Stream: argonaut
Topic: Resource Update - Differentiate correction & clinical change
Nick Schmidt (Apr 16 2021 at 18:27):
When getting an updated resource from a FHIR server following the US Core IG, how can I differentiate between a correction of the previous version and an update due to a clinical evolution of the patient? For example if I first receive a Condition resource with clinicalStatus = active, fetch the resource from the server again a month later and get an updated resource with clinicalStatus = remission. How can I determine if the patient’s condition status has changed within the last month or if clinicalStatus = active a month ago was an error and the condition should be considered as in remission at that time already?
Vassil Peytchev (Apr 16 2021 at 18:40):
Would onset or abatement help answer that question? The Condition resource is a summary resource, and I would expect that any instance of it to be able to give the full picture of the condition.
Lloyd McKenzie (Apr 16 2021 at 20:08):
In theory, the Provenance associated with the change would convey whether it was a correction or not - but only if the system involved captured that - and in US Core, they're not required to do so.
Nick Schmidt (Apr 19 2021 at 18:18):
Thank you both! So it seems the only solution would be to build logical rules for each key in the resources where there can be some confusion, along the lines of what Vassil described for Condition and clinical status. Would anyone be aware of guidances or initiatives that could be a good basis to start?
Last updated: Apr 12 2022 at 19:14 UTC
