Stream: cda to fhir
Topic: 20211018-05 Mapping C-CDA statusCode to FHIR
Lisa Nelson (Nov 01 2021 at 00:23):
What does the statusCode element mean in CDA and how should it be handled when mapping information from C-CDA to US Core FHIR?
We need to agree that the statusCodes element in various CDA templates does not carry the same semantic meaning. We need to agree that the business concept being represented in the statusCode needs to be reevaluated for each and every clinical statement pattern.
Proposed Resolution:
CF: Adopt the assumption that only active Allergy concerns are exchanged between systems. This IS NOT the clinical status, it is an internal machine/database status.
Jay Lyle (Nov 16 2021 at 15:18):
There are two points here: "What does the statusCode element mean in CDA" and, implicitly, where do we get clinical status from?
- The CDA Act.statusCode reflects the status of the performed act (Observation, e.g.). In the Allergy domain, it's always complete, which is why FHIR does not model it.
When we get to FHIR Observations, the CDA Act.statusCode will have a better semantic target in FHIR Observation.status.
- The clinical status of the observed phenomenon is a different thing, which CDA can represent with a dependent entry for a clinical status Observation.
If a CDA Allergy is received with an explicit clinical status observation, that tells us Allergy.clinicalStatus.
If a CDA Allergy is received without an explicit clinical status observation, it is assumed to be active.
Last updated: Apr 12 2022 at 19:14 UTC
