Stream: implementers
Topic: View current PVCs/CVCs
Martin Grundberg (Oct 14 2021 at 05:29):
Hi!
We are looking into how to expose information about what pvcs and cvcs the patient currently has inserted. Eg to display in a list or plotted onto a body image.
PCV - Peripheral venous catheter (or PICC line), commonly used to give patient medications, fluids etc via a catheter inserted into the arm.
CVC - Central venous catheter (or central line), inserted into a central vein close to the heart, to give drugs, transfusions etc.
There are several business needs in this area like:
-See which ones the patient has now
-Manage them, clean skin, replace the catheters
-Ensure the patient doesn’t go home with one still inserted
Assumption
- Insertion and removal of PVC/CVC are procedures; hence exposed using the Procedure resource
Question
- How would we represent currently inserted PCV/CVCs?
We can’t just returned insertion Procedures, they might me removed. We could return both insertion and removal Procedures and let the client compare which Procedures lack a removal. Maybe this is the right way, but something doesn’t feel right about that approach. The client has to do that comparison themselves, introducing business logic on the client.
This question would apply to things like implants as well.
Thanks!
Lloyd McKenzie (Oct 14 2021 at 12:18):
Current guidance is to use Device, which allows association to the Patient they're inserted/implanted/otherwise associated with
Martin Grundberg (Oct 15 2021 at 07:36):
Thanks Lloyd!
Sounds reasonable. For this use case (and any patient related device use case?) I think we would need to know where the device is located on the body of the patient.
Hence I think it would be good to adjust the Patient element and make it into a BackboneElement including both Patient (reference) and AnatomicalLocation (codedConcept).
As tracking devices that have been inserted in one way or the other into the patient is a critical use case (e.g. implants for MRI examinations). Maybe it can be worth updating the documentation with this?
I reported a jira ticket regarding the anatomical location and improved documentation: https://jira.hl7.org/browse/FHIR-34134
Last updated: Apr 12 2022 at 19:14 UTC
