Stream: implementers
Topic: Unknown - unspecified data handling
Camilo Giraldo (Sep 27 2017 at 16:41):
Hi @everyone we're currently implementing an interoperability system based on the dstu2 specification, and we're facing some inconvenients when we're trying to handle some specific data like unknown, n/a or unspecified data in a clinical history record. Our most specific case is the following:
In our clinical history, we're gathering the information about a medication treatment recieved by the patient. We're using the <medicationstatement> resource when the medication information is available, via the <medicationCodeableConcept> and everything is going well. We have some troubles when the data about the medication is gathered as Unspecified, n/a or unknown. How is the best way to handle that information, assuming is Mandatory for our backend ( Unspecified, n/a or unknown as patient data about the medication). Is there a way to receive that information in the same medicationStatement or can we use another resource for that specific scenario ? any other suggestion would be appreciated
The same goes when a patient doesn know about if in the familyMemberHistory, the related person has or not an specific condition and we need to gather the 'Dont know' or 'Doesnt have an specific condition'. Once again, assuming the data is mandatory.
Lloyd McKenzie (Sep 27 2017 at 21:01):
Have you looked at the data absent reason extension?
Lloyd McKenzie (Sep 27 2017 at 21:02):
You can ommit a value element and include that extension.
Ewout Kramer (Sep 28 2017 at 07:27):
There's is a specific extension to help you out here: https://www.hl7.org/fhir/extension-data-absent-reason.html. This is from STU3, but it exists in DSTU2 as well. Maybe this is what you are looking for?
[sorry, duplicate - Lloyd beat me to it - but I can't find how to delete a message in Zulip :-(]
Camilo Giraldo (Sep 28 2017 at 16:07):
Thank y'all. After consulting the extension-data-absent-reason. I think it fills our necessity. Nonetheless, I have another question about how to use the extension when the resource cardinality is 1.
For example:
1)
Will this be valid? Assuming that the medicationStatement has cardinality = 1 for, patient, status and medication[x]
<medicationStatement>
<id value="previous-treatment" />
<extension url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode="unknown"/>
</extension>
</medicationStatement>
2)
Or in the other hand, will be this the valid form, for the use of extension > data absent reason
<medicationStatement>
<id value="tratamiento-previo-0" />
<patient>
<reference value="#paciente" />
</patient>
<status value="completed" />
<medicationCodeableConcept>
<extension url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode="unknown"/>
</extension>
</medicationCodeableConcept>
</medicationStatement>
Thanks again everyone for the follow-up responses :)
Lloyd McKenzie (Sep 28 2017 at 22:55):
You would have to include the extension for each of patient, status and medication. Including an extension at the top level doesn't magically remove the need to send required elements - nor to have content in them. #2 would be appropriate except that the reference to the contained patient doesn't resolve. It's also not a terribly useful thing to say. "The patient is finished taking an unknown med". But if that's what you wanted to say, that's the way to say it.
Last updated: Apr 12 2022 at 19:14 UTC
