Stream: implementers
Topic: Unrelated Patients
Bob Milius (Jul 08 2019 at 21:50):
Is there a way to indicate that two Patients are unrelated, other than the absence of FamilyMemberHistory or RelatedPerson?
We need to indicate the relationship between a transplant Donor and a Recipient. The fact that these two people may be unrelated is important for us to capture. We prefer to assert that these two are unrelated, instead of relying on the absence of an assertion that they are related.
Jean Duteau (Jul 08 2019 at 22:23):
I think the only thing you could use is the RelatedPerson resource with a new code of 'Donor' or 'Recipient'.
Grahame Grieve (Jul 08 2019 at 22:25):
does this mean, no genetic relationship?
Lloyd McKenzie (Jul 08 2019 at 22:50):
Genetic or personal I presume.
Grahame Grieve (Jul 08 2019 at 23:02):
well, we need to specific statements around the difference then
Bob Milius (Jul 09 2019 at 14:31):
No genetic relationship other than histocompatibilty (HLA typing). There are donors that are family members (e.g., sibling). Others are found using a donor registry (people who have signed up to get their HLA typed and agree to be a donor for a stranger if a match is found). I can create a familial relationship between two patients using FamilyMemberHistory extension familymemberhistory-patient-record. But other than the absence of that, I can't see how to assert that two patients are unrelated (matched though a donor registry).
Brian Postlethwaite (Jul 15 2019 at 05:10):
I agree this doesn't feel right to leverage RelatedPerson or familymemberhistory for this, and would thinkba specific value somewhere else specifically for it.
An extension on the RelatedPerson might make sense, but could also be related to however the donor part is identified.
Bob Milius (Jul 16 2019 at 17:37):
Would it be appropriate to create modifier extension to RelatedPerson to assert they are NOT related? from https://www.hl7.org/fhir/extensibility.html#isModifier : "There are some cases where the information provided in an extension modifies the meaning of the element that contains it. Typically, this means information that qualifies or negates the primary meaning of the element that contains it"
Lloyd McKenzie (Jul 16 2019 at 18:41):
Don't think you'd need a modifier. Something as simple as as an "unrelated" relationship code could work.
Last updated: Apr 12 2022 at 19:14 UTC
