Stream: cda to fhir
Topic: 20211019-01 Mapping between authors and recorders
Lisa Nelson (Nov 01 2021 at 00:31):
CDA Allergy Concern & Observation both (may) have authors; FHIR only has one recorder. Which one should be used?
Proposed Resolution:
CF: The author on the Concern act is the Allergy-Intolerance recorder. The informant on the Concern act is the asserter. The performer on the Allergy-Intolerance Observation is the person who made the diagnosis (an earlier Encounter Diagnosis). That observation's author is the person who documented the diagnosis, and the informant is the person who provided the information used in making the diagnosis.
Jay Lyle (Nov 29 2021 at 14:08):
It has been proposed to Use Provenance Author for Recorder; and to put all other authors in FHIR Provenance.
Amendments
-
Cardinality of Provenance author is still multiple. This solution doesn't solve anything unless it is restricted to a maximum of one.
-
The name "Provenance author" for the one author not to be represented by a Provenance resource is confusing. Change name to Primary Author, or always refer to it as "CCDA Provenance Author Template, not FHIR Provenance."
-
Assuming we adopt & enforce this pattern going forward, we still need assumptions to use for legacy data.
-
Future: need to retain provenance chain. Current tactical solution is to retain Last Hop only, but this could be the record importer who has had no clinical contact with patient. Next step would be, in addition to Last Hop, Original Author. Followed by Full Chain, each with some characterization of authority (based on clinical contact vs. not). User Interface: show Last (with date & activity); add indication that history exists; enable click-through.
John Moehrke (Nov 29 2021 at 14:17):
re #4, you should not be limited to one level of depth on Provenance. your example is a good reason. The Basic Provenance tried to set the bar really low, presuming that if someone needed to investigate they would be able to go ask that last exporter for more provenance details.
Jay Lyle (Jan 04 2022 at 22:33):
Summary of outgoing documents from VA:
image.png
Jay Lyle (Jan 04 2022 at 23:28):
Updated with incoming documents:
image.png
Last updated: Apr 12 2022 at 19:14 UTC
