Stream: implementers
Topic: consent.provision for DNR
Jose Costa Teixeira (Mar 26 2020 at 09:40):
For a DNR, we can use code 304253006| DNAR - Do not attempt resuscitation. I have 2 questions:
- is this code in Consent.provision.action, or Consent.provision.code (or..?)
- provision.type = deny (I think so, but not sure that is a double negative..)
John Moehrke (Mar 26 2020 at 12:20):
@David Pyke ? I think DNR has been removed from the Consent scope, but don't know where it went. We should have breadcrumbs to push the reader to the right place
David Pyke (Mar 26 2020 at 12:21):
That's not been decided. CarePlan was suggested with Contract for the legal aspect
David Pyke (Mar 26 2020 at 12:23):
We removed Advance Directives from scope because of the breadth of the needs. DNR was possible but that was it.
IT is possible to set Treatment scope with Deny with the code Jose suggested
Jose Costa Teixeira (Mar 26 2020 at 13:37):
you mean DNR could be a Contract?
Jose Costa Teixeira (Mar 26 2020 at 13:38):
I don't usually say "consent will fix this issue" but when I do...
John Moehrke (Mar 26 2020 at 14:04):
well, it is more that we dont have enough engagement from SME to help decide one way or the other
David Pyke (Mar 26 2020 at 14:27):
DNR in some regions need a legally binding agreement. That can be represented as Contract (or Questionnaire or...)
Jose Costa Teixeira (Mar 26 2020 at 14:46):
...or Consent?
John Moehrke (Mar 26 2020 at 14:46):
OR, it can be a Consent.sourceAttachment or Consent.sourceReferenece.... There is nothing magical about Contract
David Pyke (Mar 26 2020 at 15:16):
Yes, Consent can have the attachment and handle the other aspects
Grahame Grieve (Mar 29 2020 at 09:58):
well, do we have an example of what a DNR a care plan looks like?
Jose Costa Teixeira (Mar 29 2020 at 11:01):
you mean an example of what a DNR looks like? Or a DNR as a care plan looks like?
Grahame Grieve (Mar 29 2020 at 11:03):
2nd
David Pyke (Mar 29 2020 at 13:42):
Not that I'm aware of. I have mentioned it to Patient Care but I'm not sure they've done anything with it.
Jose Costa Teixeira (Mar 29 2020 at 15:29):
I don't mean to describe the procedure or clinical order not to perform it.
Jose Costa Teixeira (Mar 29 2020 at 15:31):
I just need to assert that the patient agreed or declined to a set of possible directives, as part of the patient will.
Jose Costa Teixeira (Mar 29 2020 at 15:32):
Currently it looks only like a set of codes :
https://www.ehealth.fgov.be/standards/kmehr/en/tables/patients-will
Jose Costa Teixeira (Mar 29 2020 at 15:34):
I don't know if this semantic difference is relevant, but it is not about planning a procedure (or its absence). It is more as a "finding"
David Pyke (Mar 29 2020 at 15:47):
Those would likely be observations(?)
Gay Dolin (Apr 03 2020 at 17:48):
Seems like DNR would just be components (orders//goals/interventions/outcomes). of a patient's Care plan - and not a different care plan. DNRs are essentially order sets that align with varying levels of the DNR
Gay Dolin (Apr 03 2020 at 17:53):
So - more like a PlanDefintion that would be personalized and a applied to a patient's Care Plan
Ardon Toonstra (Aug 23 2021 at 16:23):
Hi @Jose Costa Teixeira , I am curious about which solution you have chosen for modelling the DNR.
Does anyone have an example of a CarePlan resource that represents a DNR?
Jose Costa Teixeira (Aug 23 2021 at 16:47):
We are using Consent in our spec for now.
I looked for a single place for me to put the code (from dnr0 to dnr3) and tbh CarePlan seems (even) more complicated than Consent - I think the closest would be activity.plannedActivityDetail.code
Last updated: Apr 12 2022 at 19:14 UTC
