Stream: implementers
Topic: pregnancy history
Dongtu (Nov 07 2019 at 16:38):
I am presenting pregnancy history information. There are some info I 'm mapping with fhir structure (Observation Resource)
+ number of pregnancies
+ pregnancy day
+ Birth date of Fetus
Please see the msg below that shows me errors if any
Thanks all
{
"resourceType": "Observation",
"subject": {
"reference": "Patient/01"
},
"identifier": [
{
"system": "my-system",
"value": "pregnancyID"
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "67471-3",
"display": "History of Pregnancy"
}
]
},
//pregnancy day
"effectiveDateTime": "2019-09-11",
"component": [
{
//number of pregnancies
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "64720-6",
"display": "number of pregnancies"
}
]
},
"valueInteger": 2
},
{
//Birth date of Fetus
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "75092-7",
"display": "Birth date of Fetus"
}
]
},
"valueDateTime":"2019-08-02"
}
]
}
Lloyd McKenzie (Nov 07 2019 at 16:40):
You're going to need separate observations for those things.
Lloyd McKenzie (Nov 07 2019 at 16:40):
Each of them are separately evaluatable/attestable statements
Eric Haas (Nov 07 2019 at 18:42):
I think there us a fhir project somewheres for this? @Sarah Gaunt ??
Sarah Gaunt (Nov 07 2019 at 18:52):
There is a C-CDA supplemental pregnancy IG.
The eCR FHIR IG also has some pregnancy profiles (that map to the CDA ones). Will send links as soon as I get to my PC.
Sarah Gaunt (Nov 07 2019 at 20:59):
Profiles:
- Last Menstrual Period: http://build.fhir.org/ig/HL7/case-reporting/StructureDefinition-last-menstrual-period.html
- Postpartum Status: http://build.fhir.org/ig/HL7/case-reporting/StructureDefinition-postpartum-status.html
- Pregnancy Outcome Observation: http://build.fhir.org/ig/HL7/case-reporting/StructureDefinition-pregnancy-outcome-observation.html
- Pregnancy Status Observation: http://build.fhir.org/ig/HL7/case-reporting/StructureDefinition-pregnancy-status-observation.html
The last profile contains components that represent Estimated Gestational Age of Pregnancy and Estimated Date of Delivery.
The IG is going through the publication process right now, should be published before the end of the year.
Dongtu (Nov 08 2019 at 01:34):
when should use StructureDefinition? I think it used when we can't map with Resource.
Lloyd McKenzie (Nov 08 2019 at 03:19):
Basic is used when you can't find another appropriate resource (though you should generally check here first). StructureDefinition is for defining profiles
Dongtu (Nov 10 2019 at 16:06):
@Lloyd McKenzie Is there way of gathering Observations into another Resource? I want to gather that information into one pregnancy profile and send multiple records like that in one message
David Pyke (Nov 10 2019 at 16:15):
You can send them as a bundle or if that is going to have special requirements/constraints/etc., you could create an implementation guide that outlines the usage.
Jose Costa Teixeira (Nov 10 2019 at 16:26):
"one pregnancy profile" suggests you are looking at a document - sounds like Composition is your way to go.
if that "profile" is a consistent set of information, Composition is appropriate. If you just care about the "loose" resources, you want a Bundle
Jose Costa Teixeira (Nov 10 2019 at 16:26):
http://build.fhir.org/composition.html#bnr
Lloyd McKenzie (Nov 10 2019 at 17:07):
FHIR gives multiple ways of sending a bunch of resources at once:
- messaging
- documents
- batch/transaction
- passing a collection Bundle to an operation (or just storing it as a 'collection', though that doesn't support searching).
Richard Townley-O'Neill (Nov 11 2019 at 00:25):
I think of a document as a special Bundle with a Composition as its organiser. Another way of organising Observations in a Bundle is with a List.
Lloyd McKenzie (Nov 11 2019 at 02:18):
Right - specifically a Bundle that is targeted at human presentation and long-term persistence.
Mike Ryzhikov (Mar 31 2020 at 08:41):
Hi! I would be grateful for your help. What do you think about using Condition.stage (ref: Observation) for containing information about gestational age (week/day of pregnancy)? Is it the right place if I use Condition for the pregnancy (Z32.0 / Z32.1 / O30)?
Lloyd McKenzie (Mar 31 2020 at 14:50):
@Michelle (Moseman) Miller
Michelle (Moseman) Miller (Mar 31 2020 at 15:04):
I'll add this question to the agenda of the next Patient Care FHIR conference call on Thursday (April 2) and let you know.
Jay Lyle (Mar 31 2020 at 15:30):
Conceptually, pregnancy Condition.stage, if assessed as a period, and GA should be the same values -- I think they're both estimated off of LMP -- even if the subject reference is a little complicated. Sarah's eCR PregnancyStatus Observation above might fit in there. @Michael Padula
Mike Ryzhikov (Mar 31 2020 at 16:09):
Michelle (Moseman) Miller said:
I'll add this question to the agenda of the next Patient Care FHIR conference call on Thursday (April 2) and let you know.
Thanks! I'm looking forward to your reply.
Michelle (Moseman) Miller (Apr 02 2020 at 23:41):
@Mike Ryzhikov Patient Care does not believe stage should be used for gestational age. The stage is reserved for clinical or pathological diseases, such as cancer. The gestational age changes over time (daily). Disease stage has a progression over time, but isn't expected to change daily.
When we talked about how this could be represented, we questioned whether the relationship is indirect via EpisodeOfCare. For example, use the Observation extension http://build.fhir.org/extension-workflow-episodeofcare.html and then EpisodeOfCare can reference Condition http://build.fhir.org/episodeofcare-definitions.html#EpisodeOfCare.diagnosis.condition
Mike Ryzhikov (Apr 03 2020 at 13:52):
Michelle (Moseman) Miller said:
Mike Ryzhikov Patient Care does not believe stage should be used for gestational age. The stage is reserved for clinical or pathological diseases, such as cancer. The gestational age changes over time (daily). Disease stage has a progression over time, but isn't expected to change daily.
When we talked about how this could be represented, we questioned whether the relationship is indirect via EpisodeOfCare. For example, use the Observation extension http://build.fhir.org/extension-workflow-episodeofcare.html and then EpisodeOfCare can reference Condition http://build.fhir.org/episodeofcare-definitions.html#EpisodeOfCare.diagnosis.condition
Ok, thanks!
Last updated: Apr 12 2022 at 19:14 UTC
