Stream: implementers
Topic: Remote Appointment
Luan Garrido (Mar 25 2020 at 19:47):
What is the proper manner to say an appointment will occur remotely (telemedicine)?
Should I use some sort of extension?
Lloyd McKenzie (Mar 25 2020 at 21:39):
@Brian Postlethwaite
Lloyd McKenzie (Mar 25 2020 at 21:39):
(Though seems like something we should be able to do w/ core...)
Luan Garrido (Mar 25 2020 at 22:01):
Lloyd McKenzie said:
(Though seems like something we should be able to do w/ core...)
I looked for a previous suggestion on use AppointmentType to do the job, but I need to have bouth informations.
Examplos: (1) Routine - Remote, (2) Emergency - In person, (3) Emergency - Remote... an so on.
Grahame Grieve (Mar 25 2020 at 22:26):
in Australia, we are using system http://hl7.org.au/fhir/CodeSystem/AppointmentType code teleconsultation
I think it would be excellent for HL7 to publish an implementation guide for Appointments:
- how do you indicate that it's a remote consultation
- what extension to use for the actual communication details (we're using a URL, in an Australian extension)
- if you'er going to put up an API for this, how to indicate what questionnaire details the requirements for choosing a telehealth consultation
(I'm presently using SMS to set this up, but an API would be better)
Grahame Grieve (Mar 25 2020 at 23:25):
also
- how do you indicate that the patient has answered that they are showing symptoms of Covid-19
Jose Costa Teixeira (Mar 25 2020 at 23:33):
that IG would be very timely indeed. I'l also working on Primary care planning and coordination, can I help with that IG?
Brett Esler (Mar 25 2020 at 23:45):
Appointment.reason (Condition) for patient indicated symptoms?
Brett Esler (Mar 25 2020 at 23:49):
Condition.verificationStatus = unconfirmed ; Condition.code = 840544004 SCT ? (Synonym 3950926016 Suspected COVID-19)
Grahame Grieve (Mar 26 2020 at 00:42):
for SCT countries, yes
Grahame Grieve (Mar 26 2020 at 01:49):
I'm not sure that this is an IG, really. I suppose there should be a profile...
Grahame Grieve (Mar 26 2020 at 01:57):
also we have ActCode.VR
Grahame Grieve (Mar 26 2020 at 01:57):
actually, the reason code is in the GPS free set
Lloyd McKenzie (Mar 26 2020 at 04:49):
Keep in mind that someone might be suspected COVID but not be admitted because of their COVID symptoms. (Not typical, but certainly possible.) So Encounter.reason isn't necessarily the only place COVID should appear. I'd recommend always putting it in Encounter.diagnosis and searching there if you want to know who's (potentially) infected
Grahame Grieve (Mar 26 2020 at 07:04):
Not typical
Actually, it's pretty likely. I was in a clinic this morning and people were coming in for other reasons and reporting covid-19 symptoms. Which could be something else. So you need a code for
- suspected disease
- symptoms that raise concern
Grahame Grieve (Mar 28 2020 at 18:47):
Follow up: http://www.healthintersections.com.au/?p=3017
Jens Villadsen (Mar 28 2020 at 19:21):
This is the danish take on it ... https://docs.ehealth.sundhed.dk/latest/ig/StructureDefinition-ehealth-videoappointment.html - its originally designed for non-acute telemedicine care (initially COPD)
Sonja Ziegler (Apr 20 2020 at 17:00):
As a corollary to this how do we represent in the Provider directory what services are available remotely? How could we indicate if a provider is available for remote appointments? Wanting to do this consistently.
Eric Haas (Apr 20 2020 at 18:08):
@Brian Postlethwaite did we cover remote services in VHDIR? or @Mark Scrimshire in PDEX?
Martin Grundberg (Apr 21 2020 at 07:26):
I think we would see this as something that goes on the Encounter.class (Encounter.class.code=VR) if it is purely the method of contact with the patient, and not the actual service that is being provided. And just saying Telemedicine is not a clinical service, as opposed to lets say "virtual follow up" or simolar.
On an Appointment level, we feel we would like a HealhtcareService reference rather than what we have in Appointment today for similar things that are all codeableConcepts (Appointment.serviceCategory and .serviceType). That would allow for many benefits as we can use clinical services in a more structured way, and also say there whether they are provided in "virtual" context like telemedicine.
Last updated: Apr 12 2022 at 19:14 UTC
