FHIR Chat · Multiple Category codes

Stream: genomics

Topic: Multiple Category codes

Jamie Jones (Aug 08 2019 at 22:00):

I heard through the grapevine that the SMART specification is looking to make Observation categories more useful for scoping access to resources in terms of what patient data apps can view. Given that category is 1..*, are we suggesting a "genomic data" category for anything? Last I saw genotypes/etc would be "Laboratory", same as blood pressure, eg... We may want to get in on defining a new universal category or 2...

Lloyd McKenzie (Aug 09 2019 at 00:49):

Lab is appropriate as a high-level category as we'd want to make it easy for someone to filter for "all lab results". However, within lab, being able to split chemistry, hematology, microbiology, genetics, etc. would be useful - so perhaps a hierarchical code system where you could convey more detail if you had it, but still infer "lab" for gross filtering...

Kevin Power (Aug 09 2019 at 01:26):

It does sort of beg the question - if someone wanted to ask "give me all genetic observations" - is there a simple way we could suggest as of now?

Lloyd McKenzie (Aug 09 2019 at 01:50):

Nope. Not without an additional category or sub-category.

Jamie Jones (Aug 20 2019 at 18:21):

Possible topic for FHIR-I and/or O&O during WGM? Observation category codes is "preferred" http://build.fhir.org/codesystem-observation-category.html

Without proposing to change any structures, wondering how appropriate adding the "social-history" category flag to genomics observations in addition to "laboratory" may be. Currently defined as,

"Observations define the patient's occupational, personal (e.g., lifestyle), social, familial, and environmental history and health risk factors that may impact the patient's health."

May help flag the larger personal context of genomic data, any thoughts?

Hayden Bader (Mar 10 2021 at 23:00):

Where did this topic end up going?

In the current IG, DiagnosticReport has a category of genetics, but the base genomics observation has a category of laboratory.
http://build.fhir.org/ig/HL7/genomics-reporting/StructureDefinition-genomics-report.html
http://build.fhir.org/ig/HL7/genomics-reporting/StructureDefinition-genomics-base.html

Even though "genetics" isn't listed in the Observation.category codeset it seems to me that if a DiagnosticReport about the laboratory genomic findings can be categorized as genetics, then the Observations should be able to too - unless the DiagnosticReport is not necessarily associated with a lab?

@Jamie Jones @Lloyd McKenzie @Kevin Power

Patrick Werner (Mar 11 2021 at 14:05):

I agree. We should "flag" our Observations with Category genetics as well.

Jamie Jones (Mar 11 2021 at 14:16):

I think it's just a terminology issue. Genetics isn't present on the observation category list.

Hayden Bader (Mar 11 2021 at 14:50):

So does it make sense to get it added as a category option for Observation, or should we just update the genomics-base to have both a laboratory category and a genetics category? With the second option, we'd end up keeping one of the current list of preferred values.