira (Feb 18 2020 at 08:22):
Ok I understand now, thanks
David Pyke (Feb 18 2020 at 13:55):
Then Consent, using the Treatment scope, with a judicial policy code, can be set permit for a specific encounter/treatment
Last updated: Apr 12 2022 at 19:14 UTC
