Stream: cda to fhir
Topic: Problem Section & Problem List
Jay Lyle (Feb 15 2022 at 23:00):
Does inclusion in the CDA Problem Section imply membership in a Problem List, or is it a collection of all known problem observations?
Companion Guide 5.2.6: "Currently the Problem Section uses the Problem Concern template to record concerns commonly identified as being “on the patient’s problem list”."
Section code: 11450-4 (Problem List - Reported)
Knowing there are cases where this guidance is not followed, should we assume it is, try to change those cases, or decline to follow it?
Jay Lyle (Feb 15 2022 at 23:01):
cross-ref issues at https://confluence.hl7.org/display/CGP/Issues+And+Decisions
Jay Lyle (Feb 15 2022 at 23:27):
Background: VA VHIE puts "Problem" file problems in problem list & "Visit" diagnoses in encounters, but aggregator also searches encounters and adds found diagnoses to Problems section.
Tone Southerland (Feb 16 2022 at 15:20):
This highly depends on the clinical workflow and implementation, and I don't believe it to be a simple problem to solve as a one size fits all solution. We did some work in IHE PCC several years ago around this creating a base concern entry, and derived entries for problem concern and allergy concern that may provide some addition understanding. These entries were then used in Profiles to provide further usage/use case constraints as appropriate. Check out section 6.3.4.11 in the PCC TF Vol 2: https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_TF_Vol2.pdf
Last updated: Apr 12 2022 at 19:14 UTC
