Stream: argonaut
Topic: Encounter Reason For Visit
Grahame Grieve (Jul 20 2020 at 21:31):
The base FHIR specification has Encounter.reason : CodeableConcept or Reference, defined as:
Reason the encounter takes place, expressed as a code or a reference to another resource. For admissions, this can be used for a coded admission diagnosis.
But in CDA land, the reason for encounter is always a narrative, and I'm told that attempts to code it have been voted down. And so this is reflected into FHIR IGs that inherit logically from the CDA process - CCDA on FHIR, eCR, and possibly others, make it narrative - e.g. Composition.section.text
I'm doing some work around implementation of the IGs, and I'm not sure what to think about this. How is this populated out of the EHRs in either case?
(@Sarah Gaunt @John Loonsk)
Grahame Grieve (Jul 23 2020 at 11:46):
@Jenni Syed @Danielle Friend is this you that can comment on this?
Grahame Grieve (Jul 23 2020 at 11:48):
I have a simllar question about History of Disease - is this a field in an EHR? or is this something constructed for an encounter summary?
Michele Mottini (Jul 23 2020 at 11:56):
In our system it is a Condition linked to the Encounter and with a specific type - and we render it as reasonCode for US Core reasons
Jenni Syed (Jul 23 2020 at 14:14):
Our Encounter reason for visit is not coded - it's textual
Jenni Syed (Jul 23 2020 at 14:25):
We actually have questions about this b/c US Core has must support for reasonCode, but a text only entry meets this. However, inferno seems to be requiring a coded value
Jenni Syed (Jul 23 2020 at 14:32):
https://chat.fhir.org/#narrow/stream/179309-inferno/topic/Encounter.20reason.20for.20visit
Grahame Grieve (Jul 30 2020 at 11:01):
I think inferno is wrong then
Robert Scanlon (Jul 30 2020 at 14:02):
Inferno allows this. I believe the misunderstanding was that our reference data set provides a code. But our reference data set isn't the only data set that can be used.
Cooper Thompson (Jul 30 2020 at 18:36):
For Epic, we have two options for entering in reason for visit, one is free text, one is coded. In some cases the organization decides which option is used in specific workflows. In some cases both are available to users, and the user chooses which to use.
Grahame Grieve (Jul 30 2020 at 23:41):
ok thanks
Keith Boone (Jul 30 2020 at 23:55):
Sometimes it’s codeable, sometimes not. I’ve seen people build EHR templates that are for very specific kinds of visits where reason can be coded, but at other times, its text. CodeableConcept is workable for this, condition somewhat less so, bothe are used in production systems i have worked on.
Last updated: Apr 12 2022 at 19:14 UTC
