Stream: argonaut
Topic: Clinical Notes attachment requirement
Yunwei Wang (Oct 28 2020 at 15:24):
The Clinical Notes Guidance specified 5 types of DocumentReference and 3 categories of DiagnosticReport as "minimum" required clinical notes.
US Core FHIR Resources to Exchange Clinical Notes section states that
In order to enable consistent access to scanned narrative-only clinical reports the Argonaut Clinical Note Server SHALL expose these reports through both DiagnosticReport and DocumentReference by representing the same attachment url using the corresponding elements listed below.
Does this attachment matching requirement apply to
1) only the 8 minimum required clinical notes, or
2) DocumentReference with category=clinical-notes and DiagnosticReport whose category is not LAB, or
3) any DocumentReference and any DiagnosticReport
Example: a Pathology DiagnosticReport has a presentedForm sample.pdf and the same pdf is attached in a Referral Note DocumentReference. Since Referral Note is not on of the 5 required DocumentReference types, does such match satisfy the attachment matching requirement?
Another question is statement
If servers properly categorized scanned reports and used the correct resource per report type (e.g. Pathology scan in DiagnosticReport) this wouldn’t be required.
Does this statement create an exception from the SHALL requirement?
Brett Marquard (Oct 28 2020 at 17:15):
no, the statement doesn't create an exception -- it is included to support the design of referencing from both.
Brett Marquard (Oct 28 2020 at 17:17):
for your path question, is this a hypothetical or something you are seeing in implementation?
Yunwei Wang (Oct 28 2020 at 17:31):
It is a hypothetical. I am checking if Inferno tests this area correctly. My first thought was that the attachment in DiagnosticReport has to be also included in one of the 5 required DocumentReference. But when I though more about it, I am trending to think that any DocumentReference with category=clinical-note should be included. On top of that, since the guidance does not say that DocumentReference SHALL has category=clinical-note and the terminology binding is extensible, that means I cannot exclude any DocumentReference in theory.
Brett Marquard (Oct 28 2020 at 18:07):
The DocumentReference is generic -- we didn't create it just for clinical-notes
Yunwei Wang (Oct 28 2020 at 19:35):
I undserstand. So what's your opinion on my question about the matching attachment requirement? Or what is the intention for that section?
Brett Marquard (Oct 28 2020 at 19:45):
My immediate reaction is limiting to those 5 doesn't sound quite right.
Yunwei Wang (Oct 28 2020 at 19:58):
should I raise a ticket to clarify that?
Brett Marquard (Oct 28 2020 at 20:05):
If you have a proposal, else we should discuss a bit more
Yunwei Wang (Oct 28 2020 at 20:47):
I agree that only those 5 doesn't sound right. So the first question is if the requirement covers DocumentReference with category=clinical-notes, or any DocumentReference.
Brett Marquard (Oct 28 2020 at 23:39):
My immediate reaction is any thing that is a 'clinical-note' in DiagnosticReport must be available through DocumentReference. Defining that list is the challenge
Yunwei Wang (Nov 02 2020 at 17:13):
At least the three minimum required by the guidance.
Last updated: Apr 12 2022 at 19:14 UTC
