Stream: implementers
Topic: Using Encounter in absence of patient
Halina Labikova (May 06 2019 at 18:57):
We need to capture an event that comes as a result of an Appointment. In this event, physicians meet to discuss a patient case, but the patient is not physically present. Appointment resource includes "a scheduled conference call between clinicians to discuss a case" as an example for use, but Encounter resource clearly restricts its use to "An interaction between a patient and healthcare provider(s)". Would stretching the definition of encounter to "proxy of the patient (imaging, slides, reports..) is present" be an acceptable solution? If not, what resource would you suggest to capture the event?
Lloyd McKenzie (May 06 2019 at 18:58):
@Brian Postlethwaite ?
Stefan Lang (May 06 2019 at 19:01):
If you are thinking of things like tumor conference, we represent these as a Procedure
Stefan Lang (May 06 2019 at 19:14):
This, because it actually is a procedure that is performed not directly on, but definitively with an impact on the patient.
A procedure can have multiple performers (the discussing physicians), a report (to document the decisions made and the reasons therefor) and even a recorder (the person doing the protocol of the conference).
It also can be basedOn the same ServiceRequest as the Appointment.
Halina Labikova (May 09 2019 at 11:52):
Thank you Stefan, using Procedure seems reasonable. I'm concerned about the lack of consensus in the community though; one would think that capturing a meeting instance is not that uncommon of a usecase. I also wonder what @Brian Postlethwaite has to say?
Brian Postlethwaite (May 09 2019 at 13:56):
The encounter seems right, any chance you could log the issue, and we can discuss it here at the WGM today
Brian Postlethwaite (May 09 2019 at 13:56):
Agree that it's not clear, and it should be.
Lloyd McKenzie (May 09 2019 at 18:12):
Lunch discussion was that either Encounter (if the definitions are loosened to allow "about the patient" rather than "with the patient). Alternative is Observation. Procedure is focused on making a physical or mental change in the subject. Observation is about collecting, analyzing or synthesizing information. A case conference is definitely about analyzing and synthesizing information.
Martin Grundberg (May 29 2019 at 18:05):
In Sweden we would consider this an Encounter. Encounters can be physical (F2F, admission, day case), remote (telephone, video) or ”indirect” (meeting about a patient, letter to patient).
That doesn’t mean that there can’t also be a Procedure during that Encounter, but the Appointment could result in an Encounter even for a meeting about a patient. As an example, SNOMED CT has Multidisciplinary care conference as a procedure concept.
Encounters are often the basis for billing, and you want to know what procedures (via codes, opcs4, SCT etc) have been performed during an Encounter, a care conference could be one of them.
Last updated: Apr 12 2022 at 19:14 UTC
