Stream: v2 to FHIR
Topic: Map ACC
Henrik Blau (Jun 25 2020 at 11:39):
Hi all,
I would like to map the ACC segment to a FHIR resource, but can't find anything suitable. Are there any suggestions or will there be a new resource for it in the future?
Keith Boone (Jun 30 2020 at 13:50):
The ACC segment reads very much like a "case report" for auto accidents. That would lead me to believe that it maps to Observation with components. However, it appears within the Financial Management chapter, and based on syntax, seems to be part of the billing assignment process (e.g., figuring out who's insurer handles payment for an accident). The closest thing I find for the ACC segment is Claim.accident or Claim.supportingInfo.
Lloyd McKenzie (Jun 30 2020 at 14:10):
@Paul Knapp
Hans Buitendijk (Jul 13 2020 at 18:45):
@k connor : How did you progress with the ACC mapping in light of the discussion there might be a new FHIR resource to document accidents?
k connor (Jul 13 2020 at 18:54):
I was not working on mapping ACC. I have done some work on mapping ARV segment to FHIR Security label.
Brian Postlethwaite (Aug 27 2020 at 00:31):
@Hans Buitendijk which workgroup was working on the proposal for an accident resource, I remember hearing about it at the Baltimore meeting I think, but haven't heard anything since.
Lloyd McKenzie (Aug 27 2020 at 03:18):
Probably FM...
Lloyd McKenzie (Aug 27 2020 at 03:18):
@Paul Knapp ?
Hans Buitendijk (Aug 31 2020 at 15:19):
I believe that was Kathllen Connor in FM.
Paul Knapp (Sep 03 2020 at 04:16):
@Hans Buitendijk @Brian Postlethwaite @Henrik Blau @Keith Boone We have accident information in the Claim resource which covers claims, predeterminations and prior authorizations - but we (FM) have never contemplated an accident resource.
Hans Buitendijk (Sep 03 2020 at 13:01):
@k connor : Do you have further insight on this as we put ACC to an empty resource in understanding an Accident resource might be on the way. Being only part of Claim might be a challenge, but for FM to consider.
k connor (Sep 03 2020 at 16:23):
I'm not sure of the answer, but ACC segment, which is defined in Chapt 6 is also used in Chapt 16
Seems like it should be a Resource, perhaps as a type of Observation?
Chapt 6
BAR^P01^BAR_P01: Add Billing Account
DFT^P03^DFT_P03: Detail Financial Transaction
BAR^P05^BAR_P05: Update Billing Account
DFT^P11^DFT_P11: Detail Financial Transaction - Expanded
Chapt 16
EHC^E20^EHC_E20: Submit Authorization Request
Hans Buitendijk (Sep 08 2020 at 15:50):
@k connor : Was your plan to create a FHIR resource to capture this?
k connor (Sep 08 2020 at 21:25):
No, not on my remit. I suggested that Observation could be profiled as an accident report if someone needs it.
Hans Buitendijk (Sep 09 2020 at 20:09):
@k connor , @Paul Knapp : As FM was thinking of including accident data in Claim, then perhaps a good idea to talk about how Observation could be profiled? That would then indicate how to map ACC as well.
Paul Knapp (Sep 10 2020 at 03:37):
@Hans Buitendijk @k connor We already have accident covered in Claim (claim, prior auth, predetermination). We could see where else accident information is used in V2. I haven't looked but is there a RIM class for accident?
Keith Boone (Sep 10 2020 at 05:23):
The real question is how to map the ACC segment to FHIR resources. I don't see any mappings from V2 ACC to Claim or we wouldn't be asking these questions. RIM isn't all that relevant for V2.
k connor (Sep 10 2020 at 19:13):
I think the solution is to check whether the way accident report can be conveyed in FHIR claim covers all of the V2 ACC accident segment. As stated above the ACC segment is defined in Chapt 6 is also used in Chapt 16
Seems like it should be a Resource, perhaps as a type of Observation?
Chapt 6
BAR^P01^BAR_P01: Add Billing Account
DFT^P03^DFT_P03: Detail Financial Transaction
BAR^P05^BAR_P05: Update Billing Account
DFT^P11^DFT_P11: Detail Financial Transaction - Expanded
Chapt 16
EHC^E20^EHC_E20: Submit Authorization Request
Aditya Joshi (Nov 08 2021 at 18:30):
I have similar requirement. Need to map ACC segment to FHIR. By the way, ADT messages also consists of ACC segment. There, it might be just about capturing accidental information, like Patient getting admitted after an accident. In such cases, there is no Claim resource, its just plan accident information. So, ACC shall be able to map to FHIR without claims data. Observation profile seems the only answer as of now. I found this profile- http://hl7.org/fhir/us/vrdr/2019May/InjuryIncident.html. Though, this does not provide mapping of all ACC data to FHIR Observation resource but gives input on how one can proceed using Observation. Any thoughts please? @Keith Boone , @Paul Knapp , @k connor , @Hans Buitendijk .
Aditya Joshi (Nov 08 2021 at 18:32):
Found a post by @Grahame Grieve though very old post where he is suggesting to use Observation.
https://stackoverflow.com/questions/22547878/how-to-query-accident-information-in-fhir
Hans Buitendijk (Nov 10 2021 at 22:14):
Agreed that Observation is currently the most appropriate resource to use to represent accident information. In looking at the Vital Records Reporting it appears their approach is to have Observation.component cover the various aspects of an incident that need to be reported. But with the variety of profiles it is not clear to me yet how that is all tied together: DiagnosticReport? Observation.hasMember? In the v2-FHIR mapping project we have not yet tackled ACC mapping, but if you can provide the team with the specific fields in ACC you want to have clarity on, please share that, as well as the message(s) from which you would map the ACC data to FHIR resources.
Hans Buitendijk (Nov 15 2021 at 14:58):
@Aditya Joshi : Realized I cannot edit my message above to add your name to ping.
k connor (Nov 23 2021 at 05:19):
Hi - Financial Management WG will be discussing this issue tomorrow - 2021-11- 23 FM Interim Meeting https://confluence.hl7.org/display/FM/2021-11-+23+FM+Interim+Meeting+-+DRAFT
11 AM ET, 10 AM CT, 9 AM MT, 8 AM PT
Join Zoom Meeting https://us02web.zoom.us/j/82031005986 Passcode: 098894
Last updated: Apr 12 2022 at 19:14 UTC
