Stream: netherlands
Topic: Patient.contact vs RelatedPerson
Alexander Henket (Oct 10 2017 at 20:28):
GF#14024 Patient.contact and RelatedPerson need better connection
Today I was on the Patient Administration TCON and asked about the relationship between Patient.contact and RelatedPerson after receiving implementer feedback from Theo that we as a MedMij group were not really able to mitigate. I have crafted the ticket linked above. Please add stuff you feel is relevant to the conversation here so I can continue this discussion next TCON with the PA group with the right backup from you guys. If you feel like being there on the call, please check the HL7 Conference Center: http://www.hl7.org/concalls/Default.aspx?ref=nav
@Theo Stolker , @Ben Schrijver , @Marten Smits , @Irma Jongeneel, @Michael van der Zel
Theo Stolker (Oct 13 2017 at 10:46):
@Alexander Henket
Thanks for this action, GF#14024 perfectly summarizes the issues related to Patient.contact versus RelatedPerson.
The broader issue FHIR must address is to allow for less duplication of information across resources. A use case that we have in the Koppeltaal Project is that the same (Related) person is a related for multiple Patients, or a person being a Related Person at one point in time requiring counseling and that way being "promoted" to be a Patient. The current FHIR resources seem to implicitly assume that Name, address, telecom and gender are copied in in every resources linked to the same person. As we know from the past, if such a person changes name, address or telecom, it will very likely not be recognized that it has to be changed in all duplicated resources, leading to miscommunication and frustration.
FHIR has partly addressed this by adding the Person resource. However, the Person resources refers back to Patient, Practitioner, RelatedPerson or Person.
One problem is that this means we cannot use it from Patient.contact, and the other is that now my Person resource has to change every time when a person gets a new role.
Also, this introduces a security Risk, because now you cannot hide any longer that a Practitioner is also a patient, etc.
What I had expected and I think would be the better model is that Patient, Patient.contact, RelatedPerson, etc. would have optional resource references to Person, instead.
That way, Patient, Patient.contact and RelatedPerson becomes roles of a Person, and we can avoid the error-prone duplication of name, address and telecom across resources.
I think FHIR must address this issue for it to continue to serve the goal of interoperability.
@Ben Schrijver , @Marten Smits , @Irma Jongeneel, @Michael van der Zel
Last updated: Apr 12 2022 at 19:14 UTC
